NHS CB outlines primary care IT split

GP Systems of Choice will continue to be funded and managed at a national level, while responsibility for hardware and networks, IT support and training will go to clinical commissioning groups.

The latest NHS Commissioning Board bulletin for CCGs provides some more detail on the future of primary care informatics.

However, GP leaders say on-going uncertainty around the allocation of funding and how the new arrangements will work is concerning, given that IT is essential to the day-to-day functioning of GP practices.

The bulletin says the commissioning board will be accountable for the delivery of primary care IT, with funding and responsibility for GP IT delegated to CCGs.

The local service provider contract and GPSoC will continue to be managed and funded at a national level, but CCGs will be expected to provide appropriate support and training to practices if they choose to switch to an alternative system.

The new responsibilities of CCGs include the provision of hardware, network services, support and training.

Responsibility for other primary care IT systems, such as dentistry or ophthalmology, will be managed through the NHS CB’s local area teams.

“CCGs as commissioners will need to own a locality informatics strategy as part of their role in driving forward transformation of services,” the update says.

“Clinical systems and their provision are a vital part of this and important enablers in ensuring primary care quality and innovation.”

Work is on-going with primary care trusts to determine the level of current spend on GP IT. Once this is completed, the allocation of IT funds to CCGs for the coming financial year will be decided.

Dr Chaand Nagpaul, a negotiator for the BMA’s GP committee, said the situation remains confusing.

“The original remit of CCGs was not to have responsibility for GP IT. This was always considered – rightly – to be a responsibility of the NHS Commissioning Board, because it relates to contractual responsibility,” he said.

“We still are unclear with regards to the funding and resources for CCGs to take on this function and unclear about the boundaries between CCGs’ function and commissioning board and GPSoC arrangements.”

Dr Nagpaul said there are also questions regarding whether CCGs will have the capacity to take on this additional role effectively.

The groups could chose to use commissioning support units to provide the service, but this would still involve considerable organisational planning on both sides before April next year.

“It’s not just going to be simply that they delegate to CSSs,” he explained. “There’s a considerable task ahead of how GP IT will both be funded and delivered post April 2013 and it’s of great concern that we’re half way through the financial year and we still don’t have clarity on these matters.

“GP IT isn’t some theoretical issue of whether it happens to sit within CCGs or the commissioning board, it’s a practical reality for all practices on a daily basis.”

Dr Paul Cundy, who is joint chairman of the BMA and RCGP’s joint IT committee, said he is delighted that GPSoC will continue to be managed and funded at a national level.

“There are good administrative and bureaucratic and performance reasons for why it’s organised under this call-off contract arrangement,” he explained.

“We think GPSoC has been a stunning success in terms of revitalising the market in GP systems, it’s achieved some continuity and conformance and it’s also increased the amount of choice that GPs have.”

GPSoC version two is therefore designed to be a “refined and better” version one, he added.