Two lines to combat GP cynicism - Jeavons

Tags: Choose and Book GP London

03 Oct 2005

Connecting for Health’s director of service implementation, Richard Jeavons, has attributed GP cynicism about IT modernisation to the newspapes and reports from Parliament’s scrunineer of public spending, the National Audit Office.

After speaking at the New Frontiers conference in London this week, Jeavons was asked by a GP clinical lead how cynical colleagues who have read about public sector IT failures might be better engaged. He replied: “It would be incredibly easy to be defensive and cynical based on what I read in my paper and what the National Audit Office writes and I completely understand that.”

He said he would engage the cynics with two lines of conversation. First, that the development of the use of IT in healthcare is a completely inevitable and enduring proposition. Second, that in the context of spending over the next 10 years the National Programme for IT will cost £6 billion from the £1000 billion likely to be spent on the service. “We shall have invested 0.6% of that [in the NPfIT] to create an infrastructure that will have enormous impact.”

Speaking from a grassroots perspective, Tony Howe, a GP from Dorset, said that he and colleagues were going through the introduction of Choose and Book and had signed up for the incentive payments for the adoption of smartcards and the October deadline for 50% electronic booking.

He said PCTs had been presented with a system not yet fit for purpose. It was slow and unstable, he said. “Why put these rigid date landmarks in place when we are being faced with an incomplete solution?” he asked.

Jeavons responded: “So what’s the learning from the reality you describe which I fully recognise?”

He rehearsed the lessons to be learned from the Choose and Book experience and concluded: “We have to be brutally tough and say we shouldn’t be here,” he said. But he added that despite the problems there was something worth having.

Connecting for Health GP clinical lead, Dr Gillian Braunold said UK GPs led the world in their use of IT but there were still problems with the system which needed to be solved. She said: “The 10% of treatment outside general practice is the most risky and patients care about it passionately. Why then is the information needed about it sitting in my surgery?”

She pointed to the work she and the other GP clinical lead, Professor Mike Pringle, were doing to co-ordinate views on the development of the summary record. The consultation, now in its 19th iteration was available on the internet and Dr Braunold said she was receiving six or seven sets of constructive comments a day on it.

“GPs are in the driving seat” she said.

Reader's Comments

Cynicism

bnq@bneq.net

04 Oct 05 20:10

GPs might be less cynical if we were provided with software that worked, adequately considered deployment plans and less suggestion of chaos & panic.

Jeavons and reality

05 Oct 05 12:10

Maybe Jeavons needs to read the papers and read the Audit Office reports to realise the problem, but I would like to assure him that most GPs have been concerned long before the issues were aired by either.

Learning the Lessons

malcolm.vincent@nhs.net

05 Oct 05 14:10

It's 2005. Surely CfH don't need to make elementary mistakes in order to acquire knowledge on how to avoid them? As a voiciferous opponent of the chosen implementation strategy for C&B, my documented objections about a completely unrealistic view of likely transaction times (never measured during any trial), best use of GP time, the reality of patient expectations as they have been created by the misleading C&B website, etc.ect.have been at best deprecated and usually lost in a fog of "you make some interesting points which we will ...." but they won't!

Richard Jeavons - and sound bites

mary.hawking@nhs.net

05 Oct 05 19:10

If Richard Jeavons *really* thinks that GP concerns are due to " the newspapes and reports from Parliament?s scrunineer of public spending, the National Audit Office." we have a problem: the apparent belief that GPs depend on this type of information, and if the papperazzi and NAO could be fixed, GPs would accept whatever they were told I don't think this is the full story.

GPs are pragmatic - and, as independent contractors, - financially realistic: offer something which makes business sense, and we'll be beating the door down to be included.

You don't *need* to sell the "better mouse trap" - it sells itself!

As a GP (and here I can only speak for myself) I am prepared to make some compromises if - and only if - it is beneficial to my patients.

I depend on IT: we are paperless and our patients depend - as we do - on our GP system (EMIS - but it's the same in other paperless practices regardles of system) for their care.

IT *has* improved patient care in general practice: there are large areas where it has improved patient care in secondary care but a great deal of this is not about the integrated electronic patient record. I don't have sufficient information on this to comment - and anyway, this was going on long before NPfIT: again, business cases and better mouse traps.

There are good things in each of the re-iterations of NHS IT policy ( don't forget that one of the objectives of the 1992 IMG IT policy was to introduce the NHS number.. where would we be now without it?)

I just wish CfH would get their act together! It *ought* to be a great act! Great pity it doesn't appear to be fulfilling promises - and expectations...