GP Out of Hours ICT Management, Maintenance, and Support

The regional GP OOH clinical information system (Adastra and Odyssey) is the central piece of the GP OOH ICT infrastructure. DXC and via their contractual relationship with Advanced provide a managed service to provision and support these services. The Regional GP Out of Hours (GP OOH) service provides, for urgent conditions, a comprehensive, safe and efficient Out of Hours Service to the Northern Ireland population, who are also entitled to General Medical Services (GMS) services until the patient's own GP surgery is next open." During the covid pandemic the OOH service was expanded to provide an in hours Phone First Service for Trust ED departments directing patients to the most appropriate point of care. The Phone First services have continued post pandemic and will continue for the foreseeable future. This also expanded the service from an out of hours (6:00pm to 8:00am) service to a 24x7x365 service. There are 5 Out of Hours Providers commissioned by the Department of Health Strategic Planning and Performance Group (SPPG) to provide the GP Out of Hours Service to the population of Northern Ireland. These five GP Out of Hours provider organisations in Northern Ireland deal with over 600,000 patient contacts per year. The services are required to provide continued management maintenance and support of the Regional GP Out of Hours Clinical information system and the supporting IT services that enable its operation. Moving to an alternative provider incorporating all of the required managed services provided by DXC is not possible before the expiry of the current contract. Transferring the technical support services, experience, and expertise that DXC provide to another supplier without an appropriate knowledge and skills transfer process would be extremely high risk to the continued operation of the GP Out of Hours service and could not be done safely within the time currently available. We estimate it would take at least six months to safely transfer the support of these services to another provider and this would require both DXC as the current provider and the new provider to be involved jointly in the hand over process. Failure of the OOH service means that patients, by default, will attend the already overburdened Emergency Departments. Outside of Advanced, who currently provide the out of hours software solution to over 95% of UK and ROI service providers there are only two other suppliers across the whole of the UK and Ireland. One is the GP software provider TPP - their software is used by one small OOH provider in England. The TPP solution does not have all the added benefits such as Nurse Triage and integrated decision support. This would not be sustainable in NI as the numbers of GPs available to provide OOH services is diminishing and service is moving to increase the use of nurses and other multidisciplinary teams. The TPP solution does not integrate with the current infrastructure in Northern Ireland for example NIECR nor does it provide the messaging services to GP Practices following a consultation with the Out of Hours service. Considerable development work, requiring additional time and cost, would be required to facilitate development of this functionality.