IT support for commissioning needs to be driven by GP consortia, rather than being provided by the centre, the Primary Health Info conference heard.
Dr Paul Zollinger-Read, director of GP commissioning for NHS East of England and primary care lead for the King’s Fund, said GP consortia should follow US physician-led organisations, which designed their own information systems.
Dr Zollinger-Read, who sits on the NHS Commissioning Development Board, told the conference: “What comes out of commissioning support needs to be grown from the bottom up not dropped from the top down.”
However, Dr Zollinger-Read said he also understood that current thinking from the centre about what consortia would need to support them is that there will be a couple of commissioning support units.
The GP and former primary care trust chief executive said pathfinder consortia were “really moving ahead” despite the "pause" in the passage of the Health and Social Care Bill that was called amid political controversy about the latest round of reforms.
However, he said their number one issue was getting hold of timely, accurate information.
He added: “When I was a PCT chief exec it was not unusual for data to be three months out of date, whereas in the US risk stratification is absolutely their lifeblood and they know exactly where their patients are on a daily basis.”
He said GP consortia also wanted to tackle variations in the performance of practices, which was identified as a key issue by a recent Kings Fund’s report on the quality of general practice.
He told the conference: “GP leaders in the pathfinders want to take on managing quality in primary care but want the tools to do it.”
He said peer review would be crucial but GP consortia would also need to be much more robust about audits.
Dr Zollinger-Read predicted that, despite the pause, the authorisation process for consortia would begin by the end of the summer and by next year the first groups would be up and running.
© 2011 EHealth Media.
Recipe for disasterSunking 200 weeks ago
When I heard Paul Zollinger-Reed describe his vision of GP IT Support as one in which GP consortia should follow US physician-led organisations, by designing their own information systems, my heart sank.
When I joined the NHS in 1991, the GP Clinical system marketplace was in a state of anarchy. There were over 120 available systems solutions, many of which designed by enthusiastic GP's on BBC Micros and similar. No standardization of record structure or content, no ability to communicate, share or transfer information at all, in fact a total hodgepodge of rubbish.
Are we really planning to turn the clock back to those heady days of well meaning but ill thought out, half-baked lash ups?
I'm the first to admit there are shortcomings with most current systems, but please; do what you do well, i.e. be Doctors. Tell systems designers and informaticians what you want, get involved in design and development if you must, but please think about the big picture before deciding on a gung-ho approach to parochial and local problem solving.
The NHS already possess the right people with the right skills and appropriate level of understanding to deliver all the information requirements that Primary care consortia need, they are the informaticians, the analysts and the specialists that are now leaching away as a result of the disastrous Heath & Social Care bill.
However, they are not clinicians, and it is sublimely arrogant and monumentally naive to assume that clinicians could fulfill this role.
RisksKathie Applebee 201 weeks ago
As the person responsible for the 'frank reminder' from the floor that we have only 10.5 months to go until we start our shadow role, I am happy to support local solutions, especially using Vision 360 and EMIS Web to pool practice data. However, there is always the nagging fear that Big Brother (in this case, the National Commissioning Board), may then decide on some form of top-down solution, if only bureaucratic standards. And then there's the possibility of new IG standards. So a hands-off approach is fine but it needs some safeguards to justify the investment that we are going to have to make.
Chairman, National Vision User Group
Agreelindad 202 weeks ago
A speaker from the "centre" in another session referred to work being in "early days" and received a frank reminder from the floor that consortia are only ten and a half months away from being in shadow form.
It all points to the Big Pause resulting in some slackening of deadlines, I guess.
Very DisappointingNick Tordoff 202 weeks ago
If a member of the Commissioning Board is this confused about commissioning systems then we are in trouble.
"IT support for commissioning needs to be driven by GP consortia"
Does he mean IT or does he mean Information and Analysis?
"current thinking from the centre about what consortia would need to support them is that there will be a couple of commissioning support units."
Then why are all the cluster being tasked with setting up CSUs?
"When I was a PCT chief exec it was not unusual for data to be three months out of date"
That was nothing to do with the PCT teams it was the result of the nationally set timetables for data exchange. It is faster now (though not yet fast enough)
"whereas in the US risk stratification is absolutely their lifeblood and they know exactly where their patients are on a daily basis.”
a.This is a completly different issue from the business and contractual information which he was talking about.
b. Risk stratification only deals with a small (but important) subset of everything the GPs will have to commission
"He said GP consortia also wanted to tackle variations in the performance of practices"
Consortia will not have power over GP performance only over the use of secondary care resources which they commission.
GP Commissioning Information Services will have to happen from the bottom up not because of any policy decision but because there is clearly a dearth of any serious understanding at the top.