Cost and privacy concerns erode doctors' confidence in NHS plan

Survey reveals growing number of clinicians worried about roll-out of national IT systems

Survey reveals growing number of clinicians worried about roll-out of national IT systems

Support among the key target users of the world's largest civil computer programme, the IT-based modernisation of the NHS, has largely dissipated despite a major communications drive in recent months, according to a new survey.

Only 1% of those who responded to the largest survey yet carried out into the views of doctors on the national programme for IT in the NHS (NPfIT) rated progress as "good" or "excellent".

Last June and July a poll by Mori showed that IT specialists in the NHS had a generally favourable impression of the NPfIT.

But a survey by research firm Medix between December 2005 and January 2006 shows that  doctors are critical of and worried about the programme's implementation.

The NPfIT is due to cost between £6.2bn and £31bn, but the NHS is facing funding pressures. The survey's results also come against the backdrop of a 28-hour failure of the NHS data spine - the backbone of the NPfIT.

The Medix survey brought responses from 1,329 doctors - about 1.5% of the total in England. Only 1% of those who responded rated progress in the NPfIT as good or excellent. Seventy five per cent of GPs and 63% of other doctors rated progress as poor or unacceptable.

Three years ago 47% of doctors thought the NPfIT was a good use of NHS resources, but only 17% say that is the case now.

Hospital doctors were in general more supportive of the NPfIT than GPs. But only 45% of them were enthusiastic about the programme - down from 75% two years ago.

There was some good news for Connecting for Health, which is running the NPfIT: more than 50% of all doctors thought the programme would improve clinical care in the longer term. 

But fewer than 50% thought the NPfIT an important priority for the NHS, and only 5% thought personal consultation with them had been adequate. There were also concerns about whether enough money would be made available to fund the programme and whether the confidentiality of patient records held on central and regional systems could be compromised.

Only 6% agreed with the statement that their trust had or was likely to have enough money to properly implement the NPfIT, including buying new equipment, training, consulting staff and managing process change.

More than 70% of GPs and 46% of other doctors thought that the advent of an NHS Care Records Service would weaken the confidentiality of patients' records.

The Medix survey indicates that the mountain of opposition Connecting for Health will have to climb to make the NPfIT a success is becoming steeper.

Medix said, "It will now take extraordinary efforts toÉ overcome the distrust and cynicism that seems to have replaced early enthusiasm in the minds of many doctors."

The findings raise questions about whether there should be a full independent review of the programme and its future direction. Public spending watchdog the National Audit Office is due to publish a report but it has been delayed twice and is more likely to look at the programme's history than its future.

Family doctor Gillian Braunold, who represents GPs at Connecting for Health, said the survey's results did not accurately reflect the views of most doctors. She said that as doctors become more familiar with the new technology, receive further information and see that the systems raise standards they will "get switched on".

A spokesman for Connecting for Health said that confidence sometimes dips in the early stages of large implementations and "that is the phase we are in".  Greater familiarity will increase confidence, he said.


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