Users of systems worth billions of pounds due to be
installed in the NHS, last week expressed strong criticisms of the
way they were being implemented.
The criticisms by GP representatives across England are
unprecedented in their ferocity and highlight a widespread
scepticism over aspects of the national programme for IT in the
NHS.
Concerns centred on a perceived lack of consultation about changes
to IT, a rush to implement systems and a lack of funding.
The views of doctors at the annual conference of local medical
committees of the British Medical Association reinforced similar
concerns expressed privately by some of the 20,000 IT professionals
in the NHS.
At the conference addressed by Aidan Halligan, joint senior
responsible owner of the national programme, there was widespread
support for the broad goals of the NHS IT programme. But criticisms
from delegates, who represent thousands of GPs, indicated that
health service IT staff could face strong resistance from users,
particularly doctors, as they roll out national systems.
Medical committees in Derbyshire, Manchester, Gloucestershire,
Suffolk and parts of South London, went as far as recommending a
boycott of the care records service.
Their motion said that in view of the "uncertainties and lack of
consultation on the care records service", and "until GPs
legitimate concerns are answered" that "GPs should not engage with
the care records service".
The government has allocated £2.3bn for new systems under the NHS
IT programme, but in facthas awarded contracts worth more than £6bn
to national and local service providers.
Delegates at the conference attacked what they saw as a poor
understanding among local service providers of the way the medical
professions work.
They believed end-users were given little choice but to comply with
the strategy, that the intention to use IT to force change in
working practices was doomed to fail, and described plans for a
national database of medical records as "Big Brother's
dream".
Officials on the national programme hope that the worries of
doctors and nurses will evaporate once they see "early wins" from
trusts that manage to go live successfully with national systems
this year and next.
Halligan told the conference that the new systems will "match or
exceed" the expectations of the medical professions. He also said,
"I really do apologise that we have not engaged in a more fulsome
debate with primary care [GP's]."
There was also criticism of the hospital appointments booking
system.
A London motion said that e-booking could be dangerous where there
is a shortage of capacity because it bypasses a consultant's review
of priorities.
A further motion was that the conference agrees to have "no
confidence in the ability of the national programme for IT to
improve patient care because of the impossible timescales and lack
of engagement of clinicians."
At best the outbursts against aspects of the programme at the
conference will not lead to active opposition. At worst, the
Department of Health could find that billions of pounds' worth of
new systems are little used by most local clinicians who may feel
disenfranchised by a centrally-driven initiative.
Paul Cundy, chairman of the IT subcommittee of the British Medical
Association's GP committee, said, "The sentiments expressed at the
conference were clear about the lack of clinical engagement thus
far. I am reassured that the presence of Aidan Halligan [at the
conference] is a statement that this is about to change."
Patient information must be protected
One of the main projects in the national programme for IT in the
NHS is a care records service, including a national database,
called a data spine,which will allow the health records of 50
million people to be shared among healthcare staff.
But many doctors are concerned about plans to allow patient data
to be automatically uploaded from GP systems to the spine, where it
could be accessed by government agencies without the knowledge or
specific consent of patients.
Last week's conference passed a motion which called for the GP
committee of the British Medical Association to take "appropriate
action" to stop the government revising legislation which would
allow increased access to identifiable patient information.