Dr Nigel Watson answers questions on replacing printers,accreditation of clinical systems and virus protection


Q Our practice has been told by the PCT that we must replace all our traction feed printers with cut sheet feed printers, because in 2003 the NHS will stop buying the prescription paper for traction feed printers. Is this true? We will need to replace 15 printers.

A The simple answer is no, your PCT is wrong. However, there are some elements of truth in its statement. Traction feed dot matrix printers are no longer manufactured and prescription paper for this type of printer will eventually be phased out, but this is not likely to happen in the near future.

You could ask your PCT if it is willing to reimburse 100% of the cost of replacement printers when the NHS withdraws the old-style prescription paper. If it agrees, you could replace your old printers with new laser printers. They use cut sheet prescription paper, are quicker, quieter and print more clearly.

Electronic prescribing, using computer-generated FP10 forms, will help the situation.1 However, although there are pilots underway, it is not yet clear if the target of 2004 for a programme to be rolled out across the NHS will be met.

Q We are not convinced that computers help to provide a better quality of care in general practice. We have therefore refused to upgrade our practice clinical system to accept pathology links because that does not fit in with our working practice. As a result, the PCT has said that our clinical system is no longer accredited and has refused to reimburse us for maintenance. What can we do about this?

A PCTs have been told that all practices must be able to receive electronic pathology results by April 2003. Your PCT is therefore trying to meet a target that it will be judged on.

Under the ïRed BookÍ the PCT is expected to reimburse up to 50% of the cost of maintenance of an accredited system. Check what version of your clinical software you are using and ask the supplier if it complies with the latest requirements for accreditation. If it is, challenge your PCT on this point. If you need additional help contact your LMC.

Tell the PCT that you will upgrade your system, but that you expect to receive 100% reimbursement. This does not commit you to accepting electronic pathology results - it just provides you with the capability to receive them.

Your question raises wider issues, however. Computers and electronic health records are not the answer to every problem in the NHS. However, you should think about the possible benefits as well as the problems of electronic systems.

Increasingly paper records are giving way to electronic solutions. More and more practices are using electronic health records2 as the main record, so they will increasingly be transmitted electronically between practices. GP2GP, a project to transmit electronic health records between practices, is due to be rolled out in 2004.

In the near future, all pathology and X-ray results will be sent electronically. Later, all clinic letters and discharge summaries will be sent this way. Electronic prescribing1 should be available within 18 months and will be the norm for all by 2008.

If the new GMS contract is agreed, robust clinical information - obtained from computerised health records - will be essential to achieve many of the quality standards.3

Practices are wise to review their current use of IT and plans for the future4 - ignoring IT developments now could mean a mountain to climb in the future. Talk to other GPs whose computer systems are more advanced than yours and ask to visit their practices to see at first hand how they are used.

Q We have been told that as NHSnet is a private network it has an effective firewall and therefore we do not need software to protect our IT system from viruses. Is this true?

A Again, the answer is no. NHSnet is the largest virtual private network in Europe,5 and although it does provide some protection, practices do need software to protect their computers from viruses.6

It is thought that when the Melissa virus was attacking computers through the internet, NHSnet reduced but did not entirely remove the risk.

Anti-viral software needs to be properly installed and upgraded regularly. Firewalls6are an important form of protection in addition to anti-viral software and are cheap and easy to install.



  1. Watson N. Electronic prescribing will speed up repeat prescriptions. Guidelines in Practice 2001; 4(8) 47-50.
  2. Watson N. What EHRs and EPRs will mean for GPs. Guidelines in Practice 2002; 5(2) 74-8.
  3. Watson N. The new GP contract: implications for IT. Guidelines in Practice 2002; 5(5) 79-82.
  4. Watson N. Why every practice needs a computer development plan. Guidelines in Practice 2001; 4(4) 80-4.
  5. Watson N. NHSnet revolutionises information exchange in the new NHS. Guidelines in Practice 2001; 4(6) 85-90.
  6. Watson N. How secure is your computer system? Guidelines in Practice 2002; 5(3) 68-70.

Guidelines in Practice, December 2002, Volume 5(12)
© 2002 MGP Ltd
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