CCGs need IT practice agreements

Clinical commissioning groups must put an IT practice agreement in place with every practice before the end of the year, or risk losing GP Systems of Choice funding, NHS England has warned.

However, a CCG clinical leader is concerned that the published agreement could “crush CCGs with the weight of mediocrity”.

NHS England has produced a practice agreement to support its operating model, 'Securing Excellence in GP IT Services', published in April 2014.

It describes the basis on which a CCG will provide services to practices and each practice’s responsibilities. If there is a problem in reaching an agreement, the parties should take it to their regional team.

An NHS England spokesman told Digital Health News that failure to sign the agreement coupled with no escalation to the regional team by 31 December 2015, “will result in the withdrawal of central funding of GPSoC Services”.

NHS Cumbria CCG chief clinical information officer Dr William Lumb said the document creates a big administrative burden for both CCGs and practices and questioned where the resource would come from to get agreements in place.

He estimated it would take a minimum of a day per practice to implement, which would impact on the CCG’s ability to deliver much needed GP IT support and development.

NHS Cumbria’s GP IT budget is already under pressure, after being cut from £2.7 million a year to £1.3 million under the new funding regime introduced a year ago.

“For those trying to be efficient and light touch in our management this creates challenges and I would be interested to know how much this was discussed and challenged,” Lumb said.

“We could end up putting all our time and effort into trying to maintain this document and nothing will ever change. It has the ability to crush CCGs with the weight of mediocrity.”

Joint chairman of the British Medical Association and Royal College of GPs' joint IT committee Dr Paul Cundy said the CCG agreement is a revision of the previous primary care trust IT practice agreement.

“We drew that up in PCT-land and NHS England have revised it to reflect the new environment,” he told Digital Health News.

“We would strongly recommend that practices sign them. As data controllers we need to have contracts in place.”

Last April, NHS England introduced a new funding system for GP IT based on a payment per head of population. There was concern at the time regarding how this would impact practices as there was traditionally a large disparity in the amount PCTs spent on technology.

Cundy said he was not aware of any problems regarding IT funding for practices under the new regime.

“Usually complaints and grumbles make their way up to us and I have not heard of any in the past 12 months,” he said.

“I think it’s very clear now that NHS England understand the criticality of supporting GP IT as the linchpin for the future of the NHS.”

The agreement says CCGs should liaise with practices to ensure they are making the best use of their technology and that each practice should identify a lead person for IT matters.

Practices must not install any hardware or software of make changes to any configuration that uses the IT infrastructure unless agreed by the CCG. However, this agreement is “not to be unreasonably withheld”, the document says.

It also states that the CCG will offer to formally review the services it provides to each practice at least once a year.