it in general practice chris derrett general practitioner barton house group practice stoke...
TRANSCRIPT
What sort of organisation?
12,000 patientsDiversity of age,education, culture and language
7 GPs , 3 nurses , full primary care teamTeaching GP registrars and undergraduatesRented health centre, inner city
General Practices are “small businesses”The majority of GPs are self employedPartners are ultimately responsible for organising
services, premises and staff.
What sort of IT?
We have been using computers in the practice for about 15 years
Clinical records now virtually paperless 26 PC desktops In house server linked to wider NHS by
relatively narrow band connection (512K)
IT now administered and funded by NHS We generally have to deal with minute to
minute IT problems ourselves
Where have we been? Bottom up development Minimal bureaucracy Plurality of GP computer systems Poor interconnection The implementation of basic gp system has
been enthusiastically taken up by many GPs Fast response Local control and bespoke features Responsive on-line help desk Few concerns re. confidentiality issues
Where are we going?
Top down More central control (enterprise systems) Fewer systems providers Many more interconnections Greater potential for economies of scale Multiple priorities Less flexible In theory greater data security(hardware) and
system stability Major concerns about reliability, security and
data confidentiality
Choose and Book (in theory)
• Choice discussed during the consultation– 5 Options– At least 1 private
provider– Clinical performance– Social convenience
• Booking at consultation– Immediate and
convenient appointment
What CfH says.• “The Choose and Book technology works.” • “It is being used in GP practices around the
country and feedback ……. is positive.” • “Having successfully resolved the teething
issues …… the National Programme …… is ready for the wider roll out of Choose and Book.”
• “…….. 100% confident about the availability and reliability of Choose and Book.”
http://www.connectingforhealth.nhs.uk/news/310105/ Dec 2005
No Worries there then
Choose and Book (uptake)
• First Booking July 2004
• By Dec 2005 – 67,820 C+B referrals in England – Yearly total of referrals 10 million
Choose and Book (in practice)
• Choice agenda added later• Is on-line CAB Practical
within the GP consultation?
Choose and Book (in practice)
• Hospital systems are
not yet compatible so
need for call centres
• Poor communications between national and local implementation groups
• Problems with local and central demographic linkage
Choose and Book (in practice)
• Fails to allow clinical control
of priority
• System too complicated for many patients (e.g. those for whom English is not first language)
Choose and Book (in practice)
• Slow access
(lack of understanding of speed requirements)
• Unstable
(several system failures each week)
Connecting for HealthThe Clinical Record Service (CRS)
• What do you regard as confidential?
• Should you have to opt in or opt out?