London School of Hygiene & Tropical Medicine

A massive £2.3bn plan for a new NHS computer system is under threat due to a lack of communication, researchers have warned.

And they said that frontline staff were "heavily demoralised" because of a lack of information on the project from central government planners.

The new national programme for IT in the NHS (NPfIT) was originally due to be up and running by the end of 2007.

But a research team at the London School of Hygiene & Tropical Medicine (LSHTM) said the scheme was at risk and was already falling behind schedule in key areas.

NPfIT was set up to provide a new IT system across the NHS in England - including a centralised patient records system - and is the biggest civilian IT project in the world.

But LSHTM health policy researcher Dr Naomi Fulop said: "Managers felt there was so little communication and consultation from NPfIT headquarters that it posed a threat to getting the programme up and running."

And she added: "We also found clinicians don't feel involved and are still wondering whether the new system will actually meet their needs."

The research team warned that patient care could also be compromised as hospitals continue to use creaking IT systems because short-term replacements while the new system is developed would be too expensive.

Dr Fulop said: "A new patient administration system has to be installed in every trust - while trusts are waiting for that, there are concerns, including concerns for patient care."

She explained that some trusts have reported an urgent need to replace existing IT systems for radiology or pathology. But previously-scheduled upgrades have been put on hold until details of the NPfIT system have been made public.

Dr Fulop said: "There will be delays in implementing this until the new system is up and running. In the meantime, there is a risk of current systems failing before the new one is ready."

The research team looked at four hospital trusts in England, chosen to reflect the various conditions across the country and, in the first part of a continuing study, talked to a total of 23 managers and doctors involved in getting the new IT system up and running. The results of the study are published in this week's edition of the prestigious British Medical Journal.

The research team found that, although the hardware and software for the new system will be centrally funded, managers are still uncertain about where the money will come from for staff training and dealing with the changes in the way the NHS will have to work once the new system is online.

Dr Fulop said: "We are not saying the introduction of a new system is not a good thing - it is and it will take the NHS forward."

But she warned: "Unless these concerns are addressed, there will be delays in implementation and a less-than-optimal use of the new system when it is finally introduced. And that will be a bad thing for all concerned."