Cross-booking enhanced access appointments will be more challenging for PCN practices that do not have a solution to incompatible IT systems, clinical directors have warned.
In line with updates to this year’s DES, PCNs are expected to offer appointments between 6.30pm and 8pm Mondays to Fridays and from 9am to 5pm on Saturdays from 1 October.
However, practices within a PCN with differing IT systems have reported a number of issues such as the inability to protect appointments at neighbouring practices in the same network and not being able to edit patient records assigned to another practice.
This has resulted in some practices agreeing to move over to the system used by the majority in a PCN, at some disruption to workflow.
Dr Laura Mount, Central and West Warrington PCN clinical director, moved her practice from EMIS to SystmOne after realising all the practices needed to be on the same system.
She said: ‘That was a huge amount of work. We had a two-week blackout where we could record things on EMIS but they wouldn’t transfer over so we had to do it all manually.’
And Dr Sarit Ghosh – whose network, Enfield Unity PCN, uses EMIS Committee – said there is currently no easy way to allocate appointments to a certain practice.
‘So currently you can book an appointment across from any practice that has the data sharing agreement. But what you can’t do is protect three slots for practice A and three for practice B.
‘They’ll see all the slots and be able to book into all the slots, so practice A may take some of practice B’s: in other words there’s no real robust mechanism to prevent [one practice using the majority of appointment slots].’
One hoped for solution is EMIS’ PCN Hub, which has now launched, and has been cautiously welcomed by clinical directors.
According to EMIS, its PCN-facing solution, which uses EMIS Web, allows PCNs to book appointments from one organisation into another via a shared appointments book.
It does not enable free editing of a patient record by any PCN health professional, however it can provide visibility of a shared record and the ability for the consulting professional to record the consultation back for the patient’s registered GP.
The cost of the solution is based on the needs of an individual PCN, EMIS added.
Dr Ian Wood, a GP and a clinical director for EMIS, said the service has been launched and is in use at Folkestone, Hythe and Rural PCN, Kent.
He said: ‘In terms of enhanced access, the appointment booking in particular will be helpful. So once a PCN has worked out how it’s going to deliver those extra appointments across the network, they’ll need to have availability for anyone working on those services to book easily into them.’
Dr Jeremy Carter, clinical director at Herne Bay PCN, said: ‘On paper it sounds good, especially the booking on and most importantly the electronic prescription service functionality. The proof will be in the pudding though.
‘Currently we have a separate EMIS platform for our PCN provider company that you can book onto from the practice EMIS systems, and opens the host practice page up when you start the consult – so effectively it does a lot of the functionality already, except you can’t EPS from it which is a real pain.’
Dr Bal Duper, clinical director for Oldham East PCN, is concerned about investing in new IT given the limited time left in the Network contract.
‘My hesitancy is what is the financial obligation to a PCN when a lot of these features may already be available or possible within the present system,’ he said.
‘Looking at IT systems, it’s actually quite 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 a PCN coming into our last two years of the five-year plan,’ he said.
‘We want to make sure that we’re signing into a contract that won’t leave us with any liabilities after the PCNs’ five-year plan comes to its end.’
However, he added that the compatibility with SystmOne would be vital for some practices, noting that ‘interoperability with the standard EMIS offer would be challenging to say the least’.
The enhanced access requirement has been the centre of further controversy, with NHS England recently stating it will step in to find alternative solutions with local commissioners if PCNs cannot ‘safely’ deliver the services.