GP practices’ concerns about N3 are to be discussed at the next meeting of NHS Connecting for Health’s GP Pan User Group (GP PUG).

Fair deal on NHS BroadbandDr Gillian Braunold, joint GP national clinical lead for CfH, told EHI Primary Care that N3 will be on the agenda at the pan user group’s January meeting. Last week EHI Primary Care launched its Fair Deal for NHS Broadband campaign to highlight the problems facing primary care and secure a fair deal for GP practices on NHS broadband.

Dr Braunold said she and Professor Mike Pringle, her co-GP clinical lead, had already passed on to the N3 team concerns about the BT-run NHS network raised during CfH’s current series of GP engagement events around the country.

Issues practices have highlighted to EHI Primary Care include concerns that practices do not have adequate broadband speeds to use systems such as Choose and Book, that the cost of upgrading must be met locally and can be as high as £30,000 for a three year contract, and that inadequate broadband speeds are particularly affecting branch surgeries where the impact is felt not only on national applications but also on GPs’ clinical systems.

Dr Braunold told EHI Primary Care that although it was sometimes difficult to identify what were the underlying problems causing systems to run slowly, issues with broadband speeds and branch surgeries had been raised to the GP clinical leads.

She added: “Some of the issues turn out not to be the broadband connection but other issues – but branch surgeries have been an issue and there is work going on to resolve it. Initially we hoped a rapid move to hosting would enable the branch surgery issue to be sorted quickly – but the various system suppliers are not ready to migrate everyone safely yet so the branch surgery issue needs looking at more urgently.”

Last week CfH told EHI Primary Care that they were not aware of any issues regarding speed of connection that could be explained with reference to N3. But GPs remain to be convinced.

Dr Manpreet Pujara, chairman of the EMIS National User Group, said he had already mentioned the problems practices were facing at the last GPPUG meeting earlier this month and hoped the issue would be on the agenda for the January meeting.

He told EHI Primary Care: “It’s certainly a major issue as lots of practices are concerned about it and it’s not a system specific problem but a general GP issue that need sorting out.”

Dr Pujara said that he did not believe the problem was confined to practices with branch surgeries although many of his colleagues with branch surgeries had highlighted the problem.

He added: “My own thoughts are that N3 isn’t as resilient as it is supposed to be and you do hear reports that in certain parts of the country it slows right down when everyone starts accessing their email at 12 o’clock. It’s also not looking good when you think things like the electronic prescription service haven’t come fully online yet.”

Among those who are convinced the problem extends beyond branch surgeries is Dr Ian Pace, a GP in Bourne, Lincolnshire, who says his practice mistakenly received a 512Kbps link instead of the 2MB it should have received and has been trying to get his practice’s bandwidth upgraded for about a year.

Dr Pace has written to his MP and to Richard Granger, chief executive officer of CfH, about the issue but has yet to get the link improved. He said BT had told the practice that its performance reports had showed the practice was not using all its available bandwidth and last week BT also told EHI primary Care that the vast majority of GP sites were working well below the available bandwidth.

However Dr Pace said: “We know its terribly slow and while we might not be using all the bandwidth over a 24 hour period in a morning when we are wanting to use Choose and Book it moves like a dog and sometimes times out before we get a response. The fact is I have seen Choose and Book working much better at another local practice with a 2Mb link and at the PCT which has a faster link.”

Dr Francesca Lasman’s practice in Huntingdon, Cambridgeshire, has a 1MB connection and says she is among those practices experiencing problems with their clinical system at their branch surgery due to connection speeds back to the main surgery.

She told EHI Primary Care: “It’s very frustrating. Opening attachments can be terribly slow and is so bad that some of the partners want to go back to paper and stop using scanned attachments at the branch surgery.”

Similar problems are being experience by Dr Ted Willis, a GP in Brigg, north Lincolnshire, who said a link between the practice’s main and branch surgery had worked well for ten years until N3 was installed.

He added: “Performance at our branch surgery is getting very poor. Intermittently you can type an ‘a’ and have to wait for it to come up and opening an attachment might take 30 seconds or so. We have found out various ways of dealing with the situation such as not using Choose and Book when we are consulting at the branch surgery and switching off emails but it is not a satisfactory situation.”

Dr Willis said the practice put in a bid for an upgrade from a 1MB to 2MB link but that the maximum costs quoted to the PCT, £22,000 installation costs plus £30,000 for maintenance or an alternative solution costing £14,000, were well beyond what the PCT could afford to pay.

He added: “There is no way our PCT could fund that and it wouldn’t be reasonable to afford that kind of money.”

Last week BT told EHI Primary Care that in order to enable customers to make an informed decision it provides two prices for each quotation – a “maximum price” and an estimate of the price for delivery at an average GP site.

Dr Pujara said the way prices were presented by BT needed to be revised as maximum quotes put off a lot of PCTs from approving applications for upgrades.