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Ch 1 strategic context

Chapter 1 - Strategic context for the Good Practice Guidelines for GP electronic patient records v4 (2010)

1.1 Introduction

The pace of change within the NHS is relentless and the new political and economic landscapes of recent times will have a significant and ongoing effect on the NHS environment. Equity and Excellence: Liberating the NHS[^1] sets out a radical agenda for changing the structure of the NHS in England, placing GPs at the heart of clinical and budgetary decision-making. An "information revolution" will be required to enable GPs to fulfil these new responsibilities[^2].

Set against these realities is the continuing drive to increase the quality, accessibility and accountability of health services and the health professionals who provide them. Good records sit at the heart of high quality clinical care.

General Practice has always been the most computerised sector of the NHS. Electronic patient records are now well established as the preferred means for storing and using patient personal health data to support clinical care, including prescribing, morbidity coding and business processes such as referrals and the Quality and Outcomes Framework (QoF).

1.2 Background

A recent joint review by representatives of the Department of Health Informatics Directorate ("The Informatics Directorate") and the BMA & RCGP Joint GP IT Committee (JGPITC) concluded that there was still a need for professionally owned, authoritative guidance to update and replace the Good Practice Guidelines for GP electronic patient records v3.1 (GPGv3.1 2005). The new Good Practice Guidelines for GP electronic patient records v4 (GPGv4 2011) would act as a reference source of information for all those involved in developing, deploying and using general practice IT systems. GPGv4 would also need to maintain and update the link between earlier versions of the GPG and the GMS & PMS regulations.

1.3 GPGv4 scope and definition

The joint review of the scope and content of GPGv3.1 demonstrated the need for a complete re-write of the guidelines to include all the existing sections, and extend the scope to include new services (e.g. Summary Care Record, Electronic Prescription Service & GP2GP messaging) into the mainstream guidance. The review also concluded that there is a need to develop new guidance in areas such as high quality clinical records and data quality to facilitate records sharing, inter-operability and communication within a clinical safety framework.

From a strategic perspective, GPs are increasingly likely to share their record systems with other health professionals and electronic patient records may have multiple contributors over time. For this reason the inter-operability of records and the quality of the health data they contain will be the central themes of the revised GPGv4, described within a clinical safety framework. The overall GPGv4 project brings together the various chapters and strands that will make up the guidance to ensure that our electronic patient records are "fit for sharing" in a modern NHS.

There are new safety standards issued by NHS Information Standards Board (ISB), which present new requirements for Health Organisations to manage the safety of applications during implementation and use. These dovetail with requirements on system suppliers to provide systems which are risk assessed and developed to mitigate patient risk.

The Joint GP IT Committee has representation from its parent bodies and GP system supplier national user groups from all four Home Nations. The JGPITC feels it is essential to maintain a UK-wide approach to the GPGv4 project and to GP records inter-operability, which would also ensure we are able to capture best practice from a UK perspective and ensure key stakeholders are engaged.

1.4 GPGv4 Content

The GPGv4 document is published as an executive summary, quick reference guide and full reference report in 12 chapters as below;

  1. Strategic Context for the Good Practice Guidelines for GP electronic patient records v4 (2010)

  2. The Purposes of Health Records

  3. Clinical Safety Assurance

  4. Records Governance

  5. Shared Electronic Patient Records

  6. High Quality Patient Records

  7. Clinical Coding Schemes

  8. Data Transfer & Interoperability

    a. The Personal Demographic Service

    b. GP2GP Electronic Record Transfer

    c. Data Migration

    d. Clinical Messaging

    e. The Summary Care Record and Emergency Care Summary

    f. High Quality Medication Records & The Electronic Prescription Service

  9. A Pathway to Good Paperless Practice

  10. Electronic Document Attachments

  11. Working in an e-business Environment

  12. Education and Training

[^1]: Equity and Excellence http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_117353

[^2]: An information Revolution http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_120080

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