GP2GP

GP2GP Common Questions and Answers

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General

Q:Which EMIS version is GP2GP compatible with?
A: Currently GP2GP is compatible with EMIS LV and is in development for EMIS PCS.

Q: When a response of Request Rejected is received, how long will it remain in the user’s inbox, and what should the practice do to deal with it?
A: It will remain there until the user selects to complete the task; it will then be archived.

Q: Do we still have to follow the paper process when registering patients?
A: Yes, the manual process must continue and will not stop until there is absolute confidence that the GP2GP process is robust.

Q: What patient types are compatible with GP2GP?
A: Only regular patients are transferred.

Q: When a record is transferred via GP2GP, should the new practice add Medical Records Received via RS, or should this only be done when the practice receives the Lloyd George record?
A: This is a GP Links function that runs independently of GP2GP. GP Links functions/processes should continue at the moment.

Q: When a record is sent and received electronically using GP2GP, should both practices add information to the record to show this, for example clinical term (Read code) 9b08, or is a flag of some kind automatically added to the record? If so, is there another clinical term for the opposite?
A: It is not necessary to add codes for these transactions, as they are recorded in the audit trail and a major alert is displayed on all records sent using GP2GP. However, the practice can add a clinical term so that these transactions can be found in searches.

Q: When the previous practice send the record, should they then mark the record in RS as a deduction request, or should this be left as normal to be dealt with by GP links at the health authority?
A: The HA will request the Lloyd George record via GP Links. The GP Links process has not changed and should continue as it does now.

Q: Are major alerts transferred as part of the patient medical record diary?
A: No.

Q:When the patient record is imported using GP2GP, does this also update the patient’s NHS number, or is this only updated though GP Links?
A: The patient’s NHS number is held on the Spine. When a patient is registered, the user will try to find the patient on the Spine. If the patient is successfully identified, their NHS number is downloaded to the practice’s EMIS system. This happens before any GP2GP processes, or requests, are initiated between the patient’s new practice and their previous practice. If the user cannot identify the correct patient when searching the Spine, no NHS number is sent from the Spine; the patient’s NHS number is sent in the usual way using GP Links.

Q: When the patient’s previous practice has sent a record, how do staff at that practice know not to add any more information to the record?
A: When a user finds the patient using F5 Patient Find, an alert is displayed, stating that the record has been sent electronically.

Q: Allergies are not automatically recorded when a record is imported; how are allergies dealt with?
A: When using GP2GP, there are two possible scenarios for allergies:
EMIS to EMIS transfer: The allergies are filed automatically and no action is required.
Third party to EMIS transfer: The practice must access the Inbound Allergy Task area to deal with the records, as they need to be reviewed and added individually. This is because third party software uses different coding that will not transfer into EMIS clinical systems.

Q: Is it possible to select which clinical terms are added to a patient’s record?
A: No. You can either import the patient’s previous EMIS clinical record or save the record as an attachment.

Q: Is it possible to view the patient’s record before deciding to accept?
A: Yes. You can view all aspects of the patient’s previous record and also preview how the merged record will look.

Q: When does ownership of the medical record change?
A: Duty of care for the patient changes at the point when the new practice registers the patient as a regular patient, so the record also becomes the new practice’s responsibility at that time.

Q: Are additional MUMPS licences required for GP2GP?
A: No. However, some practices may already be experiencing problems in the background that are not immediately noticeable, for example opening attachments. In these cases it may be desirable for the practice to obtain further licences to ensure the smooth running of Workflow Manager.

Q: Date entries of NK in Choose and Book (CAB) transfer as the year 1841; is this the same for GP2GP NK dates?
A: No, GP2GP NK dates are displayed at site B the same as at site A.

Q: If the record that is being transmitted is too large to send via GP2GP, does the sending practice and/or the receiving practice receive notification?
A: The sending practice will have a 'Records To Send Error' task in their Workflow Manager. The task history lets them know that the record was too large to send via GP2GP. At the receiving practice, the task in Workflow Manager remains as 'Record Pending'.

Q: Is Docman 7 now compatible with EMIS?
A: All PCTI products and other approved document management systems (such as from Apollo) allow attachments to be sent.

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Go Live

Q: A user cannot see WF - Workflow Manager on the EMIS LV main menu. Why is this?
A: It may be that the practice has not yet gone live. However, if other users at the practice can see WF – Workflow Manager, the user’s security level may need to be changed. Workflow Manager is displayed by default for level 6 users only. The practice must edit other user profiles to enable other users to view Workflow Manager.

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nGMS Contract

Q: Is it correct that the new practice gets the QOF points from the previous practice?
A: Yes. The information for the patient is viewed as if it were natively entered.

Q: At what stage will clinical terms relating to the nGMS contract be updated in Population Manager?
A: When Population Manager is run, as it is coded data.

Q: If the previous practice has added clinical term 9344 - Notes Summary on Computer to the patient’s record, this will transfer to the new practice. How will this affect QOF?
A: The new practice must still add the clinical term, as GP Links is still active. It is the logging of records sent by the health authority that starts the ‘clock ticking’ for QOF.

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Registrations and PDS

Q: Are there any changes to the way patients are registered?
A: No. The procedure remains the same. However, the smartcard must be in the reader.

Q: Is there a limit on the size of the patient record file that can be transferred using GP2GP?
A: There is a file size limit of 5 Mb including attachments, with a maximum limit of 99 attachments. This is limited by the Spine, not by EMIS. This means, for example, that a 0.5 Mb record with 4.7 Mb of attachments would not be sent. Most patient records, excluding attachments, are about 200 Kb. CFH’s calculations suggest that a limit of 5 Mb still allows 99% of all record transfers to take place.

Q: When a practice registers a newborn baby, using the pink registration form that includes the NHS number, the baby is not recorded on the Personal Demographics Service (PDS) because this is its first registration. Does the practice have to wait for the Patient Retry screen to be displayed before it can cancel the GP2GP process?
A: When a baby is born, the hospital forwards the details of the birth to the health authority. The health authority then uploads the baby’s details onto the Spine. At this stage it is likely that the parents would not have decided on a name for the baby, therefore it may have been uploaded onto the Spine as Baby (parent(s) surname). This will likely affect the baby’s GP2GP registration. As long as the baby has an NHS number it is most likely going to be on the Spine, therefore you should be able to find the baby using the advanced trace.

Q: If a practice is looking for a patient on the Spine and cannot find the right one during the registration process, what should they do?
A: The practice must try various strategies, such as excluding the patient’s middle name(s). Sometimes middle names which are double-barrelled are incorrectly recorded; some middle names are included on the Spine but not on the local system, or vice versa; and sometimes only the initial letter of the middle name is on the Spine. Small differences like this can affect the result of a search. One practice noted that their search worked when they completed the mandatory fields, but excluded the patient’s forenames. If the practice cannot find the correct patient after reasonable attempts, it is better to cancel the search than select the wrong patient.

Q: Users need to register patients whilst logged on to EMIS LV with their smartcard, but do they need to be logged on to EMIS LV with their smartcard if they are accessing Workflow Manager? Or are they prevented from doing this, as they may be accessing it to send EHRs?
A: Users are not prevented from accessing Workflow Manager. Eventually Workflow Manager will be used to access a whole range of modules, not just GP2GP.

Q: If a restricted access patient (with a password) is transferred, will they still be restricted at the new practice? If so, can only level 6 users access the record?
A: No, the patient will not be restricted at the new practice.

Q: If a practice has registered a patient without using a smartcard, can they go back into EMIS, deduct the patient, insert the smartcard, reregister the patient and use the PDS?
A: This method is not recommended, as it would have serious consequences for GP Links.

Q: If a patient is flagged (previously referred to as stop-noted), how can a practice identify them on the PDS?
A: If a direct match is obtained on a flagged patient when the practice is using GP2GP PDS Advanced Trace, the GP2GP process stops immediately, but the patient’s NHS number is added to the patient’s record. If the patient details return a multiple match of less than 50 on a flagged patient, blanked-out data is displayed on the GP2GP PDS Advanced Trace Patient Select screen. The practice cannot select the patient but, as with a direct match, the patient’s NHS number is added to the patient’s record. In both of these situations the practice must use the traditional paper record transfer method to complete the patient transfer.

Q: If the PDS returns multiple matches and the user is unsure which to select, what happens if they press ESC (Escape) to exit?
A: GP2GP only works as a complete process. If the user exits the process, they cannot try again at a later time. It is therefore important that the patient completes the initial paper registration form with as much information as possible: the more information the patient gives, the easier it is to find them using the PDS.

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Consultations

Q: When a patient record is transferred from the previous practice, how is it displayed in CM – Consultation Mode?
A: The name of the GP at the previous practice and the place of consultation are displayed in the consultation.

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Scanning and attachments

Q: If a practice files an incoming record as an attachment at a later date, can this be changed to a merged record?
A: No.

Q: What will happen if the new practice uses the same file name for an attachment as the previous practice did?
A: This is not a problem. Although the file name for the incoming attachment appears to be the same as an existing file to the user, the database actually stores the file with a different file name.

Q: If a record with an attachment filed with an *RA reference is transferred to a new practice that has the same reference in the medical record, will two *RA1 references with different file names be displayed?
A: When an attachment is sent from the previous practice, a new *RA reference is created, based on the new practice’s details.

Q: Are scanned documents transferred when using GP2GP?
A: This depends on how the document was scanned: the Spine does not support all attachment formats. Unsupported attachments are displayed as a text file that shows the name and advises that the attachment is not transferable.
Supported attachment formats are:
- HTML
- PDF
- XML
- RTF
- MPEG audit layer 3
- PNG
- GIF
- JPEG
- TIFF
- MPEG Video
- MS Word document

Q: If the patient’s medical record is saved as an attachment, how can a practice view it at a later date?
A: The attachment is displayed in the patient’s consultation history, with the file name HRMedicalRecord.xml.

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Consent

Q: If a patient does not give consent to their medical record being shared with other NHS professionals, will this stop their transfer of records using GP2GP?
A: No. Consent relates to information being held on the Spine, not using the Spine as a transfer medium. GP2GP only uses the Spine to transport the record, so no data is held on the Spine.

Q: Do patients have to give consent for their medical record to be sent to another practice using the Spine?
A: No.

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Medication and prescribing

Q: Is linked medication (now required for QOF) transferred into the patient’s medical record using GP2GP, or does the new practice have to re-link all the patient’s medication?
A: Linked medication is transferred and the new practice does not need to re-link the medication.

Q: If there is an outstanding medication task awaiting authorisation by a GP, is the GP2GP message still displayed on the screen of a non-prescriber?
A: Yes.

Q: Is the patient’s medication transferred?
A: All past and current drugs transfer into past drugs. Repeat medication is transferred as current repeats.

Q: Are controlled drugs (for example, chemo/opiates) transferred differently to other drugs?
A: No, all drugs are transferred in the same way.

Q: When a record is imported via GP2GP, are the issues, authorisations and mnemonics displayed in the detailed review?
A: The principle is that, if possible, the data is displayed as if natively entered.

Q: If a user accesses a record that includes an inbound medication alert and selects Y without actioning the task, what happens if they try to issue a drug that is still displayed in red? Is a warning message displayed?
A: Yes.

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Workflow Manager

Q: Who has access to GP2GP Workflow Manager?
A: Initially only users with a level 6 security profile, but a practice can configure this by changing the user profiles.

Q: If a practice adds a major alert for a new patient, this creates a degrade task for that site. Which major alert has precedence, the system degrade alert or the practice’s?
A: There will be two separate alerts, because a degrade task is displayed in Workflow Manager, but a major alert is not.

Q: When a new practice registers a new patient and generates a request to the patient’s previous practice, what happens to the request sent if the previous practice is not GP2GP enabled?
A: A request is not displayed in the Request Sent folder if the previous practice is not GP2GP enabled. The new practice may receive a rejection if the previous practice has GP2GP installed but not yet enabled.

Q: How can a practice view completed tasks?
A: Click on the menu bar and select View Completed Tasks from the drop list.

Q: Why are numbers in brackets displayed in Workflow Manager?
A: Numbers in brackets denote the number of outstanding/overdue urgent tasks. Any number in brackets is always shown in red, unless it is a zero. The system generates the due date (apart from V1 practices sending the records).

Q: When using GP2GP, who can view incoming tasks? Is it the patient’s usual GP, or anyone with a level 6 security profile?
A: Anyone with the correct security profile can view incoming tasks.

Q: Can a practice request a patient’s medical record more than once?
A: No, the practice cannot make a second request. Registering the patient, using the Spine and requesting the medical record from the previous practice must be completed in one process.

Q: What is the difference between a degrade event and a degrade task?
A: A degrade event occurs when the system does not recognise information being received, for example, if another system supplier creates a code that EMIS does not recognise. The information is still transferred, but is recorded as a degrade event when it is not recognised as a code, repeat medication or an allergy. A degrade task is something that needs actioning, for example, reauthorizing medication or recording an allergy.

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