Tech companies challenged to develop new GP IT systems
- 23 May 2019
Technology companies are being challenged to develop new and innovative systems after the tender for the GP IT Futures Framework is issued.
In a speech at The King’s Fund’s Digital Health and Care Congress Matt Hancock said he believed the framework will create an open, competitive market to encourage the best technology companies to invest in the NHS.
In practice, this will mean supplying cloud-based, modern systems that can share life-saving patient information seamlessly and securely – from GPs to hospitals and social care settings.
According to Digital Health Intelligence, the value of the contract is estimated at around £484million and is scheduled until 31 December 2020.
Hancock said: “I believe it should be as easy for a GP surgery to switch IT provider as it is for a small business to switch bank accounts.
“Under the new contract, providers will have to follow our standards on interoperability and data access. Systems will need to be continuously upgradeable. Patient data will need to be securely hosted in the cloud.
“Sick patients should not be having to explain ‘why are you here’ for the umpteenth time every time they meet a new clinician, or carting round bulging folders of notes from appointment to appointment.
“Your medical records should be accessible from wherever you are the NHS, just as you can get to your emails from any device.”
Digital Health News has previously reported on how the framework will replace the outgoing GP Systems of Choice (GPSoC) agreement and will provide a contract vehicle for GPs, CCGs and other NHS Digital customers to purchase IT systems and services.
The secretary of state for health and social care added: “The new contract will help us deliver on that goal and will be in force from January.
“It’s an iterative process and we’ll continue to improve the approach to make sure it meets needs.
“We can only build the NHS of the future on safe, secure systems that we can rely on and we can trust.
It is hoped the changes will allow GPs to choose the best technologies to meet their needs, to improve efficiency and will enable more patients to take control of their care, including through accessing digital services such as video consultations.
The framework will also challenge the current market, which is currently dominated by two suppliers and replies on long-term contracts.
Masood Nazir, NHS England’s senior responsible officer for primary care digital transformation, said “GP IT Futures will enable the continued and future delivery of clinical IT systems to all general practices in England. It supports the ambitions set out in the NHS Long Term Plan for digital primary care.
“Technology is a key enabler of quality, safety, efficiency and positive experience. A digital first approach to primary care will become a right for patients to choose. NHS Digital is working to secure the latest standards-based technologies to enable this in the most effective and efficient way into General Practice.”
16 Comments
Mary, my memory is faulty, but I do seem to remember a spat between CfH and one of the GP software houses, because CfH wanted its own software interface between GP and hospital systems, but the software house wanted to develop its own proprietary middleware.
There was also a faction at that time who preached that any data-sharing of any sort was against (doctor/patient confidentiality, and thereby contravened the Hippocratic oath! This inhibited any progress towards electronic communications between GPs and hospitals for five years.. It was one of the causes for the glacial take-up by hospital trusts of national initiatives like the Summer Care Record, the Spine, and Choose and Book.
Good initiative, although Technology is only one aspect of the GP IT systems. Let us not forget that Alignment of all differing Working practice and process amongst GP surgeries to ensure timeliness of data entry/sharing with their Community and Acute providers is the other vital aspect to achieving single view of the patient healthcare record.
Mary and Others; can you spell out the acronyms for the medically unwashed please?
“The FcSD was replaced by the GBB and later the XYZ” is impenetrable to anybody but a medical person. This will add value to what you are saying as it can relate to IT people better. Thanks.
Richard, my recollection is that there was a lot of middle-ware being developed – until CfH killed it off: could be wrong.
At an HC before Fijitsu stopped being the Southern LSP, theree was a paaaaanel of representatives of the LSPs: the Fujitsu representative confirmed that there was no requirement for interoperability in the LSP contracts (my question was urgent: my practice was on the border of two LSPs & referred patients to London).
The initiative to change GP IT seems to suffer from the same problem: a desire for change for changes sake rather than as part of an overall plan (with DPIAs) .
The NHS is an organisation with severe memory problems – and a (political) need for shiny new announcements every time the SoS for Health changes.
I agree with Sam’s comments.
While it’s a good message tongive suppliers, the reality is that it’s not that easy to switch systems. What is the provision for data migration in the new GP tender? Will the likes of the current GP system providers (& we all know which one/s will be the most difficult) make it easy to migrate, even though they might have signed up to it with arms twisted? How much would it cost to switch systems? Why not keep the focus on joining up the silos of the NHS & ensure there’s pressure on suppliers to work towards interoperability and other standards…there’s so much more work to be done. All very well to bring your fresh perspective and fantastic that you want to make digital work, Mr. Hancock, but NHS IT is quite complex and what you see is the effect of stop-start lack of funding from the Centre and constant changing of the goal posts and rearranging the deck chairs.
Mary, the “blank field” I was referring to was not the lack of GP software, but the lack of any middleware to enable hospitals to communicate speedily with GPs, or other hospitals. My recent medical experiences indicates that the aids to communicate between most bits of the NHS are still in their infancy. NHS IT still largely stops at the hospital gate or the surgery door. This slows up the treatment of patients like me, and, as I move fro hospital to hospital, scans and tests have be done twice, because the receiving hospital cannot read the previous scan or is not prepared to accept it. Costs are doubled.
Many years ago – in the 1950s – I was given a copy of an analysis of the data flows needed in general practice used as a basis for one of the first GP IT systems.
What is striking to me is the apparent lack of any overall assessment of what is needed in business management and clinical care in the NHS, as a whole or by individual sections, as a basis for introducing new ways of working, and any risk assessment of the the process and end result.
Does anyone else remember a fire in a tunnel (?Mersey) which disrupted *all* the cables & left GPs without access to their systems, no credit card transactions & no ATMs for a sizeable area until it was repaired?
GPs – and their records – are now integrated into other local systems, either electronically or organisationally: changing GP IT systems without considering the local healthcare environment is no longer possible, & few GPs or local health economies would be prepared to risk the disruption to patient care presented by new, untested IT suppliers unless there was a demonstrable massive advantage to be gained.
Can someone tell me what this might be?
Richard. I did reply but it didn’t appear. No despair; just saying current and past form bodes ill and a Plan B is needed not a warmed up Plan A form the past.
Mary Hawking is in the ball as usual. What Matt Hancock has said is both aspirational and shows ignorance of the realities. President Kennedy was aspirational when he wanted to land an astronaut on the moon but it took a huge amount of groundwork before it happened. I cannot see this approach happening any time soon in the NHS. You could just start by looking through the “Lessons Learned” documents from previous similar projects or perhaps there are not any? As for ‘just’ being able to switch between systems (and I have been involved in a few) – this shows no understanding of what this means. No application stores the data in the same way or even the same data!
Let us do some real groundwork – such as Sam’s standards? As for a plan, there no plan as would understand it (or NASA would.)
The positive side to this is that Matt Hancock seems to be well aware that there are issues with NHS IT. As he learns, perhaps the situation will improve.
“Hancock said: “I believe it should be as easy for a GP surgery to switch IT provider as it is for a small business to switch bank accounts.”
I think the problem is a bit different.
It is easy enough for a customer to switch banks – or a patient GP surgerys: the analogy should be with the bank switching IT suppliers – & several examples such as TSB & Nat West suggest that this is not easy – & can lead to considerable problems, for banks *and* their customers.
In 2004, CfH was *not* operating “in a blank field”.
CfH thought it would produce a blank field (bit like creating a desert & calling it peace) by eliminating all the IT already in use (including mission-critical highly developed GP IT systems ) and replacing it with LSP dictated existing systems (apart from Lorenzo vaporware) with no regard for the end-users or their requirements.
Hence the introduction of GPSoC in England.
OK, Terry, I have to agree that all “forward plans” have so far failed. But is it absolutely impossible for any to succeed? And why has a more effective way forward not been found in the last fifteen years.
Is despair the most appropriate reaction?
This not a game, you know. The treatment I have been receiving recently on my heart and lungs would have been done with fewer delays if the communication systems had been more seamless between the hospitals concerned.
Richard, of course they won’t make the same mistakes/ They won’t get anywhere. I have a list of a score ‘forward with the NHS’ reports, none of which produced anything except NPfIT which produced a thumping £ 12 bn. loss.
Examples? NHS will be paperless by 2018 (Jeremy Hunt c. 2014). Now its 2020 (watch this space. As far I am concerned, NHS reports on ‘futures’ aren’t worth the paper they are typed on. How can ANY sane person believe in ANY NHS futures reports given this abysmal record on delivery? “You can fool some of the people all the time and all the people some of the time but you can’t fool all the people all the time.”- Abraham Lincoln, but they haven’t fooled me and many, many others.
These are admirable aims, but, looking at them closely, I find that they are almost identical to the aims of Connecting for health, AD circa 2004.
How can we be sure that the same mistakes on implementing them will be made, and they will all fail, as CfH failed? Back then, in 2004, it was a relatively easy job, as CfH was to be built on a blank field. Now is much more difficult. Any new, singing and dancing, system will have to be built on a mess of small non-interoperable networks, by people with a bottom-up culture.
Have the mistakes of CfH, and the mistakes made since, been learnt? I see little evidence of humility of NHS leaders, clinicians or IT people begging forgiveness..
Without a well defined, open data sharing standard between these different care settings surely the most likely outcome is proprietary formats and vendor lock-in.
Sort out the basics before putting things to tender…
Whole of primary care £484million
Three hospitals £150 million
Talking about individual practices swapping earlier while the talk on the ground is about how we work across Networks.
Is primary and community care feeling confident about this?
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