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Following on from the contract announcement, I am certain practices are looking at the Digital section and wondering to themselves what does some of this mean. The intention of several of the agreements is to enable practices to offer greater digital access to patients, as well as helping manage demand and workload. Making sure digital technology works for practices and helps reduce workload is one of our top priorities; I’m fully aware of the anxiety that these new requirements could cause, so we'll be monitoring this very closely.
The changes are first and foremost predicated on appropriate and functional infrastructure being in place. In this blog I will focus on some of the main agreements and those that will impact practices in 2019/2020.
We hear time and time again of how it’s the simple things that do not work due to being reliant on old archaic hardware, outdated inefficient software or low broadband speeds that simply make our day to day working difficult whilst we try to access patient records and go about our daily jobs. As a result, we have secured commitment in line with the current arrangements for provision of IT and digital infrastructure from the Commissioner, for a recommended specification in order to ensure that all relevant infrastructure is functional, appropriate and up-to-date at all times. A new framework for digital suppliers to offer their platforms on standard NHS terms will be developed.
Recognising the workload intensity and burden associated with processing subject access requests, we have agreed for £20m to be invested into global sum each year for the next three years, this is to cover the costs of Subject Access Requests. This is a temporary measure for the next three years whilst we work to establish a programme to digitise paper records that will commence to enable the creation of a complete electronic record for each patient.
DPO support will be provided for by CCGs, the ethos behind this agreement is that this new requirement on practices as a result of changes to the law should be fully funded and an agreement has been reached that resource will be provided by CCGs.
Noting the importance of having a seamless, uninterrupted electronic health record, and the scale of resources currently being utilised maintaining and storing Lloyd George paper records, we have secured a commitment to move to a fully digitised system over the course of the next three years. NHS England and GPC England will work together on the digitisation of records to ensure it has minimal impact on practices and is prioritised and by doing so frees-up much needed space in many practice premises. This program of work is currently being scoped by NHS England and we will share more details in due course.
Access to records
System functionality dependent, there is an expectation in 19/20 that newly registered patients will have access to prospective data from April 2019, including the ability to add own information. We are currently working through developing joint guidance with NHS England to describe this in more detail, including what practices will need to do whilst ensuring any process adopted is GDPR compliant.
Online appointment booking
With over 25% of patients now registered to book/cancel appointments online, by July 2019, practices will be expected to make at least 25% of all appointments available for online booking. Practices retain control of these appointments, meaning that they can choose which 25% of appointments are offered and what format they take – they do not have to be face to face. These are not new or additional appointments; they are simply 25% of a practice’s current appointments, providing an alternative route for patients to access the booking of appointments. This could for example be a combination of nurse, HCA, telephone triage, GP appointments covering a whole variety of different aspects like smears, flu, phlebotomy, travel clinic etc. It would be fitting to spend some time thinking through this and what it will mean for you as a practice, more guidance on this can be found in our access guidance. Hearing from practices who have increased the number of online bookable appointments, we understand that it has freed up reception time which could be better spent managing other practice related tasks.
You can track appointment booking stats for your practice and compare it with your neighbouring practices and CCGs here.
Electronic prescribing and repeat dispensing
It is estimated that 90,000 patients request prescriptions online every day. As many practices already do, practices are to continue to offer and promote electronic ordering of repeat prescriptions and use electronic repeat dispensing (ERD) for all patients for whom it is clinically appropriate, as a default from April 2019. You can view and track electronic prescription service (EPS) and ERD stats by practice and by CCGs here.
The NHS App is now available for patients to download. It provides patients access to a range of healthcare services and in the future, it will be a platform whereby patients can access their GP record, book appointments, update data sharing preferences etc. giving patients more control over their healthcare. As part of this agreement, practices will be required to provide specific information to the NHS App so that it provides appropriate information to the practice’s patients. GP practices are being connected to the app gradually following a successful pilot with an expectation that all functions of the app should be fully available across England by 1st July 2019, after all GP practices are connected to the app.
Following on from various news stories where faxes have been mislaid, sent to the wrong organisation or simply been an inefficient way of communicating important messages, we have agreed from April 2020 onwards that practices will no longer use fax machines for either NHS or patient communications.
Below you will find a checklist highlighting the key digital requirements for 2019/20 and their deadlines to assist in your preparations; a number of the requirements will be reliant on and will be pending system infrastructure and functionality.
Checklist for 2019/20 (and preparation for 2020/21)
Practices to engage with the CCG about resource for the DPO function for practices
Practices to provide access to prospective data for newly registered patients, with ability to add own information
From April 2019
Practices to use electronic repeat prescriptions/dispensing as the default (as clinically appropriate)
Practices to make 25% of appointments (defined by the practice) available for booking online by patients or their representatives
By July 2019
Practices to prepare for patients to have access to online correspondence
By April 2020
Practices to update their online presence, with key information available as standardised metadata
Further information and relevant guidance will be issued as soon as possible.
the GP app does not allow patients to make appointments with other health care professionals , so alreadywith on line booking we have had patients booking in for GP inappropriately eg for smears as there is no option to direct patients to the correct person. 111 making appointments will be a right mess as 111 assessment of problems is extremely poor and direct patients to completely the wrong place over 50% of the time. this means appointment we would have had for patients is now taken up with unecessary appointments or seeing the wrong person. IT options need to be appropriately developed before this happened. probably as sucessful as NHS engand subcontracting to Capita for making a really disaster out of patient records, payments to practice and pensions.
Digital services are very convenient to use and this is a very good initiative.
Modern medicine gives everyone a chance. Do not give up!