The vast majority of doctors are still in the dark about the
government's £2.3bn plan to overhaul NHS IT, according to a survey
jointly commissioned by Computer Weekly and The Times. James Rogers
examines the findings
As the national programme for NHS IT draws nearer to its
implementation date, a survey of 1,000 doctors has revealed that
more than four-fifths have yet to be consulted about the
initiative.
The survey, by medical research specialist Medix UK, revealed that
81% of doctors possessed little information about the national
programme. Over one-third admitted that the survey was the first
that they had ever heard of the programme, and only 1% felt they
were in possession of fully adequate information about the
scheme.
NHS leaders have already warned that winning the support of the
medical profession will be key to the long-term success of the
national programme. Former health minister Lord Hunt and Frank
Burns, chief executive of Wirral Hospitals NHS Trust, are just two
of the figures that have highlighted the importance of getting
doctors on-board for the programme to succeed.
Many of the findings follow a similar trend to those revealed in
another survey by Medix earlier this year, which suggests that GPs
and hospital doctors are still not getting the national programme
message.
In the previous survey, 32% of doctors had not heard about the
programme prior to taking part in the study and three-quarters of
those surveyed said they had not been consulted about the new IT
scheme.
The latest research does reveal that the government may be missing
out on a crucial opportunity to win the hearts and minds of the
medical profession, with many doctors having a potentially positive
attitude to the national programme.
Nearly three-quarters of the respondents rated the scheme as either
an "important" or a "very important" priority for the NHS. About
two-thirds foresee an improvement in clinical care as a result of
the programme.
But attitudes towards some of the technology projects due to be
implemented differ greatly. Perhaps not surprisingly, eight out of
10 doctors cited the integrated care records service as either
"important" or "very important".
The integrated care records service is at the heart of the NHS IT
overhaul. One of its key functions will be to store millions of
electronic patient records.
Similarly, well over half of the doctors responding to the survey
had positive feelings about the government's plans for electronic
prescriptions, although electronic appointment booking was less
well received. Less than one-quarter said it was important and only
16% felt it was very important.
There is also a degree of confusion over whether the £2.3bn
investment in NHS IT is likely to be an effective use of resources.
More than one-quarter of doctors felt it was not, although over 40%
said it was.
Significantly, nearly one-third of doctors were still unsure. It is
possible that these waiverers could eventually be persuaded to see
the merits of the national programme.
However, despite the obvious potential in getting the medical
profession on-board, a significant question mark remains over the
problem of doctor buy-in.
Lack of user involvement has been a factor in the failure of other
NHS IT projects, such as the Wessex Regional Health Authority IT
project.
Grant Kelly, chairman of the British Medical Association's IT
committee, underlined the importance of getting doctors on
board.
"It is very important the government learns from the mistakes made
in the past," he said. "If you do not ask the people using the
system to get involved, the system will not be designed
correctly."
The risks are clear. In the document, Delivering 21st Century
Support for the NHS, that launched the national programme last
year, the government defined a number of key risks.
One risk was a "lack of co-operation and buy-in by NHS
stakeholders", with the suggested remedy being the "full
involvement of interested parties".
Aware of this, the government has already undertaken work to get
input from clinicians on projects such as the integrated care
records service.
But doctors themselves have warned that getting the medical
profession on-board is easier said than done.
Bedfordshire GP Mary Hawking said, "There is a lot of experience
with electronic records in general practice, but roping that
experience in and finding the correct mechanism is a big
problem."
Hawking pointed to the cultural differences between doctors and
local service providers, the consortia of private sector suppliers
that will deliver the project.
She said, "The national programme and the local service providers
are approaching the plan from an industry viewpoint, but GPs are
approaching it with the experience of the systems that have already
been built to meet their needs. They are coming at it from opposite
ends."
Paul Goss, research director at healthcare analyst Silicon Bridge
Research, said the national programme, run by NHS IT tsar Richard
Granger, needs to undertake a major charm offensive to get round
these problems.
"There is a huge hearts and minds operation to be undertaken by the
national programme," he said. "The government has to be very clear
with doctors about what can be delivered.
"Doctors are a very intelligent community and there is a risk the
national programme could promise too much to soon."
However, despite the current lack of information, there appears to
be a groundswell of support from doctors wanting the national
programme to work.
Hawking said, "I think it is very exciting. We have been asking for
a cohesive national approach to NHS information management for
years.
"It is bound to advance what we have already got, but there are
enormous obstacles to be overcome such as confidentiality, data
quality and data compatibility."
Kelly was also cautiously positive about the long-term impact of
the national programme. "If it works for everybody, it will be a
good thing, but the government has to ask what users want."
The Department of Health was unavailable for comment.
About Medix UK
Medical research specialist Medix has carried out more than 300
independently-commissioned healthcare-related surveys with its
members.
Such is the accuracy of Medix's research methods that it
successfully predicted the outcome of the recent poll of GPs on
their new contract. There was no significant difference between
Medix's prediction of those voting in favour (76%) and the actual
result (79%). Established in 1999, the company specialises in data
collection using the internet. This is the second piece of research
that Medix has completed on behalf of Computer Weekly and follows a
similar survey undertaken in January.
Carried out between 20 and 24 June, the most recent
internet-based study was offered to 1,115 doctors in England
registered with the General Medical Council.
With 1,001 doctors responding, the acceptance rate was extremely
high. Just under half of the respondents were GPs, the rest
covering a wide range of health specialties, ranging from
paediatrics and oncology to geriatric medicine.
www.medix-uk.com
Is the government listening?
Opinions on the national plan for IT
"If this is done correctly (based on input from clinicians) it
could be the saving of the NHS. If it is done incorrectly -
designed by an IT fat-cat who has never seen a patient - it could
be the final nail in the coffin. I expect it to be the latter"
GP
"Few clinicians can design an IT system and even fewer IT
experts appreciate the needs of clinicians. Without very close and
detailed collaboration the system will not work and the vast cost
will be wasted" Hospital doctor
"It is a good idea in principle, but reputations will crash and
burn if it is not implemented in a way that meets the needs of
patients and clinicians" GP
"Masses of cash has been wasted before on failed institutional
computer systems, such as Wessex. Let us learn from the mistakes of
the past" GP
"I am surprised that such a major project is planned without any
real consultation with frontline NHS staff. We will use the system
and yet no one has asked us what we would like to see included in
the programme" Hospital doctor
"I fear this will be more money misdirected at political targets
which appeal to the media, not to clinicians" Hospital doctor
"I have no faith in the ability of the NHS to spend the extra money
wisely" GP
"A decent IT system could free up doctors' time much more than
any other proposed restructuring. The current system is
infuriating" Hospital doctor
"The NHS IT initiatives are to be applauded and will modernise
the patient interface. Adequate services must be available to
patients and health workers" Hospital doctor
"Likely to be more of a fiasco than the Dome"
GP
"The politicians have unrealistic expectations of what computers
are able to achieve. Current systems should be evaluated before
embarking on even more ambitious schemes" Hospital
doctor