The private providers winning contracts to run general practices have information technology close to the top of their agendas.
Atos Healthcare is a typical example. Last month it beat off competition from some high profile NHS GPs, including former BMA deputy chairman Dr Sam Everington, to win the contract to run St Paul’s Way medical centre in Bow, east London. The company has also won the contract to run a practice in Shinfield, Berkshire from March.
IT as a selling point
The healthcare technology specialist has IT at the heart of all its plans and hope it will be a selling point in the contracting process as it goes forward.
Nigel Beverley, director of NHS services at Atos Healthcare, says a key part of the company’s strategy is to continue bidding for more Alternative Provider Medical Services (APMS) contracts and to look at the polyclinics being set up as part of Lord Darzi’s review of the NHS.
Beverley highlights the company’s IT governance system, the Integrated Quality Audit System (IQAS), as an example of the way Atos will use IT in general practice.
IQAS is a companywide clinical audit system already in use as part of Atos Origin’s existing business providing occupational health services and medical assessments for the Department of Work and Pensions. Atos also runs two walk-in centres in Manchester and Canary Wharf
The system audits clinical work against standards of professional practice with random and targeted sampling of work for peer audit and mentoring.
Beverley adds: “IQAS has been developed across all of our business but it is highly relevant in the primary care environment. That system is one of our differentiations and the feedback from the NHS about our proposition of using IT to drive quality has been very positive.”
APMS enables technology use to be mandated
An advantage for the NHS of APMS contracts is that they are able to specify their requirements on IT rather than relying on powers of persuasion. It is common practice for APMS contracts to specify compliance with all aspects of the National Programme for IT, for instance mandating use of Choose and Book, a requirement most PCT managers can only dream of.
For Atos Healthcare, whose parent company has developed the Choose and Book system nationally, e-booking is a natural partner.
Beverley says: “We would like our practices to be a shining example of how Choose and Book can be implemented and developed.”
Delivery of integrated services
Care UK now runs two NHS general practices, two out of hours centres, two minor injury units and four walk-in centres as well as a close association with Frome Medical Practice, one of the largest general practices in the UK. Group IT director James Greenman says integration will be a vital part of its service delivery, enabling seamless transfer of information, for example between primary care and out of hours services or between primary and secondary care.
Greenman says: “We don’t have any different tools to anybody else, it’s just that we can make them work.”
His personal view is that in future there will be greater local innovation and use of interoperable solutions outside of the local service provider model and he sees innovative use of IT as a minimum entry requirement for those tendering to run general practices.
New providers driving use of telehealth
Private providers are also driving forward use of new technology such as telehealth. The private company Chilvers McCrea, which now runs almost 40 general practices, has set up a separate company in combination with telehealth specialists ITAL TBS to deliver telehealth services. So far, the company has been piloting the service in one of its practices in Harlow, Essex. A small number of patients with chronic obstructive pulmonary disease (COPD) have been giving a pulse oximeter to measure their arterial oxygen saturation with results relayed daily for monitoring by health professionals.
Company chairman Dr Rory McCrea says the system has been included in the PASA framework for telecare and telehealth equipment and the company hopes to work with practice-based commissioning groups to install the system, not just within their own practices but in others around the country.
Dr McCrea says: “I think there are two levels of IT in primary care, IT that supports general practice and IT that supports services to patients with long term conditions. There will come a point when these two will come together but that point hasn’t happened yet.”
“The loyalty to an existing IT system that GPs working in their own practices may feel does not apply to the private providers”
The loyalty to an existing IT system that GPs working in their own practices may feel does not apply to the private providers. Dr McCrea says his company usually adopts the existing GP system in use in the practices it takes over but its eventually aim is to come down to any of three systems and in some cases has already migrated systems in line with PCT plans.
Delivering patient-centred care
However, just as with IT-literate NHS practices, the private providers are also keen to harness IT for patients to access care. Online appointment booking, repeat prescription requests and greater provision of information to patients including patient record access are all on the agendas of the private providers.
Beverley says: “We absolutely passionately believe in improving the quality of primary care from a clinical point of view and from a patient centred perspective and there is a big IT element in both of those things.”