Over 80% of doctors not consulted over NHS IT

The vast majority of doctors are still in the dark about the government's £2.3bn plan to overhaul NHS IT, according to a...

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.  


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

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