The pace of change in IT within general practice is predictably rapid. On the one hand there is a move to web based clinical systems, and on other hand there are many national programmes such as the Electronic Prescription Service (EPS). Practices do, of course, have day to day issues with hardware, which with the introduction of the 2004 contract, became a responsibility of the Primary Care Trusts. Following the passing of Health & Social Care Act, accountability for IT rests with the NHS England Area Team, but the responsibility and the funding will be passed down to the CCGs. They, in turn, have to decide whether to host the service in house, utilise the Commissioning Support Unit (CSU), or commission another provider whether it be, say, a hospital trust IT service or a commercial organisation. In Lancashire and Cumbria we have a number of different models and it will be interesting to see how these develop.
There are basically three tiers of service,
- National “must dos” , ie service that must be provided to practices
- Non-core – eg IP Telephony
- Business Systems, that is systems which the practice need for their efficient running
Clearly the service provision will be affected by the budget. A frequently quoted example is that of EMIS Web. We know that the system supplier is expecting practices to migrate over. There is no doubt that EMIS Web divides opinion. Yet in some cases the performance of EMIS Web is affected by the link. So the IT service has to decide what the priority is, spending money on improving the link or resourcing a good service for practices switching over. In cases where EMIS Web installation is delayed this calls in to question whether servers need to be replaced to avoid them failing- a further cost.
LMC continues to be part of the discussions on these issues on behalf of practices.
In the last couple of years we have been heavily involved in supporting schemes for Local Care Records to facilitate access out of hours to patient records. This has partly been in response to the difficulties caused by the consent model proposed in the Summary Care Record project. These have now largely been resolved and we regard it as a practice decision as to whether they wish their patient records to be uploaded. We continue to support practices to make the decision.
Practices will be aware of the Directed Enhanced Service (DES) for working on schemes to allow on line access to appointments, patient on line access to their medical records and electronic ordering of repeat prescriptions. As with all Enhanced Services this is voluntary and we will be happy to work with individual practices to help them decide how to proceed.
Information Governance (IG) is an important area for surgeries to have a good knowledge of and be actively practising. The whole health economy needs to be tight on this and part of that is the annual IG Toolkit. We recognise that this is potentially a lot of work for practices and that it is frustrating that the Toolkit keeps changing. We will continue to represent practice views on this nationally.
We would encourage all practices to consider having their own website.
LMC sits on a number of IT groups to represent general practice and if you need us to take up and particular issue then please contact us.
Our Advice and Guidance Section contains useful reference material about IT issues and will be regularly updated.