Practices under pressure to go with LSPs’ suppliers

Practices are continuing to face pressure to change to their local service provider’s preferred computer supplier despite an agreement three months ago that aimed to give GPs greater choice, say the leading user groups.

Dr Manpreet Pujara, chairman of the National Emis User Group, is to write to all user group members following his concern that “a significant minority” of primary care trusts across England have been ignoring the Department of Health decision to give GP practices a choice of all the practice systems that have a contract with any of the five LSPs.

He told EHI Primary Care: “The announcement and what that means hasn’t filtered down to all PCTs and practices are being unnecessarily bullied into changing systems.”

Dr Pujara claimed that different strategic health authorities were approaching the issue in different ways with some top slicing PCT budgets to meet any extra IT costs not covered by the LSP so that a move to an LSP solution was effectively free for the PCT.

“If PCTs move practices to the LSP solution they are getting it for free. If practices want to keep their existing systems the PCT has to fund that.”

Dr Pujara said practice managers contacting the user group for advice were not revealing their names or the practices they work for fear of being identified.

“That shows you what sort of fear they are living in.”

Dr Pujara said a typical case involved a practice with an NT server which is no longer supported by Microsoft. The practice had asked to upgrade its server but had been told it would not be funded to do so but instead it was suggested that the practice move to the LSP solution in which case all costs would be met.

Dr Pujara claimed the cost of continuing to pay the software support and maintenance costs of the existing system plus the cost of a new server would still be less than the cost of data migration to a new system.

The agreement on choice of system includes the condition that any switch to a new system must be to a hosted data centre.

Richard Gunn, chairman of the iSOFT User Group, said iSOFT users were facing pressure both to move to a non-iSOFT system in some cases and to move to the hosted version of iSOFT Synergy.

He told EHI Primary Care:” If you are going to move systems you have to make a business decision that is right for your practice. It’s not clear that decisions are being made on that basis but rather because LSPs have got to get so many practices to move to meet their targets. That is deeply damaging, particularly when it’s not clear where we’re heading."

Gunn said there were advantages to moving to a hosted data centre but these had to be considered alongside potential disadvantages.

He added: "There are confidentiality concerns and you need to ask yourself quite a lot of questions such as who controls access to the system, what happens when a locum turns up on a Monday morning and you want to add them on to the system immediately, what happens about the third party software you have on your existing system, what happens about all your reports and templates and so on."

Richard White, administrator of the National Vision User Group, said there was evidence from across the country that practices which needed to upgrade their IT infrastructure were facing “subtle pressure” to move to their LSP’s hosted system.

He added: “The underlying assumption is that if the practice wishes to retain their own in-house system and obtain a suitable upgrade they’re going to have to finance it themselves.”

White told EHI Primary Care that the Vision user group continued to have concerns about hosted systems. He added: “It’s not that we are carte blanche against the concept of hosted systems but we continue to recognise the potential pitfalls and to work with InPractice Systems and others to ensure our concerns are mitigated.

“Hosted systems may be appropriate in some circumstances but what we find difficult is where practices are required against their will to lose their in house system in favour of a hosted system.”

Links

Practices to get choice of any LSP primary care system