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GPs must not be railroaded into computer change

GPs must not be bullied into taking on IT systems. This has been reaffirmed and endorsed by the Department of Health.

I quote from the BMA website: 'Our advice to GP practices, which is endorsed by the Department of Health and the National Programme for IT, is as follows. Practices with RFA99+ accredited systems with which they are currently happy should not agree to transfer to an alternative system as long as their current supplier has confirmed their desire to make their system ''PfIT compliant'' (our understanding is that most systems will be made compliant). The National Programme expects LSPs to take all reasonable steps to support any accredited systems where local demand exists.'

PCTs will seek to have one unified system. That idea seems tidy to them, and in the short-term it would reduce their costs. In the long-term PCTs are likely to have to pay for their LSP (NPfIT) services.

A single system would stultify future primary care IT development. A single system is not required. GP systems will communicate with the National Spine. Miquest allows PCTs to get data from any GP system and GP2GP will allow electronic transfer of data between systems when patients register.

To assure ourselves that PCTs do not take absolute control over our clinical software GPs should make sure the PCT never funds, and hence owns, the practice's clinical server. The servers are now a small proportion of most practices' IT infrastructure.

GPs should bite the bullet and purchase or upgrade their servers out of their own funds and not involve the PCT.  They can continue to enjoy the 100 per cent funding and PCT ownership of everything else such as wiring, printers, client PCs and antivirus software. But not the server.

By owning the server it is clear the GP remains in charge of his IT system in his practice and also remains controller of the data.

Once PCTs own the servers

they may claim they own the data in the same way that the NHS owns the Lloyd George envelopes and cards.

My suggestion is that GPs should dig into their pockets and retain ownership of clinical servers and insure them in the normal way. Otherwise it may be possible that PCTs, claiming ownership of entire systems within GP surgeries, will feel they have the right to walk in and replace the clinical system at will, and even against department advice.

Dr Gerard Bulger



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