Clinical commissioning groups will have responsibility for GP IT, but the funding arrangements for this new role remain unclear.
A new NHS Commissioning Board document – 'securing excellence in commissioning primary care' – says expenditure on core GP IT and premises reimbursement is included in the total primary care commissioning budget of £12.6 billion.
It says the commissioning board will manage the premises reimbursement budgets, but will delegate GP IT functions to CCGs to “help integrate these with broader system development.”
Dr Chaand Nagpaul, a negotiator for the BMA’s GP Committee, told EHI Primary Care that GPs had been waiting for a long time to get some understanding about how GP IT will be managed post 2013.
“We’ve been awaiting clarity for about a year. Commissioners are only being informed now that they will be taking on this responsibility, so it’s at a rather late stage in the day,” he commented.
GPs and CCGs now need an “urgent dialogue” with the government about what the statement will mean in practice, he added.
“While the current information does specify how the government wishes to see it operate, the devil will be in the detail,” he predicted.
There needs to be some assurance that CCGs have the capability to service this responsibility and the resources to support them, as the original CCG allocations did not take this new role into account.
Dr Nagpaul said the £25 per head management fee that CCGs are due to receive was allocated prior to this expansion of their role and was not intended to cover any element of GP IT. They will therefore need extra resourcing to enable this to happen.
GP IT covers the supply and support of all hardware and software to GP practices to allow them to function, he said. This includes the provision of GP Systems of Choice and N3.
“It’s absolutely pressing that we need to have a dialogue with the government to iron out exactly what this means and how it can function because this area is an area that GP practices need to function on a daily basis and we are at quite a late stage in the development of CCGs,” Dr Nagpaul said.
He did not think there was a particular push by GPs to get local control of IT. “There were a range of options available, of which devolving some responsibility was one option. Now the government has given the direction of travel we need to put some flesh on the bones,” he said.
Dr Neil Paul is one of five executive GPs for NHS South Cheshire CCG and said the commissioning document statement was news to him.
“My initial reaction is ‘brilliant, wonderful’, but now I need to understand exactly what budget I’m being given and what it doesn’t cover,” he said.
Dr Paul added that when working with the old primary care trust on IT issues, it was always difficult to determine “which budget was paying for what.”
“On the one hand I’m relatively pleased and excited that it [GP IT] has not gone to some organisation miles away with no idea of what we do locally and all the time and trouble invested in IT, but it comes back to understanding budgets and spread sheets that never made a lot of sense in the past,” he said.
The NHS CB document says that the board will provide more details about the primary care operating arrangements, including GP IT, over coming months.
Dr Neil Paul's latest column, looking at how commissioning support services and clinical commissioning groups will work together, is published in Insight.
© 2012 EHealth Media.
NGMS budgetskenni39 75 weeks ago
As someone who actually manages the current NGMS budget allocated for GPIT, I don't see the transfer of this to CCGs, post authorisation as a problem. However, what will be is the intricacies of what that actually entails, and how it will fit with Son of GPSOC, or CCG SOC, as has been suggested. CCGs demanding that practices move to a single system is contrary to the Connect All mantra that most organisations are working toward. Also, there is the issue of who does manage it, i.e. a Post. Most Primary Care IT managers sit within a PCT, soon to be gone! So does that post transfer, with budgetary allocation, to CCGs? P45s all round!!!!!
Cumbria and LiverpoolCertaCitrus 75 weeks ago
Is C&L that different from other solutions, the data is streamed one way, so that would imply the complete patient record can only be viewed via the PCT/CCG clincal system, i.e. they are on a single EPR?
Why not CCG SoC?Daniel Defoe 75 weeks ago
Mary, just for the sake of academic debate, why shouldn't CCG SoC replace GP SoC? Or at least, why shouldn't a CCG, preferably based on evidence, come to the conclusion that (and I'll choose my example wording carefully here for obvious reasons), GP System A is preferable for their purposes to GP System B, C, or D, and include either sticks or carrots in their contracts with GPs to achieve that? It's just possible then that the overall cost of GP and CCG IT might be lower than it is at the moment. After all, I seem to remember that GPSoC came about only as a compromise.
Business case for single systems locally?Mary Hawking 75 weeks ago
Daniel, just for the sake of academic debate, there are a number of different issues here - and I think each CCG - suppose it intended to follow the NPfIT idea that what the NHS needed was a single EPR system (Lorenzo Regional Care originally included general practice: I never did manage to get any details of how it would/will work) would need to have a business case and fairly detailed implementation plan to convince practices not using the CCGs preferred system that this was in their - as well as the CCG's - interest to change: after all, in areas where this might occur, it is probable that there is already a good deal of joined-up strategic use of the CCG's preferred system in the local health economy system to demonstrate the need for the other practices to change systems.
I am not clear that many - if any - shadow CCGs who are not already using a system from a single supplier in innovative ways have a sufficiently developed IT strategy to convince practices who have not changed to the locally majority system that they ought to change - so that leaves the possibility of CCGs - if they are made responsible for managing GP IT system contracts and support - deciding to exercise this control to force practices to change without any rules to prevent this: at present the individual practices do have the right (which is also in the nGMS contract) to choice of continuing their current system and on changing systems: this might just de facto vanish with the change in control.
A single system in a local environment might in some circumstances be a good thing - but I think in areas such as Cumbria and Liverpool where there has been innovative use of systems to enable joined up care, it hasn't been necessary to force practices using different systems to change systems for the General Good ;->
Sticks and CarrotsGeepsi 75 weeks ago
Given that the practices (are supposed to) be involved in the strategy of the CCG and can vote to disolve the govening body, I actually feel that it will be less, rather than more, likely that a CCG can impose a single system. It would mean convincing practices that the end result would be worth the disruption and clinical/legal risk of going through a system swap.
Sticks and carrots sound great but these cannot be financial as the practices contracts are held by the NCB, not the CCG.
CCG SoC?Mary Hawking 76 weeks ago
The GP contract gives individual GP practices a right to choice of GP systems - hence the fight for GPSoC.
In Pulse there have been reports of the extremely er - demanding agreements (with penalties) CCGs (which I thought were supposed to be Member Organisations and had, as yet, no legal basis) are demanding that their Members should sign as a condition of membership.
Does this new, last minute decision mean that we will have, in fact, a CCG SoC to replace GP SoC?