Care setting considerations

You can increase the success of a GP migration to a new GP clinical system by:

• using a structured digital adoption approach
• using change management tools and techniques
• early engagement
• carry out a thorough impact assessment and stakeholder analysis

For your implementation to be successful you need to understand the impact a new GP clinical system will have on:

• your practice and patients
• services your patients may be using such as:
  • community
  • palliative care
  • mental health
  • secondary health

You should engage with key stakeholders across all care settings that will be impacted by a change of GP clinical system. For example:

• community
• palliative care
• out of hours

Those individuals identified should have a good understanding of their GP clinical system and its capabilities. 

More information can be found in our digital adoption change management chapter along with downloadable checklists.

When migrating to a new GP clinical system take into consideration the impact this will have on:

• your practice
• the wider ecosystem
• your patients
• how your patients will access services they use

Consider how you interact with services and how it will change after the migration. Services such as:

• community
• palliative care
• mental health
• child and adolescent mental health
• podiatry
• physiotherapy
• children

If you have a single system ecosystem, it is assumed that internal interoperability and integration are heavily relied upon. A single system ecosystem would have the same electronic patient record (EPR) across services such as:

• primary care
• community care
• palliative care

When there is a mixed supplier ecosystem then GP Connect will need to be used for:

• booking appointments across the different organisations/systems
• viewing the GP record
• sending and receiving consultation summaries

Primary care networks (PCNs) are managed differently across the regions.  Where the GPs within the PCN are on a single ecosystem (same GP clinical system) they tend to utilise a version of that system for PCN working. 

If you have a single ecosystem it is common to use the internal interoperability and integration. Once you migrate to your new GP clinical system, this interoperability and integration could be lost. The recommendation is to make use of national services such as:

• GP connect
• summary care record

Where available, these should be implemented prior to your GP go live.

You may find that not all your systems were developed using national APIs. This means they might be lacking in some capabilities that you need. If this is the case, your PCN might need to upgrade their system. This could mean extra costs on top of current fees such as:

• licences
• configuration
• activation

It is important to understand all of this ahead of your migration. 

It's important that you don't make any assumptions about your GP clinical system either. Just because it is Spine enabled, it doesn't mean that it is also Smartcard or CIS2 (care identity service 2) enabled. Nor does it mean they are using national live services such as:

• personal demographics service
• electronic prescription service
• GP connect
• summary care record

You also need to consider the following:

• who will provide smartcard and/or CIS2 support
  • will this incur additional costs
• will staff need training on matching patient records to:
  • patient demographics service
  • GP connect
  • summary care record
  • electronic prescription service

Palliative care is usually a charity funded service. Like community, their system of choice may well be Spine enabled. However, they may not have implemented these functions or use smart card/CIS2 access.

You also need to consider the following:

• who will provide smartcard and/or CIS2 support
  • will this incur additional costs
• will staff need training on matching patient records to:
  • patient demographics service
  • GP connect
  • summary care record
  • electronic prescription service

When moving from a single to a mixed ecosystem, consider the systems used within the following services:

• your PCN
• community
• palliative care

If people are not using the national live services and still log in to systems by hand, you will need to look at how they work now. You will also need to plan how they should work in the future to support the GP practice migration to a new GP clinical system. This will help the systems connect and work together.

Things to consider include:

• who will manage and fund smart card/CIS2 access
• will these services need a different version/module of the system
• will these services need to apply for new ODS codes to support general practitioners committee (GPC) capabilities
• dependent on system, providers will need to request a prescribing cost centre ODS code too, irrelevant of if they use EPS or not
• do not underestimate the level of training required in utilising live services once enabled

Create a smoother, safer migration for your practice and stakeholders by:

• working through the above considerations
• prepare each care setting potentially impacted by your migration

These actions will:

• reduce risks
• strengthen interoperability
• ensure all staff affected by the change are ready to work on day one
• maintain continuity of care for patients
• minimise disruption during change

This will provide you with a future proofed digital environment that supports better outcomes across the whole ecosystem.