N Yorks GPs protest over system choice

GPs claim their PCT is acting outside the GP Systems of Choice initiative by outlining a plan to encourage all practices to move onto the local service provider solution TPP’s SystmOne.

North Yorkshire and York PCT ‘s IM&T strategy states that the introduction of SystmOne will be “actively promoted and supported by the PCT” giving consideration to the objectives of the strategic health authority, the principles of GPSoC and the best interests of patients.

It adds: “The way forward is to support the incremental use of the NPfIT primary care system (SystmOne). Planning and progress for this should be underpinned by an appreciation, achievement and evaluation of the respective benefits to patients of the integration of primary, community and secondary care record services.”

The strategy says around 80% of the 102 practices covered by the PCT currently use the GP system EMIS with only four currently using SystmOne but outlines the SHA plan to see 100% of practices in the region on TPP by 2011.

Dr Brian McGregor, a GP in York and a director of district’s LMC, said the committee first heard about the strategy at a liaison meeting with the PCT at the beginning of this month. It went before the PCT board for approval five days later.

He told EHI Primary Care: “First of all we believe it is factually incorrect as it presents SystmOne as the NPfIT solution when our understanding is that this is only an interim solution and the ultimate aim is for practices to move onto Lorenzo primary care. That could mean practices that move to SystmOne having to go through a second change.

“We also think it’s not for the PCT to promote one system over another which is something for practices to decide for themselves.”

Dr McGrgeor said the LMC feared that practices would be forced into changing systems against their will and said it was “even more galling” that a local primary and secondary care intranet in the York area, linking EMIS practices with York District Hospital, was already delivering the vision of primary and secondary care linked services that the strategy involved.

Dr McGregor said the intranet, set up two or three years ago, now delivers 1000 plus letters sent electronically direct to patient records every day and access to a shared care record was planned soon as well as possible links to the intranet for practices using other GP systems.

The IM&T strategy states that the PCT recognises the progress made in information sharing using the hospital system (CPD) and a pilot of EMIS Web.

But it adds: “These are not strategic solutions for the PCT and the expectation is that these will over time be replaced by equivalent NPfIT services.”

The strategy says significant emphasis is placed on the use of SystmOne across community, mental health and primary care services because it is a proven system with significant take up across Yorkshire, Humber and the North-east and East of England, because it offers certainty of integration with primary, community, child health and secondary care, because the software is funded via CfH and implementation costs met by the SHA and it can co-exist with legacy solutions allowing a roadmap to be drawn up to suit PCT variations.

Dr McGregor said GPSoC documents issued to all practices include a statement that those signing up to GPSoC are committing themselves to migrate to the fully integrated LSP solution when that is available. He said the LMC’s advice to practices was not to sign the document until that statement had been removed.

He added: “My personal view is that nobody should be changing systems at the moment unless there are very very good reasons for doing so.”

Dr McGregor told EHI Primary Care that it had asked the BMA at national level to take up its concerns about the PCT approach and was also taking up its concerns with the SHA.

A spokesperson for the PCT told EHI Primary Care that the PCT would be issuing a statement following liaison with the SHA but has yet to do so.

Meanwhile in Sheffield PCT, another trust covered by Yorkshire and Humber SHA, practice managers claim they were told by the trust that the PCT would receive £10,000 funding per practice from the SHA for every practice that moved to SystmOne.

One practice manager told EHI Primary Care: “It was made clear that money would be made available for moves to TPP.”

Ian Atkinson, director of performance at the PCT, said that the funding available to the PCT from the SHA was to meet data migration and training costs and would not disadvantage practices wishing to stay with non-LSP solutions.

He told EHI Primary Care: “In no way are we as a PCT in the business of getting GPs to adopt one system. If GPs choose to move to TPP there would be funding from the SHA to support the costs in the same way as there is GPSoC funding for other systems. What we would like to do is have a transparent debate about the merits of the different systems.”

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