Love 'em or hate 'em, using a computer is an essential part of working as a GP.
Tutorials for commonest clinical IT systems
Thanks to Caroline Sims for allowing us to reproduce these tutorials. If you have come across much better cribsheets for clinical IT systems, please share them with us so that we can publish them for other sessional GPs.
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Frequently asked IT questions
As a freelance GP you'll need to hold all sorts of information - names and addresses of practices; other GPs; colleagues; educational centres etc.
And what do you do with this data - do you market yourself? Is it just for invoices? Do you give your data to other GPs or practices?
It is possible that, as a small business, you may have to register with the Data Protection Act.
Whether you need to all depends on what you use your data for and, needless to say, isn't straight forward. Fortunately, the Information Commissioner's Office website has a series of simple questions to ask and, depending on your answers, will tell you whether you need to register or not (and what can happen if you don't!).
Do you get your own username and password when signing into practice computers? Sick of always being signed in under various combinations of ‘LOCUM1/DRL/LARRYLOCUM’? Perplexed as to how it’s your first time at the practice but looks like you (DRLOCUM) have seen this patient twice already this month? Irritated because you can’t work out who all the other freelance GPs are who’ve already seen this patient? Demoralised for not having the fundamental means for recording auditable medical notes? Struck off for never having officially been enabled to record a consultati…OK, you get the idea.
Secret passwords and usernames are essential to working as a GP – recording contemporaneous medical information in the patient’s notes is a vital part of clinical management; and a medico-legal requirement. And if your password isn’t secret, and call me paranoid, someone else could falsify records in your name. So how come freelance GPs are so rarely given their own? Come on chaps, stand your ground and insist on one! Some of the clinical systems are pretty easy to set up, whereas others aren’t. For example, the procedure for setting up passwords on Microtest can be quite tricky. So we’ve been working with them (and what nice people they are) to make the procedure easier.
@NASGP Huge risk area. I had my name signed to referral letter for a pt I'd never seen. V diff to ensure audit trail in such a setting...
— Dr Catherine Harkin (@buletproofcardi) March 13, 2015
Meanwhile, here is advice provided by Pallant Medical Chambers to shove under the noses of any defaulting practices.
...make it a condition that each practice gives any member working for them a confidential username and password as advised by the General Medical Council, Medical Protection Society2, Department of Health and Good Practice Guidelines for General Practice Electronic Patient Records...
If you're feeling brave*, you may fancy getting yourself a NHS email account. Sessional GPs are eligible for one - either ask the IT person in a practice that you get on well with, or call the IT helpdesk at your local CCG, or its equivalent.
Either way, don't take no for an answer and explain that you need it to access certain courses such as online safeguarding training, for NHS appraisal (in many cases) as an appraisee, and as a GP to pass information securely about patients.
If they try to say no, take their name, their title and the name of their supervisor and read them this:
"I have made a record of your details and your refusal to supply me with a secure NHS email address that is an essential requirement as a NHS GP to transmit patient-identifiable information. I will be passing this information on to my appraiser and to your organisation's Caldicott Guardian so that I can personally ensure that all Information Governance issues have been taken care of".
Then give them your phone number to call you back should new information come to light...
*fantastically secure infrastructure, but be prepared to have to create a complicated new password every 12 weeks or be locked out. Resist the very strong temptation to write it on a post-it note and attach it to your computer. And beware that it is not encrypted if Outlook archives your email.
We have been in regular contact with the Information Security Policy Manager at the Digital Information & Health Policy Directorate (NHS Connecting for Health) to ensure that Sessional GPs are not overlooked - how else otherwise would we be able to access NHS Care Records Service (CRS)?
So far, their news has been that "GP locums, in common with other NHS users of [the NHS Care Records Service] CRS services, will be provided with digital identity and signing credentials on personal smartcards that will allow easy to apply, robust authentication, access and privilege management controls and that will also allow security management practices consistent with the latest NHS information governance guidance. The exact rollout timescales for these smartcards within local communities and for their use in [Local Service Provider] LSP services can be discussed with the local implementation teams concerned to be able to assess local opportunities."
Meanwhile your CCG or local equivalent will be able to supply you with your own smartcard.