New GMS Contract - IM&T Guidance
Date: 15 September 2003
Email: John Steyn
Lothian Primary Care Trust and West Lothian Trust
IT has an essential part to play in the delivery of the new GMS Contract.
This document has been prepared to clarify short and medium term arrangements
for ongoing procurement and support of IT equipment and services within Primary
Care.
1 Software
Where Practices use clinical software other than GPASS, the
responsibility for meeting the cost of this clinical software is now the
responsibility of the Trust. Rather than the Practice meeting the cost and
having the monies reimbursed, the Practice should contact their supplier and
arrange for the invoice(s) to be sent to Helen Buchan at IM&T Department,
Mackinnon House, Royal Edinburgh Hospital, Morningside Terrace, Edinburgh EH10
5HF. The Trust will settle the invoice (following confirmation that the
Practice is continuing to use the software).
With respect to the operating system (eg Windows
NT or Windows 2000) and other non-clinical software, the cost of software
licences will be met by the Trust. Requests for new additional software is
dealt with under the heading of Additional Software.
2 Hardware (including Maintenance)
The Trust has been tasked with the responsibility of providing maintenance of
the network at the Practice. The Service Level Agreement (SLA) which the Trust
will be expected to meet, will be forwarded to all
Practices separately.
The Scottish Executive are anticipating that, following the standardisation
of hardware on which the non-GPASS Practices run, maintenance arrangements will
be the same for all Practices – whether using GPASS or non-GPASS clinical
software.
The degree to which the Trust will provide
maintenance expertise internally, as against subcontracting to a third party
contractor, is currently being discussed. It is expected that any third party
contractor would have to be a nationally approved contractor (it is of course
possible for any supplier to subject themselves to the procurement exercise and
bid for national approval).
The concept of computer reimbursement has been replaced under this new
process. Practices should not be committing themselves directly to any
expenditure (other than consumables eg printer toner,
floppy discs, paper) – as there will be no cost to the Practice if the
Trust orders and pays for services.
For Practices who currently have a maintenance agreement with a third party
contractor, this maintenance agreement will continue to the due date of expiry.
It is the responsibility of the Trust to arrange maintenance thereafter.
Barbara McKenzie or Helen Buchan will contact the Practice Manager prior to
expiry of the current maintenance agreement to identify the arrangements for a
single point of contact for call handling thereafter.
For Practices who currently use the "central maintenance contract"
co-ordinated by Barbara McKenzie, then the Trust will be in contact in due
course once arrangements for a single point of contact for call handling have
been put in place.
The Trust has commenced the process of establishing an agreed asset register. A
technical support analyst from the Trust is visiting each Practice – and
collating a list of all hardware and software used within the Practice. This
listing will be itemised, and then discussed with the Practice Manager so
agreement can be reached with each Practice on the extent of the IT network and
software licences for which the Trust is then assuming ongoing responsibility.
Hardware and software which has been fully funded by the Practice or reimbursed
by the Trust will remain the property of the Practice. Hardware and software
provided by the Trust will remain the property of the Trust. The clinical data
on the software is the property of the Secretary of State for Scotland, but
under the custodianship of the Practice.
3 GP Choice – Change in Clinical Software
It is explicit in the new GMS contract documentation that Practices will have
the opportunity of putting forward a business case for changing clinical
software. A business plan pro forma will be available for Practices to complete
– so that information is presented in a standardised fashion, and so that
all requests can be prioritised using the same parameters. In particular,
Practices will need to demonstrate the added value to clinical care of their
patients that will be gained by changing software as part of the business case.
It is recognised that there is a considerable cost to the Practice in terms of
time that requires to be spent on ensuring accurate migration of data from old
software to new software, as well as a significant training requirement to
enable all members of the primary healthcare team to gain the necessary new
skills. It should be stated that business cases will be assessed against
available funding and local priorities.
A Business Plan template will be sent to all Practice Managers by the end of
September, and the completed pro forma should be forwarded to Helen Buchan.
4 Additional Hardware and Additional Software (incl
Fostering Innovation)
Practices requesting additional hardware or additional software will use the
same business case pro forma as mentioned above. Additional hardware will be
centrally procured and installation arranged by the Trust.
This category of additional hardware and additional software will
incorporate the requests for extending the network to include additional
primary care team members. Where members of the primary healthcare team do not
currently have access to clinical software, the additional licensing costs will
be met by the Trust. The business case pro forma will be the mechanism of
highlighting and prioritising this process.
This category also includes requests for non-standard and/or non-core
hardware or software.
5 Replacement Programme
With respect to hardware replacement and software upgrading, it is the
responsibility of the Trust to have a programme of hardware replacement. A
review of the asset register will define the hardware that is programmed for
replacement each financial year. This programme will be co-ordinated by Barbara
McKenzie. Decision on upgrading software versions will be taken after
consultation at both local and national level.
6 Training
The Trust is tasked with providing necessary training
for both clinical software and non-clinical software. A training needs analysis
will be undertaken at Practice level. The advantages of
having a named trainer attached to LHCCs has
been identified. A full range of training options will be used, including
Practice based training, computer based training,
group sessions, and taking advantage of the increasing protected learning time
within the LHCCs. It is recognised that the preferred
format of training will vary from Practice to Practice, and discussion will
take place between the trainer and Practice Manager on the preferred option in
each individual situation. A member of the training department will contact
each Practice Manager. Requests for funding for external training should be
made to Helen Buchan. Requests for priority for internal training should also be
made to Helen Buchan.
Following receipt of completed business cases, requests for resource will be
considered and prioritised by a steering group. The steering group will have
representation from Lothian Primary Care Trust, West Lothian Trust, LHCC, LMC,
GPs, Practice Managers and Practice Nurses. The process for prioritising
investment in business cases will be transparent – and will focus on
delivering improvements in clinical care.
In order to keep the process less bureaucratic, it is anticipated that the
business case pro forma will only be used where the investment being requested
is significant, or innovative. Where practices have an “urgent”
need for replacement that cannot wait for this formal review, or the amount is
less than eg £1,500 per financial year,
Practices should contact Helen Buchan directly.
The situation indicated for all the above issues is identical for GMS
Practices and PMS Practices.
