GP Systems of Choice (GPSoC)

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1 GP Systems of Choice (GPSoC) Update October 2006

2 Contents 1 Introduction 3 2 Scheme status 4 3 Overview of the scheme 5 4 Funding 4.1 IT infrastructure Annual service charges Migration 6 5 GPSoC compliance levels 9 6 IM&T DES requirements 10 7 Progress 7.1 With suppliers With GP representatives With GPs, PCTs and SHAs OJEU procurement for a GPSoC Framework GPSoC infrastructure requirement Data migration specification Existing System Compliance Status 13 8 Timescales 14 9 Contact for further information Frequently asked questions 16

3 GP Systems of Choice (GPSoC) - Update October Introduction The purpose of this document is to provide an overview of the GP Systems of Choice (GPSoC) scheme. GPSoC remains a proposed scheme and is subject to approval by the Department of Health and HM Treasury. GPSoC has been developed with strong input from GPs, via the NHS Connecting for Health primary care clinical leads. Subject to agreement with GP system providers and funding approval, GPSoC will become the basis on which primary care trusts (PCTs) will continue to support provision of clinical IT systems for GPs. The aims of the GPSoC scheme are to benefit GPs, patients and the NHS by: Maximising the benefit to both patients and the NHS of the mature and high use of IT in the general practice care setting. Under GPSoC, existing GP systems will be upgraded to take advantage of the new services provided by NHS Connecting for Health. These include the NHS Care Records Service, Choose and Book, the Electronic Prescription Service and GP2GP (General Practice to General Practice electronic patient record transfer). Offering GPs a choice of clinical IT systems. This will allow GPs to continue to benefit from the investments they have made in their clinical IT systems, or benefit from new Local Service Provider (LSP) systems. Supporting the IT requirements of the General Medical Services contract (GMS). Upgrading local practice IT infrastructure, where necessary, to the level required to operate GPSoC compliant systems and to benefit from the new NPfIT services. Providing clear funding guidance for all GP systems included within the GPSoC scheme.

4 4 GP Systems of Choice (GPSoC) - Update October Scheme Status GPSoC is under active programme management and, because of the need for additional funding is subject to approval by the Department of Health and HM Treasury.

5 GP Systems of Choice (GPSoC) - Update October Overview of the scheme Under GPSoC, GPs may: move to the GP clinical system(s) offered by their LSP keep their existing GP clinical system, undergoing upgrades as they become available under GPSoC move to another existing GP supplier s clinical system. All of the above will require an element of system migration. However, this brings risks and GPs will wish to minimise the number of system migrations undertaken to ensure that the quality and integrity of patient data is maintained. The following suppliers are working with the Department of Health to develop GP Systems of Choice: Ascribe plc BT (LSP for the London cluster) CSC (LSP for the North West & West Midlands, North East and Eastern clusters) Egton Medical Information Systems (EMIS) Fujitsu (LSP for the Southern cluster) Healthy Software In Practice Systems (InPS) isoft plc Microtest Seetec The Phoenix Partnership (TPP) Inclusion within GPSoC will be subject to satisfactory agreements being concluded with each supplier. It should be noted that the scope of GPSoC is limited to GPs and practice staff, including practice managers and reception staff only. It excludes traditional community staff such as health visitors, district nurses, etc, for whom provision will be made by the appropriate LSP.

6 6 GP Systems of Choice (GPSoC) - Update October Funding It is proposed that GPSoC will provide funding for practices with GPSoC compliant systems on the following basis: 4.1 IT infrastructure Minimum standards for infrastructure (equipment and network) will be set by NHS Connecting for Health. PCTs will receive funding to ensure GPs reach this minimum standard. Capital funding will be available in 2006/07 for practices that achieve GPSoC level 1 compliance (See Section 5, compliance levels). 4.2 Annual service charges GPSoC funding will only be available for GPSoC compliant systems. Suppliers will be funded centrally via NHS CFH. Funding for service charges will be available once GPSoC contracts are in place and the practice system is GPSoC compliant. Payments will be made from contract anniversary. A small number of service charges will start to be funded from late 2006/07 onwards with take up increased from 2007/08 onwards. Upgrade costs will be included in annual service charges, providing for the cost of deployment of upgraded software and associated training. 4.3 Migration The intention of GPSoC is for practices to retain their current system of choice as it is upgraded through the GPSoC compliance levels, or move to an LSP solution. For this reason, funding to support the migration itself will only be made available for the following scenarios: (a) (b) moving to the GP clinical system(s) offered by the practice s LSP keeping the practice s existing GP clinical system, undergoing upgrades as they become available. GPSoC funding will only apply to migration to GPSoC compliant systems and will only include the full cost of migration for options (a) and (b) above, i.e including any data migration, training and deployment costs. The cost of migration from one existing supplier system to another existing supplier system will not be funded by GPSoC, except in the specific circumstance in which one system at Level 1-3 is migrated to another system at Level 4. GPSoC will make a fixed contribution to cover the data migration cost in this case. Service charges for the system to which the practice has migrated will be funded, subject to there being a business and clinical case for the switch. The diagrams on page 8 and 9 illustrate the planned funding options. All of the above will require an element of system migration. GPs will wish to minimise the number of system migrations undertaken to ensure that the quality of patient data is maintained.

7 GP Systems of Choice (GPSoC) - Update October Funding for existing system upgrade or move to LSP system

8 8 GP Systems of Choice (GPSoC) - Update October 2006 Funding for data migration between existing systems

9 GP Systems of Choice (GPSoC) - Update October GPSoC compliance levels GPSoC puts in place a scheme to increase the functionality, security and reliability of GP systems. It will also increase the ability of systems to interact with the NHS Care Records Service (NHS CRS) and other NPfIT services as these are introduced. GPSoC will encourage GP system providers to upgrade their systems through a series of compliance levels in accordance with the GPSoC Solution Maturity Model. The levels provide an objective basis on which to evaluate systems, and set minimum standards which GPSoC systems must achieve. The national standards become more stringent as higher compliance levels are achieved, and provide a roadmap along which practices can plan, aligned with the strategic objectives of the NPfIT. There are six compliance levels within the GPSoC Solution Maturity Model: GPSoC level Level 0 Level 1 Level 2 Level 3 Level 4 Level 5 Level 6 Description RFA 99, QMAS/QoF and Information Governance (IG) Level 0 plus Choose and Book, Personal Demographic Services (PDS) access/update capability and Electronic Transmission of Prescriptions (ETP) Version 1 Level 1 plus ETP Version 2 and upwards Level 2 plus GP records transfer capability (GP2GP) Level 3 plus system provided as a data centre hosted solution to NHS CFH standards Level 4 plus ability to access/update the summary patient record held within the Personal Spine Information Service (PSIS) on the NHS care record spine. Ability to share clinical information with other systems via the spine (e.g. Diagnostics Requesting & Reporting). Use of SNOMED CT Coding. Level 5, plus fully integrated with the LSP Care Record Service system across all care settingswith other systems via the spine (e.g. Diagnostics Requesting & Reporting). Use of SNOMED CT Coding. The achievement of each level will be dependent on achieving compliance with the requirements of all previous levels. Level 0 is the minimum standard for participation in the GPSoC scheme. A system will be recognised as GPSoC compliant only once the Level 1 requirement has been achieved. Systems compliant with Levels 1 to 5 can be provided by Existing System Providers (ESPs) as well as LSPs. Suppliers will be able to choose what level they wish to achieve. Level 6 is the fully integrated LSP solution, in which the GP clinical system is fully integrated with all other care settings. The GPSoC compliance process will be administered by NHS Connecting for Health.

10 10 GP Systems of Choice (GPSoC) - Update October IM&T DES requirements Practices will be eligible to receive the Direct Enhanced Services (DES) Component 4 payment once they have successfully migrated to NHS CFH accredited hosted systems. The specifications produced for GPSoC set out what is required for accreditation as a system hosted to NHS CFH standards. All existing suppliers of GP clinical systems have access to these specifications and are being encouraged to design their new hosted systems or upgrade their existing hosted systems to meet these requirements. Whilst a number of GP clinical systems are currently hosted, the majority do not currently meet the stringent NHS CFH standards for performance, business continuity and disaster recovery. As a result, the only systems that meet NHS CFH requirements for hosted systems under DES are: - InPS Vision 3 Enterprise Edition (as delivered by BT CCA in the London Cluster) - isoft Synergy Enterprise (as delivered by Accenture in the North East and Eastern clusters). Suppliers technology roadmaps will provide details of when they intend to roll out hosted systems that meet NHS CFH requirements. The above list will be updated as more systems achieve this status thus allowing practices to become eligible for the relevant DES payment. In recognition of the fact that it will take some time for most systems to achieve compliance with NHS CFH hosting requirements, the deadline for claiming the DES Component 4 payment has been designed to allow claiming up to 31st March 2008.

11 GP Systems of Choice (GPSoC) - Update October Progress Since the announcement of the proposed GP Systems of Choice (GPSoC) scheme in March 2006, significant progress has been made. 7.1 With suppliers NHS CFH has held a series of detailed and productive discussions with existing GP clinical system suppliers since GPSoC was announced. The objective has been to agree a standard set of service delivery requirements and commercial arrangements which will apply to all suppliers. Progress with suppliers has been good and their responses to the GPSoC proposals formed a key input to the GPSoC Full Business Case. 7.2 With GP representatives NHS CFH has established the GP Pan User Group (GP PUG) as a mechanism to engage with the user groups of existing GP clinical system suppliers included under GPSoC. The chair of each supplier s user group is a delegate to the GP PUG. The RCGP/BMA Joint IT Committee is also represented at the GP PUG. Minutes of the initial GP PUG meeting on 14 July 2006, at which the proposals for GPSoC were discussed, together with the GP PUG Terms of Reference, are available via the GPSoC website. Future meeting minutes of the GP PUG will also be published on this site. NHS CFH is also in discussion with RCGP/BMA GP IT Committee in their role as representatives of GP interests in the provision of IT services to GPs by the NHS. NHS CFH will be undertaking a significant programme of GP engagement events during Autumn Proposals for GPSoC will be described at these meetings and members of the GPSoC programme team will attend to answer questions from GPs about GPSoC. For further details visit: 7.3 With GPs, PCTs and SHAs NHS CFH has held a number of workshops, attended by representatives from all five clusters to gain input from the GP and IM&T community on the plans for the scheme. NHS CFH has also provided regular updates to the SHA CIO Forum and will continue to work closely with SHA chief information officers on plans to implement the scheme. 7.4 OJEU procurement for a GPSoC Framework NHS CFH plans to conduct a formal procurement to create a standard mechanism for contracting with existing GP clinical system suppliers.

12 12 GP Systems of Choice (GPSoC) - Update October 2006 The advantages of this approach for GPs and the NHS are: A GPSoC Framework of all GP system suppliers will simplify the exercise of GP choice. This will allow practices to select their system, now and in the future, from suppliers whose systems meet all the core requirements for service and support requested by GPs. A GPSoC Framework will replace the myriad different contracting mechanisms now in place, ensuring that all contracts for the supply of GP clinical systems are based on an openly advertised and competed procurement. The introduction of a competitive environment will gain better value for money for the NHS. Central management of suppliers will ensure that development and delivery of new services such as access to the Summary Care Record can be progressed effectively on a national basis for the benefit of patients. The procurement of the GPSoC Framework via an OJEU advertised procedure could take as little as three months following formal approval of the scheme. The intention is that the GPSoC Framework contract will be held between the Department of Health and existing system suppliers. It is envisaged that PCTs will enter into call off contracts with suppliers, on behalf of practices, based on the terms of the framework contract. Practices will have a clear and active role in confirming their selected system. The announcement of GPSoC in March this year made it clear that only a small number of service charges would be centrally funded this year with take up increased from 2007/08 onwards. The target date for the substantive implementation of GPSoC remains 1 April 2007 when, subject to Full Business Case approval, funding will be available to deliver the project. 7.5 GPSoC Infrastructure Specification The GPSoC Infrastructure Specification will set out priorities for investment in GP practice IT to ensure optimum performance of NHS CFH applications alongside local business applications. Comments on a draft specification have been received from SHA CIOs and the document will be updated before wider circulation later this month (October 2006). Subject to business case approval, it is anticipated that funding will be released to SHAs for distribution to PCTs. PCTs will then be required to make local decisions with regard to the local investment required to meet the requirements of the GPSoC Infrastructure Specification.

13 GP Systems of Choice (GPSoC) - Update October Data Migration Specification As part of the GPSoC programme, a data migration specification is being developed which will set out the standards for all aspects of migration from one GP clinical system to another. These standards will apply to migrations between systems provided by the same GP system supplier as well as to migrations to a system provided by a different GP system supplier. The purpose of these standards will be to reduce the risks associated with a practice s choice to migrate to another GP clinical system The NHS CFH National Clinical Leads are working with colleagues in the Department of Health and in the profession to clarify the guidance regarding the legal requirements on GPs for retention of and access to historical patient data following system migration. The output of this work will be used to agree with suppliers a clear and equitable basis for ongoing access to historical data post migration. The GPSoC programme team is keen to ensure that the data migration specification addresses any particular issues or concerns relating to data migration and data retention encountered by GPs. Please the GPSoC programme team with your recommendations (see section 9 for contact details). 7.7 Existing system compliance status GP system suppliers have continued to work with NHS CFH to successfully develop and deploy Choose and Book, Electronic Prescription Service and GP2GP transfer functionality, all of which are required components of the GPSoC levels of compliance. It should be noted that no existing GP clinical system can claim to be compliant with GPSoC requirements, since formal evaluation against the new compliance levels has not yet been undertaken. Based on current supplier plans it is anticipated that all systems will be at GPSoC Level 1 at the formal inception of the GPSoC scheme. The compliance status of existing GP clinical systems will be assured using a new, robust approach known as the Common Assurance Process for GP Systems CAP (GP). CAP (GP) updates the former GP system accreditation regime (RFA99), and incorporates the appropriate elements of the LSP product assurance and Spine compliance testing regimes. Significant work has been undertaken by NHS CFH, in consultation with GP systems suppliers and GP representatives, to develop CAP (GP). CAP (GP) is currently being piloted with suppliers.

14 14 GP Systems of Choice (GPSoC) - Update October Timescales The target date for full commencement of the GPSoC scheme across the NHS in England remains 1 April However achievement of this target is dependent on the timescale for approval of the scheme by the Department of Health and HM Treasury.

15 GP Systems of Choice (GPSoC) - Update October Contact for further information Please visit for copies of published GPSoC documentation. Please to contact the GPSoC programme.

16 16 GP Systems of Choice (GPSoC) - Update October Frequently asked questions When will GP Choice be available? GPSoC is planned to start on 1st April 2007, subject to DH and HMT approval. We are endeavouring to create the scheme with a sound foundation at the earliest opportunity. Can I continue to use my current GP system? Yes. The GP Systems of Choice (GPSoC) proposal provides for compliance testing of current GP systems. GPSoC funding will only be provided for GP systems that have achieved a GPSoC level of compliance. The following GP system suppliers have confirmed their intention to achieve compliance under this regime: Ascribe plc BT Capital Care Alliance (LSP for the London cluster) CSC (LSP for the North West & West Midlands, North East & Eastern clusters) Egton Medical Information Systems (EMIS) Fujitsu (LSP for the Southern cluster) Healthy Software In Practice Systems (InPS) isoft plc Microtest Seetec The Phoenix Partnership (TPP) Inclusion within GPSoC will be subject to satisfactory agreements being concluded with each supplier. Can I change to another GP system supplier? Yes. The intention of GPSoC is for practices to retain their current system of choice as it is upgraded through the GPSoC compliance levels, or move to an LSP solution. For this reason, funding to support migration will only be made available for the following scenarios: (a) (b) moving to the GP clinical system(s) offered by their LSP keeping their existing GP clinical system, undergoing upgrades as they become available. GPSoC funding will only apply to migration to GPSoC compliant systems and will only include the cost of migration for options a and b above. The cost of migration from one existing supplier system to another existing supplier system will not be funded by GPSoC, except in the specific circumstance in which one system at Level 1-3 is migrated to another system at Level 4. GPSoC will make a fixed contribution to cover the data migration cost in this case.

17 GP Systems of Choice (GPSoC) - Update October Service charges for the system to which the practice has migrated will be funded subject to there being a business and clinical case for the switch. Will the PCT be able to force me into changing my GP system? The GPSoC proposal aims to fund compliant systems from existing system suppliers. This will provide clarity on funding for PCTs with financial pressures in respect of GP systems and will facilitate GP choice. An appropriate performance management regime will be put in place. Does my practice database have to be hosted at a data centre outside the practice? To achieve Compliance Level 4, the GP system requires off site hosting. All suppliers of Level 4 hosted GP systems will have to demonstrate how they will provide and maintain business continuity in the event of a disaster. This will include an explanation of where practice data will be stored and how it will be recovered Migration to a Level 4 hosted solution will attract a contribution to costs under component 4 of IM&T DES. Such payments are only available once practices have moved to a hosted solution. When will my GP system become eligible for DES Component 4 payments? The specifications for NHS CFH hosting standards have been published to all suppliers listed in Section 3 of this document. All suppliers are currently working to develop their hosted systems to meet these requirements. NHS CFH will validate achievement of the hosting standards, and will confirm further information as suppliers achieve the appropriate status. In recognition of the fact that it will take some time for most systems to achieve compliance with NHS CFH hosting requirements the deadline for claiming the DES Component 4 payment has been designed to allow claiming up to 31st March Who will run those data centres? System suppliers are free to choose the provider of their data centres and may choose to run their data centres themselves. There are many expert operators in this field. The key proviso is that this infrastructure provision must meet stringent information governance, business continuity and disaster recovery requirements.

18 18 GP Systems of Choice (GPSoC) - Update October 2006 When will the GPSoC Infrastructure Specification be issued? The GPSoC Infrastructure Specification was reviewed by SHA CIOs during September, and a revised draft is due to be issued during October. This document will be for information only, and subject to business case approval by DH. Do any of the LSP GP systems have a special status in these new arrangements? No. Under the proposed arrangements for GP Systems of Choice, the LSP provided systems will be measured by the same criteria as the systems provided by the existing system suppliers, allowing GPs to choose between systems on an objective basis. The only exception will be that value for money is already proven in the business case for migration to LSP systems. Will a fully integrated Level 6 GP system be available in my area? GPs are already enjoying the benefits of integration with community, mental health and child health services in some clusters. In time, LSPs will develop solutions that are fully integrated with all care settings. The intention is that fully integrated Level 6 solutions will be available to all practices from their LSP. What happens when a fully integrated Level 6 GP system is available? Will I be forced to move to it? When a fully integrated Level 6 GP system is available and certified by GP professional representatives as offering improved functionality compared to other GP systems, there will be an expectation that practices will migrate to that system. Will there be significant differences in functionality between the systems offered by current GP suppliers and a fully integrated Level 6 system? Systems that are not fully integrated, can never offer as effective data sharing and transfer as a fully integrated system. The standards for non-fully integrated systems will seek to minimise the difference.

19 GP Systems of Choice (GPSoC) - Update October How will a system offered by a current GP supplier integrate with community and mental health records? Before full integration, standards will be used to maximise the communication between health service sectors. What is the role of the Spine for practices using systems from current GP suppliers? Existing system providers will offer functionality that is currently available through the Spine. This includes Choose and Book, the Electronic Prescription Service, GP2GP and personal demographic information. A number of existing GP system providers have already implemented elements of this capability. In future releases, the Spine will also hold the Summary Care Record. Existing system providers who support hosted systems will be able to link with the Summary Care Record. How will my GP system be funded? There is capital funding available in the 2006/07 financial year to upgrade the IT infrastructure in GP practices where an upgrade is required to meet the requirements of the LSP or upgraded existing system providers systems. Funding for service charges will be available once GPSoC amendments have been included in local agreements and the practice system is GPSoC compliant. Payments will be made from contract anniversary. A small number of service charges will start to be funded from late 2006/07 onwards with take up increased from 2007/08 onwards. Funding for compliant systems provided by existing system providers will be provided by NHS Connecting for Health who will also continue to fund the LSP systems. Why has NHS Connecting for Health bowed to GP pressure and diluted its vision for a fully integrated record system? The strategic goal for NHS Connecting for Health remains the provision of GP systems which are fully integrated within the LSP solution. GP Systems of Choice aims to ensure that GPs who choose to retain their existing systems can achieve a level of integration with the applications being rolled out by NHS Connecting for Health such as Choose and Book, GP2GP, the NHS Care Records Service and Electronic Transmission of Prescriptions

20 Full details on the GP Systems of Choice scheme can be found on our website at: NHS Connecting for Health is delivering the National Programme for Information Technology Crown Copyright, 2006 Ref 3569

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