GP system choice still under negotiation with LSPs

NHS Connecting for Health (CfH) is unable to provide a firm date on when arrangements will be finalised to provide GPs with choice on their practice software.

New arrangements for delivering GP choice were first promised by CfH in March, following a protest campaign by GPs unhappy at the lack of system choice that had been written into the new GMS contract. Some six months later these new arrangements, which need to be negotiated with local service providers (LSPs), remain to be announced.

Speaking at the British Computer Society’s Primary Health Care Specialist Group conference in Cambridge last week Gordon Hextall, CfH’s chief operating officer, said that he was unable to give a firm date on when the arrangements would be finalised.

"We recognise that GP choice is hugely important, and we are now trying to contract for it," said Hextall.

Asked by EHI Primary Care whether he could predict by when these arrangements will be in place, he replied "No".

Hextall said that the negotiations with the LSPs to supply a choice initially between EMIS, InPractice Systems, The Phoenix Partnership and iSOFT primary care systems were proving complex.

It has been suggested that some of the LSPs are not keen on the concept of delivering choice of GP systems. This is thought to be the case in the Accenture clusters where the LSP has well established contractual arrangements with The Phoenix Partnership as its alternative GP system supplier.

Hextall explained: “You can understand that if Accenture have signed an agreement with The Phoenix Partnership for the North East it’s very difficult to work out a price for them to offer services like EMIS."

Asked by EHI Primary Care whether CfH was still confident that it would be able to deliver on GP choice, Hextall said: "I continue to write to our suppliers to get their commitment as recently as two weeks ago."

Separate to the contractual difficulties of delivering GP choice the CfH COO said that integration was proving a bigger challenge than had initially been imagined. "Integration is the huge thing that everyone has to try and manage. That’s what has exercised ourselves and suppliers."

Hextall explained that CfH had established a national integration centre in Leeds and a series of test beds, or "sand pits", across the country. "Integration has proved to be more difficult than most of our suppliers had planned for," he said.

He described integration of local departmental, cluster and national systems as the foundation of the national programme as the "alternative to rip and replace", and the model favoured by the national programme. "I’ve actually never been an advocate of rip and replace, you’ve got to start with what’s out there already."