How will IT be paid for? ask doctors

Sixty-six per cent of doctors believe there are not sufficient funds in their NHS area to properly implement the National Programme for IT (NPfIT), according to the latest Medix survey.

Sixty-six per cent of doctors believe there are not sufficient funds in their NHS area to properly implement the National Programme for IT (NPfIT), according to the latest Medix survey.

Although £6.2bn of IT contracts are being paid for centrally by NHS Connecting for Health, an agency of the Department of Health, the local NHS is still expected to find funding for training, business process re-engineering and some technology upgrades.

Of the 1,000 doctors responding to this month's survey by healthcare online research organisation Medix, 28% said they disagree and 38% said they strongly disagree that their NHS organisation would have sufficient funds to enable it to properly implement the NPfIT.

The findings come at a time when the government has announced that the NHS is expected to suffer a £94m deficit for 2006/2007, although strategic health authorities are expected to find a contingency of £100m to cover this deficit.

The pace of the roll-out of national systems to hospitals is expected to accelerate this financial year, as service providers that have signed NHS contracts worth billions of pounds to implement the system attempt to claw back delays.

However, the local NHS trusts must be ready to invest at the same time, according to Kate Grimes, chief executive of Queen Mary's Sidcup NHS Trust, the first trust in London to receive national programme patient administration systems.

Speaking at a Health Service Journal conference last month, Grimes said that her trust had underestimated the effort required to process and train staff to use systems. She warned other trusts planning to roll out national programme systems not to do the same.

Whether they will be in a position to follow her advice will depend on their financial position. Doctors, at least, do not think this will be easy.

However, 68% of those surveyed agree that current local working practices should be aligned with the NPfIT before new systems are introduced.

Other findings from the Medix survey show that Connecting for Health is failing to sustain doctors' enthusiasm for the project, which most IT experts believe is essential for effective business process change.

In February 2004, 56% of doctors said they were enthusiastic about the NPfIT this dropped to 21% in January 2005, and since then the number has grown only slightly to 25%.

The survey also invited doctors to comment on the NPfIT. About 30% took the time to do so. Many expressed their backing for some of the objectives of the programme, but also their frustration with it.

"It is vital over the longer term to improve IT, and some of the aims of the NPfIT are laudable," one doctor said.

"However in these days of scarce resources, where many services are being closed and staff are being made redundant, the overspend and lack of progress make it a questionable use of resources at present."

Another doctor said, "Setting up a system of electronic patient records and communication within the NHS is essential and, if it is done properly, will undoubtedly save money in the long run and improve patient care.

"Unfortunately the process appears to have been totally mishandled with gross incompetence and the wasting of huge amounts of taxpayers' money. This is a scandal. It is also typical of the Department of Health's organisational skills."

Clearly the NPfIT has some way to go before it can regain the early enthusiasm doctors showed for this project.

More on NHS IT

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