How the NHS IT programme, TPP's SystmOne, CSC and BT can help GPs during the floods

One result of the floods is that a GP practice in North East Lincolnshire is working from a neighbouring practice, and another is working from a local hospital’s accident and emergency department.


They’re able top operate by way of BT’s “N3” network linked to a remote data centre. Other GP practices have been spared closure because their clinical data was held remotely.

This is one of the advantages of the NHS’s National Programme for IT [NPfIT]. Part of the programme involves storing medical records at data centres run by NPfIT local service providers.

And so, for some GP practices in North East Lincolnshire, the deliverer from the floods was TPP, an NPfIT supplier of the SystmOne GP system. TPP is a subcontractor to CSC, the main local service provider to the national programme.

Says SystmOne on its website: “Patients’ clinical data recorded on SystmOne is held safely in a secure data centre and not in the practice itself. In the past, flooding would have meant closing the surgery, which would have had serious consequences for business continuity resulting in appointments, patient clinical history information and prescriptions not being available.”

TPP does not, however, name the GP practices it has helped to save from the floods, or give details of the costs, or any of the complications of, for example, setting up a surgery at the local hospital A&E department .

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My (admittedly quite remote) practice loses regularly for hours or days without any particular warning its N3 connectivity. DNS down, local exchange down, telephone network down, whatever. All several times over the last 6 months. So often anyway that I ceased noting it as a significant event.

Patient data though is stored both locally and held on backup tapes outside of the practice. So lack of N3 connectivity has fortunately no serious relevance for us.

Should at any stage our practice be so badly become flood damaged that our server was killed, our N3 line would be gone too (same shelf) and the building in all likelihood be gone too. After all which flood reaches a server rack in 1 mtr height but leaves the building usable?

I could still set up practice with my backups and some borrowed boxes - in the community hall or wherever. A few hours and I would be running again.

But would I get N3 connectivity overnight - when they are quite clearly unable to keep delivering in a reliable fashion even at normal times? I doubt it.

Peter von Kaehne

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To be very clear, this is no particular gripe about N3 (Scottish Version), just a much more general comment towards the faulty thought that centralised data storage causes less likely problems and is more likely recoverable. I doubt it.

Catastrophic failure scenarios are obviously easily conjured up, but the daily experience is that I am still working when telephone etc network is (not infrequently) down, but I would not if my data was held somewhere else. A city experience might be very different.

Peter von Kaehne

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We have similar problems with the HPA's connectivity, especially now that we use a web-based system ('HPZone') for case management.

When the HPA considered and consulted on its IT strategy there was a unanimous view from frontline staff that data should be held locally, not centrally. After all, we are supposed to be critical in the event of emergencies, which could well take out internet access. If data is held locally, then we could at least carry on doing much of our work - and recording our actions - in this event.

It would be possible to do this - we could use mirrored local servers, which could synchronise with central servers in real time (and a delay of a few minutes would seldom if ever be an issue). Unfortunately, the cost of this approach is considered excessive.

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