Hancock pledges to shake-up GP IT systems with new framework
- 3 January 2019
Health secretary Matt Hancock has pledged to shake up IT systems being used in GP practices.
The Secretary of State for Health and Social Care announced a number of changes will be made under the GP IT Futures framework.
The framework will move away from having principal and subsidiary systems to one that supports modularity, with a view to making it easier for new market entrants to provide services to primary care.
It is hoped this new framework will create an open and competitive market which is currently dominated by two main providers, EMIS and TPP.
By creating a more open market, the government hopes this will lure more technology companies to invest in the NHS.
The Department of Health and Social Care has said that by 2023 to 2024 it wants every patient in England to be able to access GP services digitally, with practices able to offer online or video consultations.
Hancock said: “Too often the IT used by GPs in the NHS – like other NHS technology – is out of date. It frustrates staff and patients alike, and doesn’t work well with other NHS systems.
“This must change.”
Part of the framework also feature standards, developed by NHS Digital, which will introduce minimum technical requirements so systems can talk to each other securely and are continuously upgradable.
Any system that does not meet these standards will not be used by the NHS and the government will look to end contracts with providers that do not understand these principles for the health and care sector.
Sarah Wilkinson, chief executive at NHS Digital, added: “The next generation of IT services for primary care must give more patients easy access to all key aspects of their medical record and provide the highest quality technology for use by GPs.
“They must also comply with our technology standards to ensure that we can integrate patient records across primary care, secondary care and social care.
In addition, we intend to strengthen quality controls and service standards, and dramatically improve the ease with which GPs can migrate from one supplier to another.”
4 Comments
The duopoly can ride this out if they start playing nicely with the few competent and properly accredited IT suppliers, as there are a lot of cowboys out there, and EMIS and TPP are rightly concerned with the safety of patient data, and standards compliance.
We in SouthWest London have just done an integration with about 450 EMIS practices – done by a company from Cambridge handling the data and doing the nuts and bolts- I had never heard of called ??L2S2. Anyway EMIS had no objection (might be the SoS’s sabre rattling!) and it all seems to be working just fine.
So it just goes to show that it can be done. We need more success stories not just the doom and gloom.
I wonder what the commercial reality of this will look like. I know the new strategy has moved from accept a world where EMIS and TPP are dominant, and instead have a myriad of suppliers all making up a patch work type of approach to clinical systems. But, that’s going to mean that commercially everyone will be after scraps. What kind of investors want to invest in very small business because of the behaviour of the market, rather than companies that make more serious amounts of money. I can only see that as stifling innovation because businesses will struggle to either get seed funding or scale in terms of development, sales, deployment, and hosting. And with a long list of standards to adhere to from check in screen behaviour to wiping of one’s behind, its going to be ever more difficult to bolt into the primary care funding framework.
I’m with the sentiment but it ignores the reality. GPSoC was supposed to open up opportunities for subsidiary systems but by giving the GP suppliers a key role in deciding who could connect lost the opportunity..
What we need is a single gateway owned and controlled by the NHS which exposes a FHIR API. The GP suppliers will; only need to deal with the gateway and the decision of who is allowed to access the gateway should be with the NHS and who accesses individual GP records should be with the patient.
Ideally a significant proportion of the revenue paid to GP suppliers should be linked to traffic through the gateway NO PLAY – NO PAY.
The technology to do this is available and proven at scale – Look at something like the open source tyk.io API Gateway.
Having witnesses Jeremy Hunt’s attempts to sort out one of the more recalcitrant GP suppliers while I was working inside NHS England I am frankly not optimistic that Matt Hancock will have any more success.
It’s really important that we unlock GP data and break what is effectively a unhealthy duopoly in this sector. GPs are the gatekeepers of the NHS and participants in the vast majority of care pathways and we need to create an open API on top of these legacy behemoths as the first step to replacing them with a truly open platform
This makes sense, especially the bit about using the flow of transactions to determine PAYMENT. e-RS may be able to play a part. The bottom line … Take all the IT management away from the GP, they are way way to busy to have to get involved
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