Consultation worries as user group is canned

The Department of Health has abolished a clinical user group set up to help design multibillion-pound systems as part of the...

The Department of Health has abolished a clinical user group set up to help design multibillion-pound systems as part of the national programme for IT in the NHS.

Angus Goudie, IT clinical lead for Sunderland Teaching Primary Care Trust, who was due to take part in the group's meetings, said the original idea early in 2003 was for up to 200 "clinical advisers" to meet regularly - they were told a weekly meeting was the likely commitment.

In fact, Goudie was involved in only one meeting, in July last year. He said he knew a number of clinicians who were due to participate in the exercise, but their planned meetings did not materialise.

A spokesman for the national programme for IT said that, despite the group being wound up, there has been involvement of about 300 clinicians in the design of systems.

But the failure of the group has underlined concern in the NHS that the mass of clinicians will not feel sufficiently involved in the planning for the design and implementation of systems. Yet their support will be critical to its success.

Critics of the Department of Health's plans said it has relied too heavily on a core of clinicians whose views may not always reflect those of doctors and nurses in general.

A report by the National Audit Office in February 2004 on the failed introduction of national systems for the Criminal Records Bureau found that end-users were involved in the design of systems. But they were not always representative of end-users in general. The report concluded that fundamental design assumptions were not adequately researched with potential users.

Under the NHS's original plan for the national clinical adviser programme, clinicians were due to meet to feed ideas and reactions on prototype systems to help designers.

This is being replaced with clinical adviser programmes that will be run by local "clusters" and strategic health authorities.

Goudie, a strong supporter of the national programme, welcomed the involvement of clinicians in cluster and strategic health authority initiatives. But some see the establishment of local consultations with clinicians as coming late - the first national systems are due to go live this summer.

A spokesman for the national programme said, "Clinical advisors have been engaged on the national programme at a number stages of the programme. Originally this aspect of the programme was led by Anthony Nowlan. Unfortunately, he left the programme in summer 2003.

"Significant numbers of clinicians have been involved in the programme in the same timeframe."

Aidan Halligan, newly appointed joint responsible owner of the national programme, is establishing an expanded role for the National Clinical Advisory Board, which includes representatives of medical colleges such as the Royal College of Physicians.

IT in the NHS

The NHS national IT programme comprises four main projects:

  • A national system for electronic booking of hospital appointments 
  • A national care records service 
  • A broadband infrastructure 
  • Electronic prescriptions.

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