Development Requests - Primary Care IT

Development Request

Name(Required)

First Last

Role (Job title)

Email(Required)

Phone

Please state which practice you are from, or if you are not from a practice, the PCN, federation, ICB or other organisation:(Required)

Please select the clinical system you use:(Required)

EMIS Web

SystmOne

What is your TPP Org number or EMIS CDB (if practice based)?

Please select if the request is referring to a:(Required)

New tool

Existing PCIT tool

If you have selected 'Existing PCIT tool' above, please state the name of the tool as it appears in your clinical system(Required)

Type of resources requested(Required)

Priority(Required)

Justification for level of priority

Request title(Required)

Summary of the request

Please probide a brief overview of the development request.

Please describe the details of the development request (for both new and existing tools)(Required)

Please provide as many details as possible, including: the reason behind the development request, other details you think are relevant, the type of resource e.g: search/report, protocol, template, protocol alert (EMIS), patient status alert (SystmOne), OneContact, or OneAnalytics. If there are any specific codes or specification documents (e.g. for a locally enhanced service) please submit these with the request.

What would this development allow you to do, which you can’t do currently?(Required)

What guidance are you following when asking for this request?(Required)

For example: NICE guidance, LES, DES, etc. if this relates to any business rules or specifications (please attach these below).

Do you have any reference examples

Please provide examples or references that illustrate what you’re looking for (if applicable)

Please upload any supporting documentation for your request

Max. file size: 50 MB.

Click here to view our development process support article

I confirm that I have read the support article about development requests and acknowledge that my request will be evaluated and dealt with in line with this process(Required)

Yes