Model 1: Single GP system and no other system needed. No need for interoperability as the challenge is system functionality. Model 2: Dual GP system only. Model 3: Multiple systems, 3 GP systems, OOH, acute systems, NHS 111, new systems such as online consultations, third party appointments, often with middleware.

Find and identify the patient within the local health and care area Access the structured care record, be able to use it for prescribing and referrals, and be able to update the patient’s GP system with the record of the consultation Access, view and book appointments at the extended hours location Send and Receive tasks relating to the patient (e.g. follow up or referral advice) Workflow for online consultation and triage and subsequent recording of consultations or direction Data extract for business Intelligence, analysing activity and service usage

Incumbent Supplier attitudes to interop? Incumbent Supplier capability and capacity? HSCIC/NHS England lack of action?

Making sure supplier attitudes are aligned and that they will priorities the things that the pilots are asking them to do. Asking the main system suppliers to do what they are contracted to do under GPSoC, but do it properly Lifting the burden from suppliers, offering help Providing open source technology to make multi-system integration between interoperable systems a reality Plugging this work into the bigger programme for interop to avoid duplication and make it sustainable