Doctors’ support for NPfIT tailing off, says survey

In their biannual poll of doctors, Medix UK asked 400 GPs and 450 hospital doctors about their attitudes to the national programme and various aspects of implementation.  70% stated that they had received “no consultation” about the programme, and a further 25% complained that what consulation they had was “inadequate or barely adequate".

Furthermore, 69% of respondents said that they agreed with the BMA’s motion passed at its national Local Medical Committees (LMC) conference on 18 June that “GPs should not engage with the Care Records Service until concerns about confidentiality and how the system will work are met."

Dr Paul Cundy, chairman of the Joint BMA/Royal College of GPs IT Committee, told E-Health Insider that the survey results showed that there remained widely-held concerns about the implementation of the national programme. “If 76% of IT-literate GPs agree with the BMA, the overall support for the conference resolution must be higher and remains a significant obstruction."

Despite the decline in support, doctors remain positive about the effects that the national programme will have on the NHS – 65% believe it to be an important priority, 42% would devote over two hours per week to it and 52% say it would improve clinical care.

The report concludes that “as new services become available, that decline will be reversed and enthusiasm reignited.” However, given the the level of scepticism revealed by the LMC motion, the Medix report advises against assuming such a swing in opinion will occur: “It may be risky to rely on that approach and that the early engagement of doctors is the better strategy."

The report instead recommends an in-depth programme of communication and engagement with clinicians: “It seems more likely that, if levels of understanding amongst front-line doctors, especially GPs, are increased by rigorous communication, doctors’ support and enthusiasm to NPfIT will strengthen, with a knock-on effect on other clinical staff and a consequential blossoming of the Programme’s prospects for success."

Dr Lisa Silver, a GP from Henley-upon-Thames, Oxfordshire and one of the doctors surveyed, agreed that lack of consultation was an enormous problem. "I support the idea of a modern NHS with the latest technology, and as a GP, I am possibly the most important cog in the wheel – yet I have had barely any information from anyone about the NHS IT programme.

“Bearing in mind that the average patient consults five times per annum with their GP and our new contract challenges us to inquire about a broad range of clinical data, GPs must be engaged with. The LSPs have been appointed, yet I have had no communiqué to tell me who ours is."

Dr James Woolley, a psychiatrist from London, said: “I am concerned that this IT programme has all the hallmarks of previous governmental IT failures, for example failure to consult with end-users about how it will integrate with their daily work and make their work easier. If it is perceived as management or government driven additional tasks (which it is currently, by the few who have heard of it), then it will fail."

Other clinicians were more positive. “I think this is a very positive development,” said one GP. “[There are] huge potential gains in patient care as well as the way clinicians work. Full realisation may take years but it is doubtlessly the right way to go.” Another stated: “[It’s] very heartening that the NHS is moving into the 21st century and also leading the world in IT facilities."

“The recently established Care Record Development Board will provide the structure for clinicians and patients formally to inform the work of the National Programme for IT.  Professor Halligan has already undertaken a number of roadshows in which he has had the opportunity to discuss the Programme with staff in frontline trusts."

NPfIT pointed out that their new website and the Frontline Support Academy will also assist in informing doctors of the programme. “We will continue to build the momentum, but we know it will take time to increase awareness and understanding."