GPs given guarantee on IT choice

Joe Lepper investigates how 'GP Systems of Choice' will help practices use their preferred clinical software.

From September 2007 a new deal was put in place aimed at protecting GPs in England's freedom of choice regarding practice IT systems.

Called GP Systems of Choice (GPSoC) the deal involves eight companies, including the two largest suppliers to GPs EMIS and InPractice Systems.

It is being heralded by the government's NHS IT body Connecting for Health as the end to years of uncertainty surrounding practice IT.

Dr Gillian Braunold, Connecting for Health's national clinical lead for GPs, said: 'This is the result of a lot of complex negotiation but we really feel that we have something in place that will give GPs that reassurance about their IT systems that they didn't have before.'

The new deal meant that by the end of last month, a centrally negotiated contract was in place for PCTs to use as a template for local deals. Crucial to this, according to Dr Braunold, is that the new arrangement gives vital guarantees to practices that they will be free to keep their system or change to another of the eight companies involved.

Among other guarantees being given to GPs is a commitment from each supplier to provide a high standard of service, including carrying out timely maintenance work and ensuring smooth data migration should the GP want to change suppliers.

Suppliers are being warned by Connecting for Health that failure to do this will result in heavy financial penalties.

Dr Braunold said: 'Previously GPs felt that if they wanted to switch suppliers there was a fear that data migration would be hampered or there was pressure to switch to a system they didn't want to. This new contract clearly spells out that every effort will be taken to ensure that data migration runs smoothly and choice remains.'

The process of changing supplier has also been made easier, according to GPSoC programme director Kemi Adenubi, who explained that this might involve practices being asked to present a business case to justify the move.

Although a PCT still has the power to turn down a supplier switch, Ms Adenubi believed this was unlikely as long as the GP's case was strong.

'A business case may not be just for financial reasons,' she said. If a GP is unhappy with the service being offered, then I can't see why it would be turned down.'

She added that if a GP disagrees with a PCT's decision then ultimately Connecting for Health could intervene.

Ms Adenubi added that new financial arrangements between a PCT's suppliers and central government were also in place that remove any 'excuses related to funding for a PCT not to carry out vital upgrades or to switch supplier'.

These arrangements include the switching of the cost of the supplier's licences from PCTs to Connecting for Health centrally, thereby freeing up hundreds of thousands of pounds.

In addition PCTs have been given an £80 million hand-out to help fund upgrades to practice IT infrastructure and to ensure that practices are brought up to national standards in areas such as connectivity, anti-virus software, migration to a hosted system and in terms of equipment such as scanners and printers.

This funding was made available in July 2007 and PCTs have until the end of the year to spend the money.

Ms Adenubi explained that PCTs should already be talking to practices to assess whether upgrades are needed, and if they are not, practices should contact them as soon as possible.

Most of the money is set to be spent on either improvements to local servers or switches to hosted systems.

Dr Braunold, among many within Connecting for Health, hoped that practices would opt for the latter.

'This is cheaper for the health service and because switching to hosting servers now doesn't necessarily mean switching supplier I'm sure many GPs will opt for this,' she said.

Dr Paul Cundy, joint chairman of the joint GP IT committee, was also optimistic that under GPSoC, GPs could sleep soundly regarding IT.

He said he was particularly pleased that Connecting for Health had involved system user groups in the creation of the new system and that all the main suppliers were on the eight-strong list. This also includes Microtest, Seetec, Healthy Software, CSC Computer Sciences, iSoft and Waveform Solutions.

He conceded there was the potential for 'maverick PCTs to try something stupid such as ask everyone to convert to one system because it is one system'.

But Dr Cundy was optimistic that the current contract arrangements would provide practices with a robust defence against such a move.

'Practices have been threatened with being forced to switch systems but I believe that under this new system PCTs will find it much more difficult to attempt that,' he said.

Another optimistic GP is Somerset LMC secretary Dr Harry Yoxall. He said: 'I think that at last they appear to have a system in place that finally says that GPs are free to use the system of their choice.'

GPC negotiator Dr Richard Vautrey warned that, 'the proof will be in how PCTs interpret this. This has the potential to really sort our practice IT and deliver improvements, but only as long as there is choice and PCTs don't resist that.'

GP Systems of Choice guarantee

  • Practices are free to keep their current IT system or change to one of eight approved suppliers. These are: EMIS, InPractice, Microtest, Seetec, Healthy Software, CSC Computer Sciences, iSoft and Waveform Solutions.
  • If there is a desire to change suppliers, maintenance work will be timely with smooth data migration.

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