Concerns over London CCGs’ vote

Emis and INPS are concerned about the procurement process for GP IT systems by four London clinical commissioning groups that have reportedly voted to switch to TPP. 

The managing director of Emis, currently the largest supplier of practice systems in London, called the procurement process ‘unsatisfactory’ and questioned whether ballots of CCGs had been fairly run, pointing to misleading pricing information.

Central London, West London, Hammersmith & Fulham and Ealing CCGs, which cover more than 200 practices, are pursuing single system strategies to support their integrated care plans.

Practices voted on whether to go with a single system and if so, which system to use.

Hammersmith and Fulham CCG has formally announced its move to TPP’s SystmOne and EHI understands that the other three groups have voted the same way.

EMIS and INPS supply systems to the vast majority of practices in these areas, while TPP has just under 100 practices live across London, mainly in the Hounslow area.

Emis told EHI Primary Care it has raised concerns about the procurement process with the CCGs.

“The feedback we have received from practices across all of the areas has suggested that there is a feeling of unease about the procurement processes that have taken place,” said managing director Neil Laycock.

“We are particularly concerned about the publication of inaccurate information about the pricing of different systems, which does not seem to tally with publically available pricing under the GP Systems of Choice framework.”

Emis wrote to the CCGs requesting a meeting to discuss its concerns and asked the Health and Social Care Information Centre to investigate the procurement process, “as a matter of urgency”.

A spokesperson for the HSCIC told EHI it will not be investigating.

An INPS spokesperson said that prior to the votes the majority of its customers did not want to change systems.

Practices have spoken of confusion around the voting process and the most recent ‘final’ round of votes had a significant number of practices not taking part, due to people being on holiday, the spokesperson added.

A practice manager within the West London CCG, who spoke to EHI Primary Care on condition of anonymity, said there was disquiet about the voting process.

The manager believed an initial ‘soft vote’ was in favour of Emis Web, but the ‘hard vote’, which counted second choices, produced a different result.

"It just appeared as though the rules kept changing.”

The manager said practices were "threatened" that unless they went with the system of choice – SystmOne – they would not receive the same level or support such as training.

However, Emis had guaranteed that it would provide the same level of support for practices that stayed with them.

“Decisions of this magnitude should be above board and transparent. This voting process has been neither and it’s that I take issue with.”

A practice manager within Ealing CCG said GPs had voted in favour of Emis Web.

However, they were later told that the CCG was re-running the vote because “certain practices had changed their minds” and because of the cost difference between Emis Web and SystmOne.

The manager was told this related to the need to bolt Docman document management software onto Emis, but believed this was not necessary with Emis Web.

“My main concern is that there is no reason for another vote, as a clear majority voted for Emis Web – will the CCG keep on voting until they get a different result?”

Farid Fouladinejad, strategic IT lead for the CCGs involved, said the purchase of GP IT systems is managed through the GPSOC framework and a new local procurement has not taken place.

"CCGs are member organisations and a full consultation has taken place with the GP practices over the benefits of moving towards one GP IT system, providing ample and equitable opportunity for suppliers to introduce their products to practices," he said.

“We are confident that we have followed a fair and transparent process and we are in correspondence with Emis over the issues that they have raised.

Emis national user group chair Dr Hasib Ur-Rub said a number of Emis users had expressed concerns to him about the voting process and outcome. He said it would be a breach of GPSoC to force a practice to change systems.

“The GPSoC framework exists to ensure that practices are able to choose to use an accredited system which best meets their needs, rather than being forced to use a system of someone else’s choosing,” he said.

Dr Ur-Rub said that if the issue is around the cost of supporting multiple systems that shows that CCGs are under-resourced.

EHI has been told that no practices will be forced to switch systems.

Londonwide LMCs medical director Dr Eleanor Scott said the LMCs’ medical directorate is aware that some member practices are not convinced of the need for a pan-CCG system and are unhappy with the decision making process for a preferred IT system.

“Londonwide LMCs is advising practices to approach their CCG governing bodies directly with their concerns,” she said.