Two primary care trusts have told practices in need of hardware upgrades to their IT systems that they will need to move to the local service provider’s GP solution or live with “suboptimal performance” from existing GP systems.
Cambridge City and South Cambridgeshire PCTs wrote to practices last week stating that the only option the PCTs could support at the moment would be to move practices that need branch link upgrades to TPP’s SystmOne, a GP solution offered by Accenture, the PCTs’ local service provider.
The letter from Ian Burns, head of infrastructure, says the PCTs still support “the principle of choice” but that because the trusts are under considerable financial pressure they had decided the only option that would solve the branch link problems and represent longer term value for money would to be to move to TPP SystmOne, which is free of charge to the PCTs.
It adds: “As you may be aware neither EMIS nor Vision are systems being offered by Accenture even though agreement has been reached with another local service provider covering a different part of the country. Discussions are ongoing but a deal with NHS Connecting for Health and Accenture is unlikely to be concluded in 2006.”
The letter from Burns states that more than 250 practices in the cluster have already been migrated to TPP SystmOne.
It adds: “Accenture is currently not offering an alternative GP system due to technical problems with the Torex [sic] Synergy system.”
However EHI Primary Care understand that Synergy systems are being deployed in the cluster although the TPP offering is popular because of the possibility of greater integration if PCTs also take TPP’s community and child health systems.
The letter says: “Any practice that needs to improve their branch surgery link during 2006 can do so by moving to TPP SystmOne. Any other practice that does not have either of these issues, but decides to move to TPP SystmOne, will also be supported by the PCT.
“Practices that would prefer to wait and see if EMIS or Vision becomes a choice available through the LSP can do so, but must understand that they will have to put up with sub-optimal system performance for longer and that there is no guarantee that EMIS or Vision will become available as an affordable option.”
The letter sets out three different options the PCTs considered for improving performance at branch surgery. It says option one, to upgrade existing bandwidth with existing suppliers, would result in a net cost over three years to the PCT of £32,200. Option two, to move to existing suppliers hosted managed data services, would cost £10,208 over three years while option three, to move to TPP SystmOne, would mean a net saving for the PCTs of £16,500.
The letter adds that some practices also have servers that are nearing the end of their life but that the PCTs are reluctant to invest large amounts in new practice based servers except as a last resort.
It adds: “We will investigate alternative solutions wherever possible which could include re-deploying surplus equipment from elsewhere.”
Dr Paul Cundy, chairman of the IT sub-committee of the BMA’s General Practitioner Committee, said GPs were entitled to be funded by their PCT to have their existing systems upgraded so that they ran efficiently.
Dr Cundy told EHI Primary Care: “These PCTs are not complying with the nGMS contract.”
A spokesman for Accenture told EHI Primary Care that the LSP currently offers two GP solutions for the North-east and Eastern clusters, TPP’s SystmOne and iSOFT’s Synergy.
He added: “We are committed to offering clinicians a choice of solutions – and understand they will each want to make the best decision for their practices.”
The PCTs’ letter, sent on 15 February, comes at a time when suppliers and the health department are finalising details of a new scheme to allow system choice.
A spokesperson for NHS Connecting for Health told EHI Primary Care: “NHS Connecting for Health and the Local Service Providers are committed to offering more choice of GP IT systems nationally. NHS Connecting for Health, the LSPs and existing system suppliers are working collaboratively and creatively to reach an agreement to allow this to happen.
"Naturally there are commercial issues to be resolved and negotiations are on-going. We are working to reach agreement as soon as possible."
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