IT managers complain about lack of information and confusion over suppliers.
As the government's £2.3bn national IT plan for the health service gathers pace, the NHS is making a concerted effort to win the hearts and minds of IT managers in NHS trusts across the UK.
Speaking at a recent conference of Assist, an organisation that represents IT professionals in health and social care, NHS IT tsar Richard Granger said it is "time for people to move from the terraces and get onto the pitch".
But there is still a degree of confusion about the impact of the plan. The consortium of suppliers is still to be decided and the tight timetable has been branded "a farce" by one executive.
One NHS IT manager said, "There are moves afoot to engage heads of IT, but at this stage it is difficult to see what is happening. Until the local service providers are in place, it will be difficult to predict what is going to happen in the long term."
A southern England NHS trust IT manager, who asked to remain anonymous, echoed these concerns. "We do not know what is going on. The programme needs better communication at the bottom end."
The plan will involve building an IT infrastructure to fit the needs of one of the largest and most complex organisations in the world. With more than one million employees, the NHS comprises hundreds of different trusts and professions. All this in an organisation that has traditionally struggled with limited resources.
Paul Goss, director of healthcare analyst firm Silicon Bridge, said, "NHS IT managers play an essential part in the delivery process because the plan will be dealing with a very complex environment.
"If the government does not get them on board, the job for the local service providers will be much harder and there will be a risk these providers do not meet their own performance criteria."
A spokesman for the national programme insisted there is engagement with the NHS IT community "on a number of fronts". He said staff from the national programme and the National Design Authority, a body which will develop and control the standards of future IT systems, meet regularly with chief information officers from 28 strategic health authorities on all aspects of the plan. The information officers are then responsible for sharing information with personnel and getting a response from IT staff in respective areas.
The opinions of trust chief executives are also being sought, according to one spokesman. "The national plan is informed and is advised by a forum of chief executives from the 28 strategic health authorities," he said.
The forum has elected a team of four chief executives to represent it on IT issues and specifically on the national plan. However, ensuring user buy-in is easier said than done.
NHS IT managers already have their hands full working on existing projects. One manager said, "To be honest, we are so busy trying to meet agendas with limited resources that engaging in the current strategy is not always possible."
Goss sympathised with the plight of NHS IT managers and highlighted some of the tensions they will experience juggling local pressures and the demands of the national programme.
"There needs to be some slack in their own organisations to allow them to get involved," he said.
Assist welcomed Granger's comments at the Birmingham conference, and said that closer links between the health service IT community and the national plan were likely in the future.
An Assist spokesman said, "We have reassurance from the national plan the situation will improve, and people at all levels will be much more familiar with how things are working out."
Assist also joined Granger in urging NHS IT managers to get involved in the health service's IT overhaul. "Assist, the profession and all the key players should start moving with the programme and getting involved," it said.
The national programme is also attempting to keep NHS IT managers, along with other sections of the health service community, involved in the development of the integrated care records service, which will store millions of patient records and is at the heart of the IT overhaul.
Although not a general information document, officials stress that the initial output-based specification for phase one of the records service is being shared in the NHS "as widely as possible".
The document details the specification and standards for the system that any company or consortium delivering work to support the national plan will have to meet.
But this crucial document has still to be finalised and has been described as a "work in progress" by a national programme spokesman. This means that companies who wish to make a pitch have to rely on a fair amount of guesswork when designing their bids.
Significantly, in his Birmingham address to Assist members, Granger hinted that the next few years could provide a gilt-edged opportunity for health service IT managers to move to the centre stage. He said, "If the service grasps the nettle it will be an opportunity for NHS IT professionals to move from the machine room to the boardroom."
Whether this proves to be correct is yet to be seen. One thing that is certain is that clear, open, dialogue between Granger's office, the private sector and IT managers will be key to the long-term success of the national plan for IT. Goss said, "There needs to be excellent communication between all three."
The IT manager's role in the NHS
The NHS is currently home to about 22,000 IT professionals. However, such is the complexity of the NHS, there are no precise figures on what proportion are IT managers.
This workforce, which has traditionally struggled with limited resources, is currently spread across 355 hospital trusts and hundreds more primary care and specialist trusts.
NHS IT managers face many of the same challenges as their counterparts in the private sector, such as overseeing the day-to-day running of networks and helpdesks.
They are, however, often responsible for dealing with healthcare-specific technology such as patient administration and medical imaging systems.
Health service IT managers now find themselves set to play a key role in the £2.3bn project to overhaul health service IT - the largest IT project the UK has ever seen. Experts have warned of the difficulties managers will face in juggling the demands of the project with existing commitments.