Pulse February 2019 issue - Page 15

Update 15 ‘This will be a bonanza for tech start-ups but a nightmare for GPs’ GPs fear disruption in IT systems shake-up Plan to overhaul IT provision has sparked workload concerns, fi nds Sofi a Lind GP IT systems are to be overhauled for the first time in a more than a decade, leading to fears of potential disruption to practices and patients. The Department of Health and Social Care said its ‘GP IT Futures framework’ procurement process would open up competition to more providers and promote systems suited to ‘the digital age’. The BMA has welcomed the move but GPs warn practices may be forced to switch systems if their current provider does not meet the new requirements set out by the DHSC, which could result in data loss and a huge increase in workload. Under the new framework, providers will have to ensure patient records can be held remotely using ‘cloud’ technology so that clinicians and patients can access information in real time. In addition, they will have to comply with the DHSC’s vision for every patient in England to have access to their GP via online or video consultation by 2023/24. The current framework – GP Systems of Choice – allows practices to choose from TPP SystmOne, EMIS Web, InPS Vision or Microtest Evolution – though most use either EMIS or SystmOne. But the Government wants to open the market for more providers to connect with the systems of other NHS organisations. NHS Digital is in talks with providers over the exact requirements and is due to report later this year. Launching the framework last month, health secretary Matt Hancock said: ‘Too often the IT used by GPs – like other NHS technology – is out of date. It frustrates staff and patients, and doesn’t work well with other NHS systems.’ BMA GP Committee IT lead Dr Paul Cundy said: ‘The BMA welcomes the planned overhaul… and changes to encourage new entrants to the market as well as improving the existing systems.’ However, he added: ‘Changing the core IT system is disruptive. GPs will need reassuring that the risk of disruption has been properly assessed and mitigated. ‘The minister must also ensure GPs will not be forced to ditch a competent provider just because its services don’t fulfil the Government’s requirements, in which case the use of bolt-on interoperable systems would be far better. We stand ready to work with the Government to ensure the programme is driven by doctors and that GP practices benefit from this refreshing approach.’ But Hampshire GP Dr Neil Bhatia, who runs a website that helps patients understand data sharing, warned: ‘I think there’s huge potential for disruption. Most GPs may not be able to ensure the accuracy of merged records Dr Grant Ingrams This is the worst idea I’ve heard in a long time. GPs don’t have outdated or frustrating technology. We need our systems to be better integrated with those of other healthcare providers. The NHS has been working on its software for a decade and we’re getting good at it. Referrals, prescriptions, discharge summaries and test results are now routinely sent electronically. The last thing primary care needs is further disruption. We want stability, to concentrate on the huge challenges we face. But I fear the proposed changes aren’t driven by feedback in consultation with GPs and patients about how to improve the doctor- patient relationship. Instead I worry that the health secretary’s vision is driven by a desire to exploit the commercial potential for outside organisations to fi nally get access to GP lists. I’m sure that would lead to a bonanza for tech start-ups but it’s a nightmare for practices. Ed Poole is IT and operations manager at Brunswick Park Medical Practice, north London. He also stood for offi ce as a Labour Party candidate. GPs are very happy with their IT system. Ours, EMIS Web, is hugely powerful, and I’m sure we don’t maximise its potential. ‘Switching to a completely different supplier would be horrendous and significantly impact on patient care and practice income. It’s a huge amount of work for clinicians and admin staff.’ It would mean ‘shutting the surgery for a while, or running a skeleton service’, he said. ‘Installation and upgrades are never smooth and we can be without our system for days. Referrals and QOF get messed up and access to hospital letters and results can be affected. There’s a risk of a delayed referral inadvertently not being made.’ Dr Grant Ingrams, a member of the BMA GPC’s IT policy group but speaking in a personal capacity, said real-time access to records would be beneficial but warned merging records that originate from different healthcare teams could leave GPs unable to ensure the accuracy of information. ‘I had a patient today where a community staff member had input a code for angina – but that was ruled out. And I can’t change it because it was put on by a different organisation,’ he said. • ‘If the rules don’t work with new technology, you change the rules.’ Big Interview with Matt Hancock, page 6 Pulse February 2019