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GPs told they have to switch IT system complain of CCG ‘coercion’



GP practices fear they could lose out on funding if they do not switch their clinical IT system, in a move GP leaders billed as CCG ‘coercion’.

Practices in South Buckinghamshire were told that as part of the new PC Development Scheme (PCDS), they will have to change practice clinical software to EMIS Web.

Local GP leaders, which are negotiating on behalf of practices, said this comes despite CCGs in the region having advised practices to choose the best system to suit their needs in the past.

Minutes from the Buckinghamshire LMC meeting last month show that a number of non-EMIS practices are resisting the move to EMIS Web, arguing that there was no clinical justification for the move and that the requirement is ‘without solid foundation’.

The newsletter says that ‘the CCG seems prepared to reward practices with an enhanced payment of 19% of their actual QOF achievement even if they do not maintain the levels of care delivered by non-EMIS practices, but it is not prepared to reward practices for good performance if they do not have [the Buckinghamshire CCGs’] preferred clinical system’.

Attendees at the LMC meeting also raised the issue of practices already delivering good care being disrupted if they are forced to switch and also expressed concern over the uncertainty of the workload change and possible inadequacy of the funding increase.

Other practices in South Bucks have expressed some concern to Pulse about what will happen when new systems are released if all practices are corralled into EMIS Web. Concerns have also been raised about the issue of cyber security if all practices are on the same system, particularly in the wake of the recent cyber attack.

Dr Paul Roblin, chief executive of Berkshire, Buckinghamshire and Oxfordshire LMCs (BBOLMC) said that the LMC, CCG and two practices that are resisting the move had had a meeting.

A compromise had been mooted but Dr Roblin is not happy with the wording of the compromise document as the move to EMIS still does not appear to be optional. He told Pulse that the move ‘feels like coercion’.

He said: ‘It is a form of coercion if you say “unless you change then the financial flows will not be made available to your practice”. And this goes against the mantra of central Government which is free choice.’

Dr Roblin also pointed out that several years ago CCGs promoted system choice at their own IT workshops, advising practices to ‘analyse the IT systems, depending on their needs and then to make a choice’.

He added that it was mainly practices in South Bucks that were affected by the decision as most of them in North Bucks were already using the EMIS Web system.

A spokesperson for EMIS said that 55% of practices in the UK use the system. She added that 51 CCGs are 100% EMIS Web while 112 CCGs are more than 50% EMIS Web.

‘In the Buckinghamshire area alone, 86% of practices that achieved over 95% in their overall QOF Scores are users of EMIS Web (119 out of 138),’ said the spokesperson.

Louise Patten, chief officer of NHS Aylesbury Vale and Chiltern CCGs said they were ‘moving towards clusters of GPs being supported by integrated multidisciplinary community teams’.

She told Pulse: ‘We have never made the use of EMIS mandatory. We absolutely understand that the choice of clinical system is the sole decision of the practices.

‘However, as member practice organisations, the CCGs must recognise that 45 of our 52 practices have chosen to use the EMIS clinical system. It therefore makes sense to concentrate on ensuring our community integrated teams prioritise firstly working with this system, because the majority of our GP clusters will be using this for cross-practice management of appointments, remote triage and consultation, more effective sharing of workforces and centralised back office functions.

‘There is further work required to integrate the minority of other clinical system practices and once this is achieved, integrated community teams will be supported accordingly.’

She further said that the NHS Chiltern CCG non-EMIS practices were being ‘supported’ to ‘assure us that they have the specific system capabilities required to progress our cluster plans so that their patients are not disadvantaged’.

‘This includes offering a voluntary opportunity to move to EMIS, including a small financial incentive, as we appreciate that switching systems can cause short-term increase to practice workload. This is building on our experience with NHS Aylesbury Vale CCG, where the minority non-EMIS member practices all asked to move over in order to create consistency,’ she added.