Clinical commissioning groups will have responsibility for GP IT, but the funding arrangements for this new role remain unclear.
A new NHS Commissioning Board document – ‘securing excellence in commissioning primary care’ – says expenditure on core GP IT and premises reimbursement is included in the total primary care commissioning budget of £12.6 billion.
It says the commissioning board will manage the premises reimbursement budgets, but will delegate GP IT functions to CCGs to “help integrate these with broader system development.”
Dr Chaand Nagpaul, a negotiator for the BMA’s GP Committee, told EHI Primary Care that GPs had been waiting for a long time to get some understanding about how GP IT will be managed post 2013.
“We’ve been awaiting clarity for about a year. Commissioners are only being informed now that they will be taking on this responsibility, so it’s at a rather late stage in the day,” he commented.
GPs and CCGs now need an “urgent dialogue” with the government about what the statement will mean in practice, he added.
“While the current information does specify how the government wishes to see it operate, the devil will be in the detail,” he predicted.
There needs to be some assurance that CCGs have the capability to service this responsibility and the resources to support them, as the original CCG allocations did not take this new role into account.
Dr Nagpaul said the £25 per head management fee that CCGs are due to receive was allocated prior to this expansion of their role and was not intended to cover any element of GP IT. They will therefore need extra resourcing to enable this to happen.
GP IT covers the supply and support of all hardware and software to GP practices to allow them to function, he said. This includes the provision of GP Systems of Choice and N3.
“It’s absolutely pressing that we need to have a dialogue with the government to iron out exactly what this means and how it can function because this area is an area that GP practices need to function on a daily basis and we are at quite a late stage in the development of CCGs,” Dr Nagpaul said.
He did not think there was a particular push by GPs to get local control of IT. “There were a range of options available, of which devolving some responsibility was one option. Now the government has given the direction of travel we need to put some flesh on the bones,” he said.
Dr Neil Paul is one of five executive GPs for NHS South Cheshire CCG and said the commissioning document statement was news to him.
“My initial reaction is ‘brilliant, wonderful’, but now I need to understand exactly what budget I’m being given and what it doesn’t cover,” he said.
Dr Paul added that when working with the old primary care trust on IT issues, it was always difficult to determine “which budget was paying for what.”
“On the one hand I’m relatively pleased and excited that it [GP IT] has not gone to some organisation miles away with no idea of what we do locally and all the time and trouble invested in IT, but it comes back to understanding budgets and spread sheets that never made a lot of sense in the past,” he said.
The NHS CB document says that the board will provide more details about the primary care operating arrangements, including GP IT, over coming months.
Dr Neil Paul’s latest column, looking at how commissioning support services and clinical commissioning groups will work together, is published in Insight.