NHS: GP Computer Systems (Hansard, 6 July 1998)

§ The Minister of State, Department of Health (Baroness Jay of Paddington)

The information requested is as follows.

Recommendation 28 called for the National Health Service Executive to:

re-examine the feasibility and cost benefits of co-ordinating the purchase of hardware and software, using the purchasing power of the NHS to secure the most cost-effective solution.

The recommendations of the efficiency scrutinies have been taken into account in the continuing development of the NHS Executive's Information Management & Technology Strategy for the NHS. A study was undertaken during the previous administration which resulted in best practice guidance being issued to health authorities. This report (HA/GP Links review of Benefits) was published in March 1997.

Following the change of government, a more detailed study has been undertaken in broad consultation with health authorities and other relevant interest groups to identify and assess briefly the potential of co-ordinated general practitioner system purchasing initiatives and identify areas where the NHS Executive may have a role to play in co-ordinating GP system purchasing.

The main conclusions of this exercise were that:

the potential for bulk procurement is limited, given that 90 per cent. of practices are already computerised and many would be reluctant to undergo the costs and risks of changing suppliers;
there are opportunities for active intervention by both health authorities and the NHS Executive to make significant savings on current GP computing spending;
there is relatively little co-ordination to ensure value-for-money, and spending restrictions deter health authorities from active intervention;
the practice/supplier contractual relationship has benefits, but is open to exploitation by suppliers;
the potential to make significant cost savings is currently constrained by national GP computing policy, which is intended to provide reimbursement to individual practices to purchase independent systems which meet their own practice requirements.

The main recommendations made from the study were that:

health authorities consider the opportunities identified in this report for improving value-for-money from GP computing;
the NHS Executive and its regional offices undertake certain co-ordination activities which are WA 105 best carried out once centrally, such as developing model contracts for use by suppliers and practices;
the NHS Executive encourages HAs to allocate resources to GP computing co-ordination, and removes the existing disincentives;
the NHS Executive investigates alternative models of providing GP information systems in the future—for example, one based on a view of practices forming an integral part of the NHS providing services to patients.

Work is continuing within the NHS Executive to see how these recommendations can be taken forward within the context of the review of the IM&T Strategy currently being undertaken, and the Government's plans for the reorganisation of primary care services and the exploitation of information technology to improve the delivery of healthcare as outlined in the recent White Paper The new NHS—modern and dependable. The report of this later study was published in April 1998; a copy is available on the Internet at: http://www.btwebworld.com/imt4nhs/

Recommendation 30 called for the NHS Executive to:

take action to co-ordinate the efforts of the GP system suppliers to ensure their limited time and resources are deployed to best effect.

Following the publication of the efficiency scrutinies under the previous administration, the NHS Executive has established the NHS Executive and Systems Supplier Liaison Forum to maintain and consolidate effective liaison with GP systems suppliers through a series of regular meetings. These meetings include systems suppliers from secondary and community care sectors of the NHS, as well as the involvement of Primary Care policy representatives and others as appropriate. The NHS Executive continues to develop close relationships with system suppliers in support of the Government's plans to ensure that all GP practices are using the NHS's information superhighway, the NHSnet, by 1999.