The most important IM&T issue likely to affect English GPs practices in 2008 is whether to keep your existing clinical computer system or move to another. Many PCT are planning to ask you to change system in the near future. Their intention is to move all their practices onto just one system, generally one provided by their local service provider. In some areas PCTs are putting pressure on practices to change, in others they are offering inducements to change system. You do not have to change. Both the nGMS and GPSoC (GP Systems of Choice) contracts protect your right to keep your current system. This website has been created to provide you with independent information and news to help practices maintain that right.
There is more information about the contracts and copies of the documents underlying GPs right to retain their system here.
The most important functions of a GP clinical computer system are to support patient care and the administration of the practice. Practices are not the same: they may be large or small, rural or inner city. Their priorities will be different. Practices are best placed to judge which system best meets their requirements.
Most practices have more than a decade of experience of their systems. They have spent years customising their systems to get the best out of them. No two practices use their systems in the same way. An average practice will have tens of thousands of years of patient records on their systems. It does not make sense to change system unless the new one is significantly better.
For the last 25 years practices have had a free choice of system and the best systems have survived and evolved to meet practice needs. Competition has ensured that all suppliers are keen not to be left behind. They all responded rapidly and effectively to provide data for QMAS (Quality Management and Analysis System) to support the Quality and Outcomes Framework and the CfH (NHS Connecting for Health) services. They continue to innovate to maintain their commercial viability. The track record of state-sponsored monopolies in the IM&T field or any other area is not encouraging. The NHS needs true competition to protect the future.
PCTs and SHAs in many areas are improperly putting intense pressure on practices to move to the PCT's preferred solution and impose a local monopoly of provision. This is partly because some SHAs are under pressure to install LSP systems to avoid paying heavy financial penalties to their LSP.
Some PCTs see that a monopoly of one system in their area makes it easier to share records between General Practice and community teams. This is despite evidence that sharing records can cause a range of problems that have not yet been solved. Shared access to key record elements can occur anyway using GPSoC systems, as any of the clinical systems will be able to export essential data to the NHS Spine. LSP shared records do not cross regional boundaries. Electronic transfer of data between systems is progressing well (GP2GP) and that may form the basis of further interoperability between systems.
If you want to change, you should be offered a choice of systems from the eight suppliers accredited under the new GPSoC agreement (see below and the GPSoC website) and the Local Service Provider’s (LSP) system, if there is one in your area. LSP clinical systems are not provided with a GPSoC contract. Once a practice has moved to an LSP solution, it remains unclear whether the contract makes it impossible to change system again. THere may be no path back.
GPSoC provides a framework in which there is a fair and equitable choice of systems accredited to a minimum standard. It removes most of the financial cost to PCTs of supporting existing systems. Most importantly it supports practices in keeping your current system if you so choose and allows for further changes in the future if a better system comes along. The GPSoC contract between your practice and the PCT has been negotiated between CfH and the profession represented by the GPC, the RCGP and the National User Groups. We recommend it as the best way forward for practices.
The purpose of this website is to provide practices with all the information that you need to make an informed choice of whether to retain your system or move to a different one.
If you feel that you are being unfairly pressurised by your PCT to change system or being discriminated against in any way by your PCT because you have not chosen their preferred system, then we recommend you contact the BMA (info.gpc@bma.org.uk) and let your national user group know too. They are all willing and able to help.
| Dr Charlie Stuart-Buttle | Dr Tom Davies | Mr Richard Gunn |
| Dr Gerard Bulger | Dr Tim Cotton |
|
All six suppliers below in the table below have signed GPSoC FrameworkAgreements with CFH. Any Framework system that is Level 2 compliant on the GPSoCMaturity Model will be available to practices. Level 2 compliance isdefined as providing Choose and Book, connection to the Spine and the PersonalDemographic Service and phase 1 of the Electronic Prescribing Service. For thelatest details visit the GPSoC website: PlannedGPSoC Framework suppliers,systems and compliance status.
Note that
· CSC (TPP SystmOne) and Waveform haveyet to sign so are not yet available
· Four of the six have publishedtheir costs
· Threeproducts have yet to achieve Level 2 compliance
| Supplier | System |
| EMIS | LV and PCS |
| Healthy | Crosscare |
| InPractice | Vision 3 |
| iSOFT | Premiere and Synergy |
| Microtest | Evolution and Practice Manager II |
| Seetec | GP Enterprise |