Trying to survive the IT payments confusion
IT payments under the new contract are confused to
say the least
Dr Paul Cundy tries to clarify an unsatisfactory situation
When GPs voted a massive Yes to the new contract the situation regarding IT seemed encouraging.
Unfortunately, while the GPC was negotiating with the NHS Confederation the Government was handing the IT purse for England to Richard Granger, who is buying the IT for the whole of the NHS.
He was given £2.3 billion to spend but wasn't told he'd have to budget for English general practice IT as well as that for Scotland, Wales and Northern Ireland. This meant that while the latter have now started to receive their IT money, England hasn't.
The amount of money allocated has also caused an upset. The cash set aside for the backdated top-up to England's maintenance and upgrades costs equates to a few hundred pounds per GP, and this has sent shockwaves through PCTs and practices.
Because the money was never ring-fenced, PCO spending data is flawed. Some PCOs reimburse for essential kit only and others only for certain systems. Yet others differentially reimburse. To further complicate things, add in the PMS bribes, savings from other budgets and incentive scheme money spent on IT but hidden from the Department of Health's historic IT spending data.
All in all the department simply does not know how much is being spent on English GMS IT.
Practices should be collecting their invoices and receipts for all the maintenance, support or annual licence fees for their current systems, backdated to April 1 this year. Keep a tally and start sending the figures in to your PCO.
This way PCOs will get a clearer picture of what they need from the department. The new contract is black and white on this issue if the money is not forthcoming then the PCO will be in breach of contract.
Practices that need upgrades or updates should also be contacting their PCTs. You should be able to get written approval for essential upgrades. I am afraid you will have to spend the money upfront and aim to get it paid back.
Personally I wouldn't spend any money against a verbal agreement. Get it in writing. The only exception to this would be a critical upgrade, such as a hard disk that's failed or is full up or a back-up system that has broken. These are important and delaying getting them replaced is too high a risk. Get them fixed but keep the bills and claim the money back later.
Remember consumables like toner cartridges and paper are not part of the 100 per cent reimbursement agreement.
GPs should also bear in mind issues relating to data.
While not all systems are capable of
reporting on the quality and outcome frameworks they are all capable of accumulating the necessary coded data to support your claims.
Remember that your claim will be made in April 2005 and most of the claims 'look back' no more than 15 months. Thus if you enter data this month it will be time expired by the time you eventually run your report.
To start this process you should be looking at the Read codes you use, creating agreed picking lists, setting up templates. Concentrate more on the process than the actual data at the moment.
Remember that the quality and outcomes framework is a moving target; once started you will need to continue to accumulate new data. Remember you can use data from any source.