Although interviews with 25 senior managers and clinicians responsible for implementing the programme in four NHS hospitals in England show they support IT modernisation, there were concerns about delays to new systems and patient safety.
However, Connecting for Health, the NHS organisation responsible for implementing the National Programme for IT, denied patient safety was being compromised.
During the first round of interviews between September and December 2004, university researchers found the main concerns were about financial deficits, delays in replacing patient administration systems, and poor communication between Connecting for Health and local managers.
Eighteen months later, the issue of financial deficits was even more acute. There was also concern that managers could not focus on implementing the system because of competing financial priorities.
Continuing delays in replacing patient administration systems, and poor communication were also still apparent in the second interviews. Respondents reported uncertainty about the timetable for delivery and felt disempowered and frustrated with the lack of consultation.
The delays were now seen as an unacceptable risk to patient safety, the researchers found. One respondent said, “Our path system is extremely out of date… it’s a huge risk to the trust that we’re still carrying this path system.”
Another warned “there are a number of risks that are associated with our old system, some very serious risks…”
Respondents also questioned whether NHS-wide connectivity would ever be achieved.
Finally, there was little support for Choose and Book and none of the interviewees was optimistic about the ability of Connecting for Health to deliver the systems.
“The software is not fit for purpose,” said one director of information management and technology.
The report’s authors said, “The staff we interviewed were unreservedly in favour of IT modernisation but this support will quickly diminish unless more progress is achieved.”
The researchers concluded that Connecting for Health needs to address the uncertainty experienced by trusts and take responsibility for advising about interim decisions, while trust managers urgently need concrete information about implementation timetables, long term goals of the programme, and value for money. Trusts also need help in prioritising IT modernisation, they said.
A spokeswoman for Connecting for Health said, "It is untrue to suggest patient safety is being compromised. NHS Connecting for Health is giving full priority to trusts with the oldest existing systems.
“In the past 12 months alone, we have installed 162 systems in the hospital sector including 15 hospital patient administration systems and 62 picture archiving communications systems (Pacs), which capture and store images electronically.
"This research reveals some of the challenges and frustrations of introducing new IT into the hospital sector.”
She said Connecting for Health was working in partnership with local NHS organisations to overcome these challenges to make best use of the technologies. The study showed the huge support for better health informatics in the NHS and the aims of the National Programme, she said.
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