Why a Design Standard is Needed for NHS GP Software

Mike David Smith
3 min readApr 28, 2021


The “floating toolbar” problem

There is a quiet revolution brewing in General Practice software. The rapid growth of accuRx is spurring other providers to adopt similar tactics to gain a valuable spot on the desktop of practice users.

Overall this growth is a very welcome development. The three main providers of GP EPR systems — EMIS, SystmOne and Vision — have demonstrated a lack of desire in the last decade to add functionality to their core products. I would argue this is both understandable and welcome. These products already contain a mountain of functionality. Adding new features risks destabilising the overall system and pulling focus away from their ability to maintain and improve the existing functionality.

Development of new functionality for practices must therefore come from outside the walls of the core EPR providers. This however has created a user experience (UX) problem that is reaching a critical point.

The floating toolbar problem

Each of these new providers needs a spot on the screen for their software to live. The providers want their software to be prominent for both promotional and usability purposes. If the user has to click “start”->”programs”->”widget” then several other buttons to do a simple task, the software will fail. Consequently, all providers are adopting the “floating toolbar” approach.

The “floating toolbar” is great for a user if there are only one or two add-on pieces of software. Crucially, it allows the tool to be launched very quickly at any time. It also does not entirely obscure the main EPR window, so a user can refer to information from both systems in parallel.

However, the welcome growth of the add-on sector means a typical GP might already have 4 toolbars running. As new tools are added, we can only expect this number to grow. Having this many toolbars running clutters the screen and irritates users and as such, is not a long term solution.

The Perfect Clinical System?

The ideal digital clinical environment would be an ecosystem of software tools that work together harmoniously to deliver a frictionless experience. Each tool would have a narrow focus and do one thing really well. Such an approach would lower the barriers to entry for new competitors and spur growth in the sector.

Maintaining a good user experience presents a barrier to the model of many independent apps interacting. The user needs some consistency of design in their system to reduce the learning curve, as well as preventing errors and fatigue. However, each system developer will feel their approach is best.

Towards Design Standards

We have reached the point where we need a set of design standards for GP software to allow the ecosystem to flourish. Such standards need to be vendor neutral, but equally ensure all vendors are invited into the debate to ensure the standard-setters are fully aware of the issues to be resolved. The W3 consortium that sets the standard for the open internet seems the natural model to follow, with NHSx taking the role of chair.

With a common design standard and equality of access to the core EPR data, we can hope to say goodbye to cluttered desktops with multiple toolbars and hello to a second revolution in digital general practice.



Mike David Smith

Doctor working in North East England with a keen interest in technology