National plan may break disaster-prevention rules

The £2.3bn IT-based plan to modernise the NHS has failed to effectively engage doctors - the key stakeholders - which raises...

The £2.3bn IT-based plan to modernise the NHS has failed to effectively engage doctors - the key stakeholders - which raises questions about whether the project meets government rules brought in to prevent IT disasters.

The national programme for IT in the NHS has already been running for 18 months, after it was agreed at a seminar at 10 Downing Street chaired by Tony Blair. Contracts worth several billion pounds have been awarded, and the first national systems, to help GPs handle the electronic booking of hospital appointments, are due to go live this summer.

But when healthcare market researcher Medix questioned 1,026 doctors last weekend about the national programme, 86% said that consultation with them had been non-existent or inadequate. Most supported the general objectives of the programme, but many were unsure or doubted whether it would significantly improve patient care.

In a briefing that accompanied the survey, officials from the national programme admitted that few doctors have had details about the initiative. But it blamed this on the "time constraints on doctors" and added that it "considers it best for information to be made available to doctors as each element of the programme is developed and introduced".

Some specialists think it could already be too late to engage clinicians now that contracts have been awarded and the first systems will go live within months.

Len Slawinski, senior executive at Misys HealthCare Systems UK, said, "There is no point introducing the clinicians late into the selection process, after the local service provider has been appointed and has established its solution vendor list. The die will have been cast by then and clinicians will be faced with a fait accompli."

Officials on the national programme said there is still time to engage clinicians, and a ministerial announcement on how this will be achieved is expected shortly.

Criteria for mission-critical systems

The failure to make doctors feel involved in the national programme raises questions of whether the plan meets the government's minimum criteria for mission-critical projects, one of which is that key stakeholders must be engaged effectively.

Last week Peter Gershon, head of the Office of Government Commerce, told a parliamentary committee that ministers have specific responsibilities to avoid failures of systems that are categorised as mission-critical - which includes the national programme for IT in the NHS. The mandatory checklist of responsibilities was introduced after Downing Street became concerned over a series of government IT disasters.

Gershon drew to the attention of the Work and Pensions subcommittee the need for departments' accounting officers to give assurances that mission-critical projects are not based on the eight most common causes of project failure - one of which is not effectively engaging the system's key stakeholders.

Full survey results


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