Scottish GPs win choice over practice systems

Scottish GPs will be able to change IT system provider under a new deal announced yesterday.

The Scottish Executive Health Department (SEHD) and the BMA’s Scottish General Practitioner Committee have agreed that practices can change to a new system provided that certain conditions are met including the agreement that any new system must use a central data server.

The deal follows considerable pressure from Scottish GPs, 85% of whom use GPASS, the official IT system for Scottish GPs which has been the subject of much criticism.

Last year’s Scottish local medical committees’ conference passed a motion that GPASS was ‘continuing to fail GPs’ and similar motions calling for SGPC to act on the ‘grave concerns of GPs regarding the current state of IT that practices are having to cope with’ were passed at this year’s Scottish LMCs’ conference held yesterday (April 28).

Dr Stuart Scott, chairman of the Scottish GPC’s IT sub-committee, was able to head off further criticism by announcing the new deal with the SEHD.

He told EHI Primary Care: “This is very good news for Scottish GPs. Those who are desperate to move will be able to do so and GPASS users who want to stay with the system will also benefit because there is now a real alternative, This will hopefully make GPASS act much more quickly than it has before and start listening to its users rather than the Scottish Executive.”

Dr Scott said plans to procure two new clinical systems for Scotland, following on from the two system choice that appeared to be available in England, had been dropped after health minister John Hutton announced plans to widen choice for English GPs to any system that had a contract with a local service provider.

From 1 May GPs can submit a business case to their NHS Board which will be assessed against agreed criteria as outlined in the new GMS contract. Practices will only be able to switch to IT systems that meet the standards set out by the Scottish Executive, agreed with SGPC, and that have met the specifications of the Scottish Enhanced Functionality (SEF) agenda.

The SEF, equivalent to the RFA in England, outlines the particular requirements systems have to meet to work in Scotland such as being compliant with its messaging system. Suppliers have until 31 October to meet the SEF requirements.

Dr Peter Wiggins, a Glasgow GP and SGPC member who has been very critical of GPASS, welcomed the announcement. He said: “This is a considerable victory for SGPC and brings Scottish GPs into line with England by giving us a choice which is what we voted for.”

The deal gives GPs a six month deadline of 31 October 2005 to finalise their business case and, subject to the scheme’s success, the SGPC says it is intended that GPs may be offered a similar opportunity to change systems during 2006.

Dr Wiggins said: “That is very clever as it gives the NHS the ability to plan and manage the change which is a good way of doing it.”

He predicted that the percentage of practices using GPASS would fall no lower than 70% in the first year. He said the promised introduction of a new system from GPASS, GPASS Clinical, would help to keep practices with GPASS up to date.

“I think this will act like a pressure cooker release and allow those who are desperate to move to do so. Many GPs don’t know that there’s any grass let alone that its greener but I think as practices see what the other commercial systems can do there may be more movement.”

Dr Wiggins welcomed the forthcoming introduction of GPASS Clinical which he described as a substantial improvement for GPASS users.

Changes of GP IT systems will be subject to deployment on a central data server.

The SGPC said the advantages of such a system including easier upgrades, improved security and reduction in administration overheads by practices and improved business continuity and disaster recovery.

Dr Scott said: “My practice has been using a server outside the practice for some years now and I think my practice manager would string me up by the thumbs if I suggested moving the server back into the practice. GPs are not IT technicians and it really is daft that we are still expecting them to do that job.”

The Scottish Executive is just beginning a pilot study with 100 practices, involving GPASS and non-GPASS systems, which was heavily oversubscribed.

However a GP who did not want to be named told EHI Primary Care that there were concerns about the capacity of existing central servers to cope with large numbers of GPASS Clinical systems which will involve moving to a new operating system for most GPASS practices.

A letter is due to be issued shortly by the SEHD providing more information on the choice initiative plus details on system accreditation, data centres and individual initiatives.