The Scottish government is to set up a national framework contract for GP systems and launch a procurement for an IT system or systems to replace GPASS, according to its new e-health strategy.
The plan means Scottish practices are likely to be brought under a Scottish version of England’s GP Systems of Choice (GPSoC) agreement with boards given flexibility about how to meet the needs of community staff. In addition a procurement will be launched for a system to replace GPASS although it is unclear whether this will involve one or more systems. Plans to procure a system that covers both primary and community staff appear to have been dropped.
The e-health strategy for Scotland was launched by Scottish health secretary Nicola Sturgeon last week at the NHS Scotland Event held to celebrate 60 years of the NHS in Scotland.
The deputy first minister told the conference the three year strategy from 2008 to 2011 would enable Scotland to build the platform for an electronic patient record to support patients and improve their experience of care throughout the healthcare journey.
As well as the primary care procurement Scotland is also seeking to procure a hospital sector patient management system (PMS) which will be available to all NHS boards.
Sturgeon said: “It’s a strategy that avoids the trap of putting all of our eggs in the basket of a single complex centrally-prescribed IT system and instead one which takes a pragmatic approach and builds on what is already working well but also makes targeted investment to fill the gaps and join up that approach.”
In primary care the Scottish government plans a “managed transition from GPASS based on choice” with the aim of having a contract in place by summer 2009 and roll-out after that. The strategy says a date will then be agreed for migration of the last GPASS practices.
Dr Stuart Scott, deputy chairman of the Scottish General Practitioners Committee, said he was "very supportive" of the strategy and predicted that the primary care procurement would be for more than one system.
He added: "There is an imperative to get something in to replace GPASS as asson as possible as it is just falling more and more behind. I think GPASS users will be ecstatic."
In addition to the procurement a national framework contract will be set up to give NHS Boards and GP practices a choice of GP systems that comply with national standards. A primary and community care e-health development fund will enable NHS Boards to have direct contractual relationships with GP system suppliers.
More than 60% of GP practices in Scotland currently use GPASS although nearly 200 practices have switched to INPS’s Vision systems under a previous agreement on IT system choice and there are also practices using EMIS and iSoft. GPASS has been the subject of much criticism with Scottish LMCs’ describing the system as not fit for purpose.
The government had previously pledged to procure an Integrated Primary and Community Care system (IPACC) to replace GPASS but this was also the subject of criticism from LMCs and is played down in the strategy
Instead the strategy says that the optimum approach for an electronic patient record system for community nurses and allied health professionals will become clear “in due course” and in the mean time boards can use the specifications developed as part of the IPACC project to inform the debate.
Dr Scott said it was disapppinting that there would be a longer wait for electronic support for community staff and allied health professionals which he said was desperately needed with many still working from paper.
NHS boards will be given money to support e-health developments for community staff with the expectation that they will work up three levels of e-health maturity beginning with basic provision of networked PCs and moving on to access to electronic referrals and discharge information followed by the third level involving use of an EPR.
The strategy adds that the primary care procurement must focus on the needs of GP practices but that the selected system may offer useful features for community nurses. Scotland’s e-health strategy also includes plans to begin the development of a clinical portal with a single sign-on to different sources of information and plans to ensure the integration and interoperability of core systems. The strategy adds that the technology that underpins the current CHI patient identification system will also be replaced and that a new consensus will be developed on information governance focusing on better use of information and safeguarding patient confidentiality.
The strategy says new national systems will be funded by the Scottish government which will also contribute to the operation of existing national systems.
It adds: “Any further e-health investment at NHS Board level will be at the decision of NHS Boards.”
Sturgeon told the conference the strategy was national but also contained the flexibility to make targeted investments at local level to meet local needs and local priorities.
She added: “The new strategy is ambitious but it is also realistic and crucially affordable.”
The government said the strategy was intentionally high level and that further detail will be published in a range of more detailed plans including a technical plan, a programme plan and a finance strategy.