IT system supplier EMIS will continue offering the integrated QRisk calculator until June next year, after GPs raised concerns over safety and workload.
In November, EMIS notified users of their intention to remove QRisk2, which is licensed by ClinRisk, from EMIS Web.
The supplier said that this was due to ‘a concern regarding the validity of the tools in SNOMED-CT’ as well as the ability to comply with the changing Medicines and Healthcare products Regulatory Agency (MHRA) regulations.
Now EMIS said it has been working ‘closely’ with NHS England, the authors of the existing tools and the regulatory bodies to address these concerns and ‘work towards standardising the safe implementation of integrated calculators’.
In particular, NHS England has worked with ClinRisk and the academic lead to review and validate the SNOMED-CT code sets against the current Read implementation.
NHS England has confirmed that although there are ‘discrepancies,’ the clinical risk due to any differences in these coding systems is ‘low’ and is ‘outweighed’ by the benefit to patients from maintaining the integrated QTools.
The MHRA has extended the deadline for the UK Medical Device Regulation (MDR) changes to June 2024.
In an email to users, EMIS said: ‘As a result of these changes, we believe that the risk benefit ratio is in favour of not removing the tools and that maintaining the tools in their current format is preferable to maintain patient safety. We are therefore able to continue offering the integrated tools within EMIS Web until June 2024.’
In December last year, EMIS had introduced alert messages notifying users of the intended removal of the tools. It is now making system updates to remove these messages.
It comes as GP practices are expected to move to routinely using QRisk3, an updated version of the risk score that takes into account other factors including migraine and severe mental illness. In recent updated draft guidance on statins, NICE said QRisk3 performed best in assessing cardiovascular risk in a UK population.
The email added: ‘We are awaiting guidance from NHS England on when and how QRisk 3 should be integrated by clinical software suppliers moving forward to ensure ongoing compliance with medical device regulations. We will continue to provide updates as they become available.
‘We understand that integrated QTools are a widely used feature of EMIS Web and we thank you for your patience whilst we have worked with national stakeholders to agree a solution which helps you to deliver safe and effective patient care.’
Professor Azeem Majeed, head of the department of primary care and public health at Imperial College London, said this was good news as estimating CVD risk scores for primary prevention would have been ‘much more laborious and error-prone’ without access to QRisk within medical record systems.
He said: ‘Given the emphasis the NHS is putting on prevention, this continued support for QRisk is a positive step.
‘Now that we have a temporary solution, I hope a longer-term fix can also be found so that the support for QRisk continues after June 2024.’
Last month, GPs warned that the removal of the QRisk calculator from EMIS at the end of March would lead to increased workload and could also mean fewer patients have their cardiovascular risk assessed.
Meanwhile, EMIS was recently questioned by GPs over a decision to remove its ‘panic button’ feature, with GPs fearing this could jeopardise safety amid increasing levels of abuse. The button is currently displayed in the top right-hand corner of every EMIS Web screen and staff can use it to send an alert to all other PCs that are logged on to EMIS Web.
EMIS said that they had been made aware that certain local network configurations ‘prevent the panic button functionality from operating as designed’ and that following an internal investigation and ‘in-depth technology review,’ a decision was made to remove it for all customers from June.