In the new slot for opinion and comment Dr Nilesh Jain of Torex Health takes up the question of GPs retaining choice over their IT now that PCTs pay for the systems.

The new General Medical Services contract will lead to a revolutionary change in primary care computing. Effective IT is needed to underpin the successful implementation of the contract, and to enable General Practitioners (GPs) to manage the new quality and outcomes framework where points mean prizes.

To ensure that GPs who have previously not taken much interest in their practice system do not lose out, the British Medical Association (BMA) General Practitioners Committee (GPC) negotiators have succeeded in obtaining 100% funding of primary care computing from the Primary Care Trusts (PCTs). As part of this, the ownership of practice systems will transfer from GPs to PCTs, but GPs must still be offered a choice of accredited systems.

Unfortunately, some PCTs around the country are choosing to enforce a single system on their GPs, often against the wishes of the GPs. I was interested to read that Dr John Chisholm, chairman of the BMA GPC, has pledged to fight to defend practices’ right to choose which practice systems they use ( GPC Chair Pledges Practices Will Retain Choice). This is also important in order to help the UK maintain its current world leadership in primary care informatics, the main reason for which has been the vested interest of the GPs who were both owners and users of the systems.

We live in an era where PCTs directly or indirectly control 75% of the NHS budget. As the patient interface and an integral part of the PCT, it is critical that GPs both influence and adhere to overall PCT policy. However when it comes to the specification of IT systems, which are an increasingly important part of PCT policy, GPs must be allowed a reasonable amount of flexibility to implement solutions that fulfil their own specific objectives.

The next few years are going to witness a dramatic change in primary care IT. Groups of practices within a PCT will get together to procure a common GP system, where the patient database will be held centrally at the PCT or a secure data centre. This will result in one to three GP systems within each PCT, allowing choice to the GPs and also benefits such as centralised IT administration and access to patient data for out of hours clinicians, given that PCTs will be responsible for providing out of hours care.

Systems will further evolve to become true PCT-wide clinical systems by incorporating functionality required by clinicians involved in delivering community care. Thus, the entire primary health care team (PHCT) will access the same patient record, resulting in improved communication among the PHCT and better quality patient care.

But it is important to remember that IT systems cannot single-handedly achieve the NHS’ overarching objectives – they can only support them. PCTs and GPs must improve communications if the objectives of the National Programme for IT are to be met. If these communication issues are not resolved the £2.3bn investment earmarked for the NHS could well be wasted.
Dr Nilesh Jain, Technical Product Manager, Torex Health

‘Open Source’ is open to anyone interested in healthcare IT who would like to voice an opinion. Rules: no plugging of products; must express an opinion; no more than 700 words; may be edited. email: