New choices for GP IT

There is a drive and commitment across the NHS to modernise primary care and reduce burdens on practice staff. We’re working to deliver the next generation of products to help achieve this.  

A key part of this is the Tech Innovation Framework (TIF). Running alongside our other commercial frameworks, the TIF will allow people who buy digital systems for general practice to procure, through the Buying Catalogue, a new set of assured products that are public cloud hosted, browser-based and built around open APIs. These products enable patient care to be delivered in more flexible ways and can easily scale up to meet the demands on primary care.   

The TIF was established in summer 2022, following research with the system and the market to understand more about the current challenges with existing solutions, and what the barriers were to change. 

As you might expect, some common themes emerged. For example, practices reported being repeatedly faced with the challenge of needing to use multiple systems to deliver patient care. The framework addresses this by mandating the use of direct care APIs, which will enable increased interoperability.

There were also clear calls for more flexibility. The TIF will introduce internet-first products that will allow GP staff to work in new ways. And with products that are hosted in the cloud, suppliers can be more responsive too.

The TIF vision has called for a significant re-think about what’s required of clinical products in general practice. We have had to make sure that what is on offer is innovative, makes use of the best tech available and puts users at the centre. The only way to do that has been to continue to work closely with the system and suppliers, existing and new, that will be at the forefront of this change. 

The suppliers on the TIF are working on products that are: 

• public cloud-hosted, so suppliers can innovate and deliver change in an agile way 
• internet-first, so end users, such as clinicians or clerical staff, can work from a browser and not be tied to one location 
• making use of open APIs, so integration with third parties is much simpler 
• adopting new standardised FHIR APIs to integrate with national programmes, so they can adapt to national change with reduced burden 
• putting users at the centre of their designs, to make sure that they support modern ways of working in general practice 

In an environment as complex as the NHS there are significant challenges to overcome to be able to introduce the first new clinical system in 25 years. We’re doing it in the relatively short timeframe of 18 months. And we’ve also had to get the balance right between being prescriptive about requirements where appropriate, whilst also supporting and encouraging innovation.

For example, any solution that operates as a GP’s main clinical system requires compliance with over 30 standards, including complex and detailed rules around information governance, clinical safety and data. It also needs to integrate with more than 25 pieces of national tech infrastructure, including NHS products such as the Summary Care Record, the NHS App, the Electronic Prescription Service and NHS e-Referral Service. As these products develop and iterate, so do the architectural requirements for TIF suppliers. 

In order to compete in the market, new products have to offer something that improves upon what is already out there. Take the GP record itself – perhaps the most complex and important source of patient data within the NHS. GP clinical systems are constantly receiving, processing and submitting data from and to other sources, to enable patients to get the care they need in the right place at the right time. It’s critical we get this right, and that the tech on offer is the best it can be to support this.

Any system needs to not only do this but be able to do this more seamlessly than before, with less manual entry and a better user experience. The better our clinical systems are, the more time those people working on the frontline have to provide patient care. 

Within 18 months we’ve made significant progress. We have a number of suppliers on the framework. Two are on target to go live in practices in the new year.         

There’s also support for buyers and primary care settings who are keen to start thinking about embedding these new cloud-based systems too. Through the Early Adopter programme, which has been running in tandem with the work we have been doing with suppliers, we’ve been supporting integrated care boards who are keen to make this change with support and guidance, as well as funding. This includes giving advice about discovery, change planning, implementation, migration and service acceptance.   

The work’s most certainly not over yet, but we’re confident that the changes ahead will mean more choice for buyers and ultimately, will raise the bar for suppliers in the GP IT market.

This work will also make a significant difference to practices, and to patients, by improving efficiencies, supporting new models of care and place-based working. There will also be further support available to practices to make the challenge of migrating systems as smooth as possible. And as we progress with the TIF, in the next few months we’ll be sharing stories from practices who have started to go through this change.