Published: 28/04/2005, Volume II5, No. 5994 Page 15
The transfer of GPs' computerised clinical records into systems that connect to the national network will take 18 years at current rates, a confidential report by the national programme for IT shows.
The report, a copy of which has been seen by HSJ, indicates that by March 2005 just 23 practices had moved their data into systems compliant with national systems.
At the current rate, it would take 18 years to move all 9,000 practices, against a target of five years.
And the report shows the transfer will cost some primary care trusts£125,000 more than others.
The transfer involves moving data wholesale from practice-based systems to databases hosted by local service providers. The report describes this as a 'complex task requiring both computer and clinical experience'.
The report also looks at the difference in speed and price between regions. Transfers took twice as long and cost twice as much in the East and North East as in London.
In the East and North East clusters, where LSP Accenture has the contract to deliver national services, the six completed data transfers took on average six to eight months and cost£5,000.
But in London, where BT-led Capital Care Alliance is the LSP, the 17 data transfers took three to four months and cost£2,500.
The report puts the variation down to technical differences and to Accenture using a 'new player' in the data transfer market, resulting in a steep learning curve.
Accenture has used Newchurch, a company specialising in primary care IT, to carry out its work.
In London, CCA subcontracted to GPData, which has been working in GP data migration since 1996.
If maintained, the cost differential has the potential to add£5m to data transfer costs at national level and will add£125,000 to the cost for a typical PCT with 50 practices on its patch.
The report says: '[This] would certainly be sufficient to influence buying behaviour if both suppliers were considered 'safe'.' The report was commissioned by the national programme (now NHS Connecting for Health) in early 2005 and circulated internally in March.
It says: 'The scale of migrations required nationally will necessitate LSPs deploying considerably more resource than is currently available.' The biggest limiting factor is the amount of time it takes GPs and practice staff to check the data before signing off the transfer, the report says.
But it also criticises the LSPs and Connecting for Health clusters for failing to sign off commercial agreements covering data transfer. There was no clear project documentation defining the input required from practices or the quality standards to be met.
GPs will need more funds to provide locum cover during transfers, the report says, while PCTs and strategic health authorities need to make a better business case for transferring.
Newchurch, Accenture and GPData declined to comment.
A Connecting for Health statement said: 'We commissioned a report precisely because of the importance of the issue which we want actively to manage... we have shared the information with our suppliers and we are already addressing the thrust of the appropriate recommendations.'
Why the switch must go ahead
If GPs do not join the national network in large numbers, it will put the brakes on the national care records system, choose and book, electronic transfer of prescriptions and practicebased commissioning - to name a few.
And unless they can be sure their data will not get lost or distorted in the process, they will be very reluctant to make the switch.
Observers say the process is in crisis.
There are several key issues:
GPs' income is based on their quality and outcomes framework scores which are derived from their clinical data. Loss of data potentially means loss of salary.
Loss of data compromises patient safety.
Data migration requires hours of work from GPs and practice managers to check the quality of the transfer.
Many lack the capacity.
Expertise is limited. To date, transfers have been ad hoc, with around 500 a year taking place.
It has been a small industry served by subcontractors providing a bespoke service.
Not everyone agrees on what constitutes acceptable quality in data transfer.
'Basically nothing has happened nationally in the last 10 years and now we have a gaping big hole, ' says one industry insider.
'GPs have to be able to trust promises on data transfer because patient safety and their income depends on it.' Another independent source added: 'One crucial thing to successful transfer is experience.
The fear is that the big multinationals are parachuting in and saying 'leave it to us' when they do not have the expertise to back up their claims.'
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