Get the doctors on board - or fail

One simple maxim should be pinned on the wall of the project management office of any major IT development: No matter how elegant...

One simple maxim should be pinned on the wall of the project management office of any major IT development: No matter how elegant the systems design and no matter how robust the final product, without the buy-in of end-users, the project will fail.

Given this universal truth, the findings of the latest Medix survey into clinicians' opinions of the national programme for IT in the NHS make particularly grim reading.

The results come after the ostrich-like behaviour last month of ministers and the national programme towards the National Audit Office's criticism of the Choose and Book project.

And they starkly highlight growing resentment at the national programme's failure to consult with clinicians and growing doubts about its core projects. More fundamentally, they raise questions about both the IT and the communications strategy associated with it.

More than 80% of clinicians said that working practices should be aligned before national programme systems are introduced across the country. This is not currently NHS policy.

Almost 90% of clinicians say early consultation is more effective than waiting until there are working systems available to show clinicians, although this too is not national programme policy.

Despite this, the national programme has said it is not too late to build wider support for its systems among clinicians and that it "recognises the importance of clinician engagement".

Unfortunately, the national programme made the similar remarks about clinician engagement after each of the previous three Medix surveys, which stretch back to February 2003.

The national programme is preparing a major publicity offensive later this year, and local NHS organisations are advertising for public relations staff to promote the project.

But if the message coming from the national programme is the continued insistence that everything is going well and it sees those who raise concerns as a barrier to progress, it may well be too late.

The lesson for anyone undertaking a major IT project, whether in the health service, the wider public sector or in business, remains simple. End-users need to be brought on board and their concerns addressed - and this is best done early.

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