English GP Systems Market
I’ve been looking at some statistics on the GP market in England which may be of interest.
Recent years have seen a considerable consolidation in the market and although there were never the number of suppliers that some of the literature suggests (The peak was probably about 40 suppliers who had sold at least one system beyond its development sites and there were never more about a dozen suppliers with more that 100 sites) However, we are now down to four significant suppliers , one small company, with a stable user base of about 160 concentrated in Cornwall and the SW and a few remnants.
We have also seen a move form practice based to hosted systems with all of the major suppliers except iSoft having a significant number of hosted systems, although the majority of systems remain practice based. This is likely to change, particularly as EMIS web starts to rollout and the only question is how long it will take for most GP practices to move to hosted systems. The hosting model is the traditional data centre one and we have yet to see GP systems appear in the cloud (but it can only be a matter of time)
National market share does not apply once you move down to local level with considerable clustering of preferred suppliers at local level although there are still very few PCTs with just two suppliers (12) and even fewer with just a single system(3) But again we can expect further consolidation at a local level driven by GP Consortia
However, many PCTs have a dominat supplier as shown in the graph below with half of PCTs having a single supplier with more than 70% market share in the PCT.
The position looks quite different between the North and South with TPP SystmOne (yes there is no “e” ) having made significant inroads in the North, thanks to it alliance with the Northern LSPs in the NPfIT, but have made little progress in the South. In the new world of GP Consortia the influence of the NPfIT will be reduced and It seems doubtful if TPP will continue its rapid growth although I expect to see continuing modest growth in market share.
My data outside England is less complete, but interesting things are happen in Scotland with EMIS and INPS finally replacing the NHS funded GP system GPASS. Contracts are in place and EMIS will take 55% of Scotland while INPS will take 45% and the transition is now well underway.
There seems little opportunity for new entrants in to the GP system market and I don’t expect to seen until we see a radical reconfiguration of health IT which I think will see a move to cloud computing, with the development of a range of service in the cloud supporting a proliferation of apps which will be not concerned with the boundaries between care settings or particular healthcare organisations.