GPs have a right to choose which clinical computer system their practice will use. This was agreed by the General Practitioners’ Committee of the BMA and the Department of Health and appears in the new General Medical Services contract of 2003. Clause 4.34 says
‘Systems will be accredited against national standards. Each practice will have guaranteed choice from a number of accredited systems that deliver the required functionality. Such choices will be consistent with local development plans (or their equivalents) and in line with local business cases and service level agreements. From 1 April 2003 every practice in the UK will have the choice of RFA-accredited systems. Practices will not subsequently be expected to exercise this right more frequently than every three years.’
You can find the full contract here.
GPs’ right to retain their system if they wish is also in the GP Systems of Choice Agreement that PCTs and practices will sign when a practice enters into a GPSoC contract with the PCT for their system. The document has been negotiated and agreed between CfH and GPs represented by the GPC, the RCGP and the National User Groups. It contains the following clauses:
‘In order to satisfy the requirements of clause 4.34 of the GMS contract, GPSoC provides Practices with a choice of GPSoC Compliant Systems in addition to the LSP provided GP Clinical IT Systems.’ - clause 3.16
And:
‘A Practice may choose to retain its existing GPSoC Compliant System or migrate to another GP Clinical IT System available from the GPSoC Framework or an LSP.' - clause 3.17
Where a practice decides to migrate to an alternative GP Clinical IT System available from the GPSoC Framework or an LSP it shall make a request to the relevant PCT. The PCT may, at its discretion, require the practice to prepare a business case to justify the proposed change of system.
This clearly means that a practice need not change its system but if it chooses to do so it can choose between GPSoC Compliant and LSP-provided systems. The next step is for the practice to produce a business case based on a review of the competing systems. The practice would be expected to take notice of the PCTs advice, but in the end the choice lies with the practice.
However practices are having difficulties maintaining their right to choose their system. In several parts of the country practices are coming under pressure from their PCTs to change to a system that the PCT prefers. There are a variety of reasons why PCTs may seek to encourage practices to change to a specific system. You can find more information about that on this website: Decision to Change Systems.