Letters - NPfIT is improving GPs' lives in so many ways

I am writing in response to Chris Lancelot's article in GP on 25th July 2008 entitled "When it comes to IT, the NHS is in the Stone Age".

The article comments on the National Audit Office report on The National Programme for IT (NPfIT) and the delayed deployment of some of the services.

The article goes on to describe the system as unreliable and questions its ability to protect patient confidentiality.

Whilst there is no doubt that there has been a delay in delivering some aspects of the programme there seems to be little recognition of what has been delivered and is working 24/7, 365 days of the year helping clinicians look after their patients.

Let's start with Choose and Book - to date we have now had over 10 million bookings with around 90% of practices using the system. Whilst the system isn't perfect it does make life easier for the clinician when there is a need to refer patients for further care offering them a choice of provider.

I know that some PCTs and NHS Trusts are advising clinicians that they will only accept electronic referrals - we all know that this is wrong as we are not mandated to use Choose and Book, but to offer a choice of provider. I, for one, cannot think of a quicker way of accessing referral information and offering my patients a choice without using choose and book. As a GP who uses Choose and Book regularly I know my patients like to have an appointment or details on how to book one, when they leave my consulting room and there's no going back to the paper system. Let's face it, when patients become more aware of what's available out there, they'll want us to use the system and may even demand it.

GP2GP is another part of the programme that is not mentioned. This enables electronic transfer of the whole GP record between compliant systems, so no more waiting for weeks on end to get medical records for newly registered patients, as now you can have them almost immediately upon registration, as long as both practices uses a compatible system and are enabled for GP2GP.

To date there have been 209,620 medical records transfers with 4,527 practices using GP2GP.

The Electronic Prescription Service (EPS), when it's fully implemented will make life significantly easier for prescribers, pharmacists and patients.
But in order to maximise the benefits for practices we need to start using some of the options available to us now, in their current form, so that we can switch to the electronic format with minimal work.

Repeat prescriptions are a significant workload for GPs and it has been possible for some time to use repeat dispensing to issue prescriptions that could last up to a year, where patients only need to be reviewed annually.

This negates the need for the patient to visit the surgery to order a prescription. However a change in dosage following a blood test or a letter from the hospital will require the practice to contact the patient, to inform them of the change as well as print out a new batch of prescriptions.

With electronic repeat dispensing the clinician is able to cancel any remaining prescriptions which have not been dispensed and replace them with the new dose and inform the patient when they call for their results. The pharmacist can also advise the patient of the change in dose when they next collect the prescription. EPS can make repeat dispensing safer and more convenient for patients and reduce practice workload releasing busy staff to do other activities.

NPfIT is providing a secure system that allows clinicians to access patient information about their medication and allergies and will with the patients consent provide medical information to those involved in their care and have a legitimate reason to access their information.

NHS Connecting for Health is listening to grass root GPs as well as its National Clinical Leads by offering them the option to keep their existing clinical system via the GP System of Choice Programme (GPSoC). Dr Peter Short and I, as the two GP National Clinical Leads, will continue to work with colleagues on IT issues related to the programme that effect them and the care they provide for their patients.

What we as a profession need to do is not only embrace IT, which we have clearly done, but to embrace standards for record keeping so that when information is shared between clinicians it retains its context and meaning.

We need to encourage our suppliers to provide us with the tools that will help us record information consistently and in a way that can be reproduced.

This will mean we can prescribe safely and effectively every time and develop systems that are responsive to the needs of both clinicians and patients - after all whose record is it anyway?

Dr Manpreet Pujara - GP National Clinical Lead & Clinical Director Electronic Prescription Service NHS Connecting for Health

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