The latest Medix survey of 1,000 doctors' attitudes to
the £12.4bn National Programme for IT in the NHS paints a picture
of a good idea poorly implemented
More than half of doctors support the objectives of the
NHS National Programme for IT (NPfIT), but most think progress
on the scheme has been unacceptably slow and the money could be
better spent elsewhere in the NHS.
These are some of the findings of the latest survey of 1,000
doctors by medical research firm
Medix. Conducted between 30 October and 5 November 2007, the
Computer Weekly-sponsored research raises fundamental questions
about the implementation and costs of the £12.4bn programme.
One of the main aims of the NPfIT is to provide electronic
medical records for 50 million people in England. The idea is that
the records can be accessed wherever the patient is being treated.
The programme also includes the
Choose and Book system for booking hospital appointments
electronically, e-prescriptions, and a national broadband network
for the health service.
In its report, Medix said doctors still support the principles
of the NPfIT, but most are critical of its costs and believe it is
being poorly implemented.
"When this all started there was lots of goodwill and optimism,
but it has been squandered by the poor choice of projects and poor
implementation," said one of the doctors surveyed.
Value for money
The success of the NPfIT is measured against improvements in
medical care, but 34% of the medics questioned said they believed
it would make no difference to clinical care, and 19% believed it
would make it worse.
Given these figures, doctors are questioning the appropriateness
of the multimillion-pound programme in an organisation built on
the promise of providing the best possible healthcare "from the
cradle to the grave".
Seventy per cent of the doctors surveyed did not think that the
IT programme was a good use of NHS resources, against 8% who
believed it was. When asked the same question in February 2003, 47%
of doctors said the NPfIT was a good use of resources.
"£12bn could have been used to improve clinical outcomes
immeasurably. The NPfIT is unlikely to make any difference to
clinical outcomes and will just become another bean-counting tool,"
said one survey respondent.
Not enough information
Gaining buy-in from end-users is essential for any IT-enabled
change programme, but the Department of Health appears to be
struggling to garner support from doctors. Most said they did not
receive enough information about the project, and they felt the
information they did receive was inaccurate.
Although 89% said personal consultation with doctors about the
project was important, only 6% said they had been adequately
consulted about the NPfIT. Twenty seven per cent had received no
information on the NPfIT, and 7% said the survey was the first they
had heard of the project.
"I am not adequately informed about the NPfIT and would like
updates," said one doctor.
Of the information about the project that does filter down to
doctors, many doubt its reliability. Of the doctors surveyed, 34%
did not trust the information they received from the Department of
Health 7% believed the information was reliable and accurate.
Progress
Five years into the project, doctors have been able to witness
the changes it has made to the daily lives of patients and
clinicians.
Medix found that 7% rated the progress of the NPfIT as
satisfactory, whereas 71% rated it poor or unacceptable.
"A good idea in theory, but introduced without proper planning
or trialling of the system and far too fast in an attempt to meet
political targets," said one respondent.
Another said, "The principles and goals of the NPfIT are great,
but the delay in implementing it is unacceptable, and the cost,
which should have been used for patient care, is, to say the least,
quite objectionable."
In the project's defence, Simon Eccles, national clinical
director at NHS Connecting for Health, which runs the NPfIT, said
it was potentially the biggest advance in the way healthcare is
delivered since the founding of the NHS.
"Sadly, that is not widely appreciated. The programme is being
actively obstructed by a minority of GPs for essentially selfish
reasons," he said.
The Choose and Book system is a good measure of the progress of
the NHS National Programme for IT. The electronic appointments
booking system is a cornerstone of the scheme.
The Medix survey revealed that 30% of doctors have had no
experience of the system, and 27% believe it has had a detrimental
effect on patient outcomes.
One doctor said, "It is essential for the NHS to embrace this
facility to improve information and communication about patients.
However, I fear that it may be mismanaged and turn out to be more
expensive than predicted."
