Primary Care EPR software provider TPP is offering English GP practices financial incentives to switch to its SystmOne software in a move that may conflict with public sector procurement rules.

TPP is targetting its main rival EMIS, which has been having significant performance and reliability issues with its EMIS Web product, in what appears to be a bid for supremacy in the primary care market.

TPP is running Twitter adverts that offer practices a £10,000 referral fee, a further £10,000 to cover staffing costs up to the value of up to £10,000 per practice as part of the migration to SystmOne migration costs, and a £3,000 migration fee waived. A further £50 M&S voucher is offered to any GP who books a demo.

The campaign is directly targeting EMIS practices, many have which have been suffering significant reliability and performance problems with EMIS Web, which had a major national outage in May.

EMIS is also facing uncertainty with the £1.2 billion purchase by UnitedHealth Group Incorporated, via Bordeaux UK Holdings Limited, continuing to be reviewed by the Competition and Mergers Authority.

A 23 June Twitter post by TPP director Ashley Brook states “Calling all GPs!… We’re making it even easier to move to @TPP_SystmOne” and lists the incentive payments on offer.


In response to a question about the time taken to cross-over between the systems, and resulting data loss for 4-7 days, Brook replied: “Yeah we are working on a zero day cutover solution. But the £10K will soften the blow in the meantime J”.

Further Twitter posts from TPP said ‘No slowness of wheel of death’ referring to EMIS performance issues:

ICBs worry campaign could breach rules

One ICB leader told Digital Health News that they were concerned that the campaign may breach public sector procurement rules, which prohibit financial inducements to parties involved in a procurement.

As it is ICBs rather than individual practices who now procure practice EPR systems, the TPP campaign appears designed to get individual GPs and practices to create pressure upon ICBs. The ICB leader said they were having to field calls resulting from the campaign which landed without any warning, not allowing time to prepare by taking formal advice on any potential procurement challenge, or to ensure that capacity is available in the system to support multiple migrations.

“TPP appear to be seeking to exploit the opportunity to become the monopoly supplier of primary care EPR systems,” the source said, expressing concerns about the uncertainty surrounding EMIS.

Another NHS source, speaking on condition of anonymity, said that with NHS England in some obvious disarray, following the merger with NHS Digital in February, and 30% job cuts there was a real worry that NHS England has taken its eye of the ball with primary care IT.

They noted none of the latest NHS England 6+1 digital priorities focus on primary care despite potential system wide impact.

The English primary care EPR market has long been an effective duopoly, split between EMIS and TPP. Repeated attempts by national policy makers to open the market to competition have failed, leaving the NHS reliant on two suppliers with little incentive to innovate.

This has provided an opportunity for other third-party suppliers, such as AccuRX, to fill the innovation gap with welcome add on tools, which whilst welcome to the end users, end up costing the NHS more.

NHS England’s GP IT Futures Framework, which made great promises to open up the market, expired in March, having had almost no impact. A replacement framework for buying primary care IT that aims to achieve the same, worth up to £1 billion, is now to be developed.  A prior information notice for the framework was issued earlier this month.

Despite promises over many years, however, there have been no significant new entrants to the primary care EPR market in almost two decades.

Ironically, TPP was helped to build its very strong market position during the NHS National Programme for IT in the early 2000s, when it was put in partly to challenge the then dominant market position of EMIS, and to provide CSC with a working interim product it could implement while iSoft Lorenzo was being developed.