Cross-booking enhanced-access appointments will be more difficult for PCN practices that don’t have a solution for incompatible IT systems, clinical directors have warned.
In line with this year’s DES updates, NCPs are expected to offer appointments between 6:30 p.m. and 8 p.m. Monday through Friday and 9 a.m. to 5 p.m. Saturday starting October 1.
However, practices within a PCN with different IT systems reported a number of issues such as the inability to protect appointments in neighboring practices on the same network and the inability to modify patient records assigned to another firm.
This has led some practices to agree to move to the system used by the majority in a PCN, at the cost of some disruption to workflow.
Dr. Laura Mount, Clinical Director of Central and West Warrington PCN, moved her practice from EMIS to SystmOne after realizing that all practices had to be on the same system.
She said: “It was an enormous amount of work. We had a two-week power outage where we could save things to EMIS, but they couldn’t be transferred, so we had to do everything manually.’
And Dr Sarit Ghosh – whose network, Enfield Unity PCN, uses the EMIS committee – said there is currently no easy way to assign appointments to a certain practice.
“So you can currently make an appointment in front of any practice that has a data sharing agreement. But what you can’t do is protect three slots for drive A and three for drive B.
“They will see all slots and be able to book in all slots, so practice A can take some of practice B: in other words, there is no real robust mechanism to prevent [one practice using the majority of appointment slots].’
One hoped-for solution is the EMIS PCN Hub, which has now been launched and received a cautious reception from clinical directors.
According to EMIS, its PCN-centric solution, which uses EMIS Web, allows PCNs to book appointments from one organization to another via a shared appointment book.
It does not allow the free edition of a patient file by any PCN health professional, but it can provide the visibility of a shared file and the possibility for the consulting professional to record the consultation for the general practitioner patient approval.
The cost of the solution is based on the needs of an individual NCP, EMIS added.
Dr Ian Wood, GP and clinical director for EMIS, said the service has launched and is being used in Folkestone, Hythe and Rural PCN, Kent.
He said: “In terms of improved access, appointment scheduling in particular will be helpful. So once an NCP has determined how they will provide these additional appointments on the network, they will need to be available for anyone working on these services to easily book there.
Dr Jeremy Carter, Clinical Director of Herne Bay PCN, said: “On paper it sounds great, especially the booking and especially the functionality of the e-prescribing service. The proof will be in the pudding though.
‘Currently we have a separate EMIS platform for our PCN provider company where you can book from the practice’s EMIS systems, and opens the host’s practice page when you start the consultation – so effectively, it already does a lot of functionality, except you can’t get EPS out of it, which is a real pain.
Dr Bal Duper, clinical director for Oldham East PCN, is concerned about the investment in new information technology given the limited time remaining in the network contract.
“My hesitation relates to the financial obligation to an NCP when many of these features may already be available or possible in the current system,” he said.
“When it comes to computer systems, it’s actually pretty cheap to get them: it’s the add-ons that add up. The cost is the support afterwards, and that’s what we need to think about, especially as NCPs entering our final two years of the five-year plan,” he said.
“We want to make sure that we sign a contract that will leave us with no liability after the end of the five-year plan of the NCPs.
However, he added that compatibility with SystmOne would be vital for some practices, noting that “interoperability with the standard EMIS offering would be difficult to say the least”.
The enhanced access requirement has been at the center of further controversy, with NHS England recently saying it would intervene to find alternative solutions with local commissioners if NCPs cannot deliver services safely.
A version of this article originally appeared on our sister title Pulse.
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