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NHS managers ‘expect’ GPs to go beyond contractual requirements on IT drive



Exclusive NHS England has said it expects GPs to go beyond the minimum requirements set out in the contract for patient online access, after admitting that the minimum requirements will lead to ‘no meaningful improvement’ for patients.

An NHS England board paper on risk assurance has said that unless GPs go beyond the requirements of their contract then the benefit for patients will be limited.

A spokesperson subsequently told Pulse that they ‘expect practices to implement access to records in the most beneficial way for their patients’ which, they add, ‘may mean going beyond the minimum’.

But GP leaders have said that practices could only go beyond the ‘minimum requirements’ if they were willing to ‘shut up shop’ for six months in order to check the accuracy of existing records.

The NHS England risk update states that the ‘technical solutions to support GPs are on track’ to implement the changes in the 2014/15 GMS contract, which brought in a requirement that patients should be able to access their records online by April 2015, and that practices should be able to offer appointments and order repeat prescriptions online by April 2014.

However, it added: ‘The concern is that practices may only implement the minimum requirement, thus there would not be meaningful quality improvement for patients.’

Beverley Bryant, director of strategic systems and technology, NHS England, told Pulse: ‘The evidence shows that patients that benefit most from access to records are those with long term conditions. Those practices that currently offer the service, give access to much more information than the contractual minimum.’

‘A minimum requirement has been set to enable practices to turn the service on without the fear of being overwhelmed. We expect practices to implement access to records in the most beneficial way for their patients. This may mean going beyond the minimum.’

Dr Grant Ingrams, a GP in Coventry, vice-chair of Coventry LMC and a former chair of the GPCs IT subcommittee told Pulse that practices who wanted to go beyond the contract minimums would have to invest months to provide retrospective access to records .

Dr Ingrams said: ‘The biggest problem is checking retrospective records because we have a legal requirement to ensure there’s nothing in that records which will cause the patient significant harm.’

‘Because of that… I’d have to personally look through 1600 to 1800 records. I can’t do that, well we could do that but we’d have to shut up shop and stop being GPs. Say “let’s not have general practice for six months while we sort out what NHS England wants”.’

NHS England stated in December last year that access to the summary care record was the minimum that practices were required to provide but that they anticipated ‘many will want to offer further information’.

And Health Minister, Dr Dan Poulter said in January that GPs would also not be obliged to provide access to the ‘retrospective’ record and would only need to show information added after they signed up.

NHS England has also said patients will be able to update and enhance their own records, but some GPs have voiced concern that even the limited information contained in summary care record could put vulnerable patients at risk.