q The GP IT Futures framework promises

to create an open, competitive market to encourage the best technology companies to invest in the NHS. All systems will be required to meet minimum standards to ensure they can “talk to each other” across boundaries. The Department of Health and Social Care (DHSC) criticised the current market for being “dominated by two main providers”, saying this slows down innovation and “traps” GP practices in long-term contracts with systems that are “not suited to the digital age”. The framework suggests moving patient data to cloud-based services which would allow secure, real-time access to clinicians and patients. It also wants every patient in England to have the option of accessing GP services digitally, with practices offering online or video consultations. The plan is designed

to free up staff time and reduce delays by allowing “seamless, digitised flows of information between GP practices, hospitals and social care settings”. Any digital providers who do not meet the new standards will not be used by the NHS, and the government will seek to end existing non- compliant contracts. Health and social care secretary Matt

Hancock said: “Too often the IT used by GPs in the NHS – like other NHS technology – is out of date. It frustrates staff and patients alike, and doesn’t work well with other NHS systems. This must change.” The framework will be overseen by NHS Digital and builds on Mr Hancock’s recently published tech vision for the NHS.

Higher death risk with missed GP appointments

PATIENTS with long-term health conditions who miss GP appointments are at greater risk of premature death, according to new research. The likelihood of missing appointments

increased with the number of long-term conditions, particularly among patients with mental health issues. These patients were found to be at significantly greater risk of all- cause mortality. The study in BMC Medicine found patients with long-term mental health conditions who missed more than two appointments per year had a greater than eight-fold increase in risk of all-cause mortality compared with those who missed no appointments. These patients died prematurely, commonly from non-natural external factors such as suicide. Researchers concluded that missed appointments represent a “significant risk marker” for all-cause mortality, particularly in mental health patients. They described existing primary healthcare appointment systems as “ineffective” and

urged practices to develop further interventions to increase attendance by these patients. RCGP Chair Professor Helen

Stokes-Lampard echoed the report’s conclusions and said patients with long-term conditions need regular monitoring and treatment and advice tailored to their unique health needs. She added: “People miss appointments for

a range of reasons but this study highlights why it’s more important to show compassion to people who fail to attend, rather than punishing them - for some, life gets in the way and they forget, but others might not turn up precisely because of their health issue.”

HOSPITAL DEATH CERTIFICATION E-TRAINING Doctors in Scotland are being encouraged to complete two e-learning modules on death certification produced by NHS Education for Scotland (NES) in partnership with Healthcare Improvement Scotland. They are designed to support certifying doctors in completing Medical Certificates of Cause of Death (MCCDs). Access the modules at: www.sad. death/death-certification

q STAFF TRAINING KEY TO DIGITAL FUTURE Healthcare staff should be trained in emerging technologies such as genomics, digital medicine and artificial intelligence to ensure the NHS is equipped for the challenges of the 21st century. That is one of the key messages of the Topol Review which looks at the role of technology in the future of NHS care. The report states that, within 20 years, 90 per cent of all jobs in the NHS will require some element of digital skills. Access the report at


ANTIBIOTIC PRESCRIBING FOR PNEUMONIA NICE and Public Health England have published two draft guidelines on antimicrobial prescribing for pneumonia to optimise antibiotic use and reduce resistance. It advises that antibiotics should be given to people with pneumonia within four hours of establishing a diagnosis. Oral antibiotics should be given as first-line treatment unless the severity necessitates IV antibiotics. Read more at


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