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At the heart of general practice since 1960

Insulin use doubles risk of colorectal tumours

Deputy chief medical officer Professor Aidan Halligan, jointly responsible for the National Programme for IT, answers your concerns about its plans and what they mean for GPs

Dr Iain Cameron Birmingham

'Why, given we already have a system that is supplying the needs of more than 50 per cent of GPs extremely well, are you willing to throw it out of the window?'

Of course we recognise that many GPs feel closely attached to the system they work with. We only want GPs to change systems when the choice offers greater functionality and better service availability than those they already use. These alternatives could include EMIS if the company decides to sign up with one or more of the local service providers.

Dr George Findlay Folkestone, Kent

'Can we have an assurance that we can continue to use our current system indefinitely?'

We will ensure any GP can continue to use their current system as long as it is compliant with national systems, but we cannot give an assurance that this will be indefinitely. You will also need to speak to your system supplier to clarify whether they are undertaking compliance work.

Dr John Addison Ashby-de-la-Zouche, Derbyshire

'Can the NHS afford not to have EMIS on board the NPfIT?'

The reality is that NPfIT is currently working hand in hand with EMIS to test and integrate its systems so that they are compliant with the national programme.

Dr Anne Baruch Chessington, Surrey

'If EMIS can guarantee its systems' information will integrate with the spine, will you allow it to continue doing so?'

As long as a system is compliant with national systems and standards, be it from EMIS or any other company, there is no reason why it should be replaced in the near term.

Dr Paul Aspinall Kettering, Northants

'At the moment I'm using the Volvo estate of GP systems. Can you assure me I won't have the choice of a blue mini or a red mini?'

Absolutely. We will never replace systems unless greater or equal functionality is offer-ed by a new one.

Dr Paul Singer Luton, Bedfordshire

'Why is there a necessity to go to a single system in one area? Do you understand the disruption changing will cause to practices?'

We do understand the strength of feeling and genuine distress that GPs feel. I got it first hand. A significant part of the problem is conflicting messages and poor communication. We are not chan-ging to a single system within one area. All GPs will be offered a choice of systems and in many cases will continue to use the system they already have for at least the 'lifetime' of that system. As and when change comes, we will do all we can to support GPs through what is always a difficult time.

Dr Alison Hutton Manchester

'Why haven't you and the NPfIT been out to see how GP systems work or how GPs provide a service to their patients?'

I and many of the team have personally visited PCTs to explore NPfIT issues and I know very well the strength of feeling. We have not been able to cover all 30,000 GPs in England but we have spoken to many GPs in the field and have recruited GPs to work with us at the national programme, advising and guiding our work. I have also met with and discussed the issues with the BMA, the GPC and leaders of the RCGP.

Dr Manpreet Pujara Rochester, Kent

'When was the last time you personally saw a patient and recorded the information on a computer? How many surgeries have you visited to see how current GP systems work?'

I am deputy chief medical officer for England but I still practise as a consultant and I see patients on a regular basis. In my current, somewhat limited, medical work I am not a heavy IT user but I am taking the European Computer Driving Licence to improve my desktop skills. Over the past months I have visited a number of surgeries and seen GP systems in operation.

Dr Dave Yates Cheadle, Cheshire

'Have you ever had the experience of using a complex computer system in clinical practice? If you have you might start to understand the anxieties the proposed changes are creating.'

I am very familiar with IT in the acute setting. I really do understand the emotion and anxieties that GPs have. However, I must stress there will not be enforced mass change.

Dr David Holland Blackwell, Derbyshire

'Since we have no idea what the new systems will offer ­ how do we know which systems will offer all we need? I am seriously considering early retirement if I am not allowed to carry on using EMIS.'

New systems are under development and it is our pledge that there must be a choice and that new systems must offer, at a minimum, the same functionality as existing systems. EMIS is working closely with the national programme to make its systems compliant and there is every expectation that you will be able to carry on using EMIS.

Dr Malcolm Willis Norwich

'In your opinion can EMIS survive without an agreement between them and the local service providers?'

This is not for me to say ­ it would be a more appropriate to ask EMIS.

Pulse

'How do you plan to engage GPs from now on?'

We know this is vital, and we also know we have not done well so far. We will hold a forum at which different GP groups will have the opportunity to discuss concerns and

issues. We know it will take time to build better understanding and support.

Pulse

'What is NPfIT doing to bring EMIS into the fold?'

We are working closely with EMIS to ensure its systems are compliant. We have also encouraged EMIS to work with local service providers.

Pulse

'Are GPs being cynically manipulated by EMIS, as the GPC suggests?'

It would not be right for me to comment on this.

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