Readers back reformed NPfIT

Tags: A coding Discharge letters Doctors.net.uk England Google Interoperability iS NPfIT O'Brien Standards

05 Oct 2009

The National Programme should not be scrapped although it should be reformed, a major survey by E-Health Insider and Doctors.net.uk has concluded.

The poll on the future of electronic health records in England was run last month in response to the publication of the Independent Review of Health and Social Care IT and the Conservative Party's response.

Although the Conservatives did not call for the programme to be scrapped, they called for much of its central architecture to be "dismantled" and for its multi-billion pound local service provider contracts to be renegotiated in favour of more local control over IT decision making.

Respondents to the survey, which has been released today to coincide with the start of the Conservative Party conference in Manchester, broadly backed this approach. EHI readers, in particular, backed interoperability rather than centrally purchased systems as the way forward.

Jon Hoeksma, editor of E-Health Insider, said: "The support given to the national programme was surprising, but it probably reflects a growing recognition that the NHS needs to get good IT systems in place.

"Doctors, NHS IT professionals and suppliers all want a national programme. Just not the one that they have got."

Doctors were keener than IT managers and suppliers for the national programme to be scrapped. Indeed, more than half (54%) of the GPs who took part through Doctors.net.uk agreed that the programme should be ended, in comparison with 43% of consultants and just 25% of junior doctors.

Just 22% of EHI readers working in the NHS and 28% of suppliers felt the programme should be ended. But an overwhelming majority – in excess of 80% in all groups – wanted it reformed.

In line with this, two thirds (66%) of EHI readers felt that centrally purchased, common systems were not the best way to develop detailed electronic patient records; and 86% felt a wider range of interoperable systems using standards to share data would be.

Doctors were less clear on this point. But then, doctors had different views from other groups on why progress on implementing IT in the NHS has been so slow.

EHI readers were much more likely than Doctors.net.uk readers to blame “centralised policies” (with 24% and 16% picking this as the biggest obstacle) but fewer blamed “political interference” (13% and 25%). Doctors were more likely to blame lack of consultation with clinicians in designing systems (46% and 29%).

Asked about the importance of the different things that the national programme is trying to do, there were some clear differences of opinion.

There was overwhelming support among all groups for detailed care records and Summary Care Records except among GPs (only 9% of whom rated SCRs as “very important”), but much less for Choose and Book, particularly among GPs (only 3% of whom rated it “very important”).

Asked about the Clinical 5 for hospital systems, there was strong support for a patient administration system and order communications.

But EHI readers were much keener on e-prescribing than Doctors.net.uk readers (with 12% and 5% picking this as “most critical to clinical care”). Doctors were more anxious to see discharge letters with clinical coding in place (27% to 8%).

"The survey shows that reforming the programme may not be as straightforward as some of its opponents suggest," Hoeksma added. "The principles of Dr Glyn Hayes' independent review are well supported, but a further round of highly-politicised change is not."

More news: The survey also revealed strong support for the NHS' personal health record platform, HealthSpace; and a lack of support for companies like Microsoft and Google holding health records.

News analysis: Read more about the survey and the comments that respondents made on it in our news analysis: Put cross here.

Lyn Whitfield

Lansley outlines Tory NHS plans (05 Oct 2009)
Conservatives to ‘dismantle’ NPfIT (10 Aug 2009) (38)
Docs call for clinical review of NPfIT (03 Jul 2009) (3)
CfH publishes OGC Gateway Reviews (23 Jun 2009)
Connelly sets a November deadline for suppliers (28 Apr 2009) (12)

Readers Comments

Non-inclusive survey

07 Oct 09 09:33

What a shame this survey was not run in nursing and allied health professional journals also. This would then have allowed all affected by these systems to contribute rather than just IT managers and doctors.

The consultants are correct though - clinical involvemment has been minimal at all levels. But then this is not a clinical project any longer (if it ever was one). The drivers are purely business led and clinician let alone patient need is ignored.

Non-inclusive survey

07 Oct 09 10:02

Another quite important group has been left out; patients.

To take issue with the last 2 comments

jon@e-health-media.com

07 Oct 09 10:18

This is Jon Hoeksma, editor of E-Health Insider.

Just to take issue with the last two comments. EHI and EHI Primary Care focus on health IT and nothing else - our audiences are IT experts and professionals and clinicians with an interest in making better use of information to improve care.

So while it may be desirable to ask patients what they want, that's not what we're here to do or the audience we report for. The news survey focuses on current proposals made by the opposition party.

We would have liked to talk to clinicians other than docs, but we had to draw the line somewhere. Maybe next time. We're not the BBC. We have to find the resource to do this kind of exercise. We've done so because we believe it is valuable and worthwhile.

I see plenty of rickety surveys and polls purporting to be news, but knowing the work that went into this and the size of the sample - 1500 - I'd argue the results are both relevant and noteworthy.

People involved in this sector do not want to see the national NHS IT programme abandoned, though they do want reform. They don't think that Google offers some magic bullet on patient's records - PHRs are not a substitute for local detailed clinical records. These are important messages to get across to the current government - and any future one.

Regards

Jon Hoeksma

Well said

08 Oct 09 08:00

Jon's point is well-made.

Let's not forget that the responsibility to put together all the pieces of the NPfIT stakeholder engagement jigsaw rests with CfH. EHI has - to my mind - presented its usual focussed perspective and has made clear the consituencies involved in its survey (something the the DH and its various units might do well to take on board).

AHPs and Patients were free to participate

09 Oct 09 13:39

Bit mystified by the first two comments. Anyone who's interested in the development of EPR and PHR most likely reads EHealthInsider anyway and so could have responded to the survey.

That would include AHPs and well as doctors - and patients.