Industry View: GP IT Contract and Internet First

At the recent King’s Fund Conference, Matt Hancock announced a new update to the GP IT contract and a move from private networks to an internet first approach.

We asked the industry for their views on these announcements and what it would mean to them.

Contributors include: X-on, Sectra, Siilo, Echo, Spirit Health, Refero and Innopsis.

Jane Rendall, President, Sectra UK

Matt Hancock’s announcement that the NHS will move away from N3 and HSCN networks to run services over the internet could have significant implications for NHS diagnostic departments across the country. So far, only one NHS trust runs its enterprise imaging over the internet, with its picture archiving and communication system (PACS) now in the cloud. This is having a tremendous impact. The trust no longer needs to worry about network capacity to deal with an ever-growing volume of diagnostic images. The organisation is in a stronger position to remain up-to-date with the latest patches, virus software and Windows updates. A whole layer of additional management and complication has been removed, that doesn’t need to involve the trust’s busy IT team. From the radiologist’s point of view, and for other healthcare professionals, imaging is accessible much more quickly to make vital diagnoses and decisions on patient care. As the technology provider working with the trust to enable this so far unique approach, Sectra is eager to share lessons with other trusts, and other vendors, to support the internet first national direction for the NHS.

Joost Bruggeman, Co-Founder of Siilo

Moving away from private networks such as N3 and HSCN in favour of an internet-first policy is an important first step towards a more collaborative NHS – an NHS looking to adopt and share digital health solutions and, ultimately, improve patient outcomes.

An internet-first policy will not only support the growing need for health professionals to work flexibly and communicate remotely but it will also ensure there is an open up the ecosystem to proven, off-the-shelf ideas as well as newly developed digital tools, potentially transforming the NHS, which for too long has been impregnable to change, ready-made solutions and digital health innovations.

Likewise, we should be tremendously encouraged by Hancock’s challenge to tech companies to develop new and innovative systems after the tender for the GP IT Futures Framework is issued.

For too long the NHS has been dominated by a small number of suppliers receiving long-term contracts and, as a result, they have become complacent. This, combined with often outdated technology has slowed down innovation and, in many instances, left organisations with solutions that are frustrating and do not fit with the evolving digital age that they experience in their personal lives.

I, therefore, welcome Hancock’s decision to open up the market to be more competitive and challenge the status quo; by nature, competition drives innovation and improves the overall quality of that innovation.

Stephen Bourke, Co-Founder, Echo

This is a positive step for the HealthTech start-up community. For too long data silos have held back innovation, frustrating interoperability and the NHS from delivering the type of services that patients expect in 2019.

Paul Bensley, Managing Director, X-on

It is welcome that the new GP IT Futures framework will help to ensure that GPs benefit from the best technology, which quite rightly should adapt to meet their needs. General practices have long been pioneers of using IT to underpin the delivery of high standards of care. Now the right cloud-based communications infrastructure is available, and there are positive discussions between practices and their suppliers, which all points to exciting times ahead for primary care IT. This framework should build on the great work to date, so we can continue to work together to help GPs to reduce their admin burden, engage with patients using phone and video, and use technology to support the delivery of excellent patient care.

Chris Barker, CEO Spirit Health Group

The move to cloud computing, including HSCN and a new GP IT contract, will enable greater collaboration between GP Practices, while the essential investment into Cyber Security will ensure data is securely stored.  The move will support greater efficiency through information sharing and improve the use of analytics on the significant amount of data in primary care, with the aim of delivering improved workflows and better patient care. All this will drive the best use of NHS resources. This work is not quick or easy but the announcements are welcome news.

Dr Ian Jackson, Medical Director and Clinical Safety Officer, Refero

I was interested to read about Matt Hancock talking about the new tender process (GP IT Futures) designed to replace the old GP Systems of Choice framework. This is a brave new approach promoting the move to cloud-based systems and is valued at close to £0.5 billion.  The hope is that this will encourage competition and new players in the market.

Hancock states “I believe it should be as easy for a GP surgery to switch IT provider as it is for a small business to switch bank accounts.” Sadly, though this is a good soundbite, it is not nearly as easy as he suggests. Safe data migration and transfer onto a new system can be a nightmare – witness the scandal seen following issues with ‘relatively simple’ banking systems (e.g. TSB).

In health, experience gained the hard way means that those looking at data transfer have to consider the quality of the data i.e. is it reliable and required for continued safe care of the patient, where does it sit within the new architecture, how can we check the integrity following transfer and of course where is it presented when required within the new system. There are a huge number of data points linked to each patient, and how these are recorded can change even between two practices using the same IT system.

In reality this will make it more difficult for new contenders to enter the market. It might also mean that either existing information is lost for easy review or there is acceptance of a need for the legacy system to view much of the old data which cannot easily be transferred.

Mike Thomas, Managing Director, Innopsis

Across the Public Sector, the proposal to migrate services to the Internet is accepted. HSCN, in many respects, is technology agnostic with additional controls and service assurance that supports NHS drive to digital, therefore we see use of the Internet as complementary and not a radical change in direction.

In relation to interpretations on the NHS policy paper, we need to understand the context of time. To fully migrate into an ‘Internet Only’ world, would rely on all relevant applications being available on the Internet. The National Centre for Cyber Security (NCSC) suggests that an internet connection is an acceptable option, provided that the service is treated as untrusted and that additional security should be deployed to protect the data in transit. Currently the vast majority of applications that NHS workers would need to access are not internet enabled, and do not have the application security recommended by NCSC yet. Indeed, the estimate is that it could be well over seven years before those applications meet the standards published or are replaced. Whilst there are pockets of NHS workers where this will be achievable much sooner as new applications are being deployed, there will need to be a greater focus and investment to bring this gestation period shorter. Therefore, HSCN will remain as the prime choice for NHS consumers for some time.

The focus for NHS-Digital should be enabling public facing, internet delivered, front ends to their current applications, where appropriate. This will help realise the Secretary of State’s vision of an internet based Health Service, complementing not replacing HSCN.