Need for better communication is vital as doctors voice deep concerns about NPfIT

Opinion

Need for better communication is vital as doctors voice deep concerns about NPfIT

Doctors' comments reveal fears of wastage and a failure to appreciate their needs

Of the 900 doctors who responded to the survey by Medix 191 made written comments, of which 93% were critical. Many think the NHS' national plan for IT (NPfIT) is doomed and will waste large sums of money.

Some of the comments, published below, show the size of the challenge facing the national programme as it embarks this year on a nationally co-ordinated exercise to inform and engage the public, doctors and other stakeholders.

 

"If every health professional treating my patients had immediate electronic access to their medical record, they would get better quicker, and be less likely to be harmed inadvertently. Surely that is a higher priority than anything else we could spend taxpayers' money on?"

Robert Varnam, GP, Rusholme, Manchester

 

"The NPfIT is a scandalous waste of money which will not meet any of its targets. There is a grave risk to confidentiality and an expensive parallel system will be required for those who opt out or are given special dispensation, eg MPs. Clinicians will refuse to use the system and encourage patients to opt out so we will be left with an expensive white elephantÉ I hope that this scheme is switched off as soon as possible to save some of the £30bn."

Mark McCartney, GP

 

"Locally we have had a series of meetings. They have in general involved long, patronising lectures with very little evidence of much interest in hearing what GPs want to sayÉ A recent meeting Essex-wide to which all GPs with an interest in IT were invited attracted only six expressions of interestÉ the majority of GPs feel that they are not being, and will not be, listened to."

Mike North

 

"We are running before we can walk even by their own admission. I don't want any of my records electronically available as they are suggesting, and I am meant to be operating the system."

Alan Campion, Bermondsey, London

 

"A triumph of hope over experience. If the US, with a trillion-dollar health care industry, cannot develop a functional EPR [electronic patient record] working across many institutions, it is very unlikely that the NHS will achieve it."

Simon Carter, consultant urologist

 

"The culture is basically if you speak out, you will be disposed of. The NHS will not tolerate criticism from those within its ranks, even if they are well educated and knowledgeable in the field they are criticising."

No name supplied

 

"Great idea, badly formulated, poorly managed, shockingly communicated, destined to disappoint."

No name supplied

 

"The lack of consultation and attempts to bully primary care to abandon its well-tried and tested systems for an as yet unproven system are autocratic and likely to alienate a great many GPs."

Derek Greatorex

 

"The fatal error is to treat GPs as employees and not self-employed business people."

No name supplied

 

"Locally two NPfIT 'discussion' groups were arranged for all NHS personnel. These were a complete propaganda exercise with no real discussion."

No name supplied

 

"I am already involved in the local implementation but find that the NPfIT only pays lip service to the clinical aspects, wanting to engineer the service to fit the software and not the other way around."

No name supplied

 

"We desperately need the basics sorted first before ideas like Choose and Book are implemented."

Michael Gocman

 

"An unprecedented waste of resources, posing a sinister threat to confidentiality and individual freedom."

Kevin McBride, The Avenue Surgery, Warminster

 

"The direct patient-to-doctor contact is the main essence of medical care and in many cases better than the prescriptionÉ the human/humane contact with doctors who are not too busy looking at computer screens is the best therapy."

A K Sood, Royal Surrey County Hospital, Guildford

 

"£6bn could do a lot if used after grassroots consultation and with intelligence. I am very enthusiastic about the sensible uses of IT and have been active in the field for over 20 years. However, I do not see the NPfIT producing a better service for those who really matter - the patients."

Roger Roycroft

 

"Choose and Book sounds like a people pleaser rather than useful, and GPs are not going to enthuse over adding booking clerk duties to their other function of computer data input clerk."

June Lodge

 

"It is an ill-thought-out scheme with minimal consultation."

Chris Dey

 

"Far too little communication with primary care and far too much spin and hypeÉ Let's hope the National Audit Office report triggers a change of emphasis."

Richard Falk, GP, Epworth, Lincolnshire

 

"Booking systems are very important, but the "one size fits all" approach is likely to cost much more and take significantly [more time] than a more locally configurable system."

Alan Jewkes

 

"We have no ownership of the project, have not been adequately consulted and do not have the time to implement it. Grassroots GPs are going to ignore it and it will be an enormous waste of moneyÉ this is all about central control of the enormously efficient but independent practices which have kept the NHS going since 1947. It stinks."

No name supplied

 

"I hope it will offer the opportunity for evolution as it will have many problems and inefficiencies at the outset and it needs to be flexible enough for individual configuration."

Mike Flannigan

Leader >>

 

Medix's conclusions   

Summarising the findings of its survey, Medix said, "The many problems recorded in this survey seem to spring from continuing poor levels of consultation."  

It added that if levels of understanding of the advantages of NPfIT among individual front-line doctors, especially GPs, were massively increased by rigorous, interactive, detailed and widespread communication, then support and enthusiasm for the national programme would strengthen.  

"But, after more than two years of delay [in consultation], it will be a major challenge to overcome the distrust and cynicism that seems to be replacing enthusiasm in the minds of many doctors. That challenge must surely be addressed urgently."

 

Whom did Medix question?   

The survey ran for five days at the end of January. Respondents were invited to the Medix website, where they completed the survey. About 900 doctors responded, all of whom practice in England. Of these, 54% were GPs.  

Respondents represent about 1% of the 85,000 or so doctors who practise in England and will, therefore, be affected by the national programme for IT in the NHS. In the past, the survey has been jointly sponsored by the national programme.  

Medix said the respondents covered a wide and well-balanced range of specialties and, in terms of grade, commitment and decade of qualification, were a good representation of practising doctors on the register of the General Medical Council.

www.medix-uk.com

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This was first published in February 2005

 

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