London School of Hygiene & Tropical Medicine

An independent academic study of staff views of the progress of the NHS IT programme locally has found that financial deficits and poor communication continue to hamper its successful implementation. It also found that continuing delays could constitute a growing risk to patient safety. The research is published online today in the BMJ.

In this follow-up to their initial study published in 2005, researchers from King's College London, Imperial College London, University of Bristol and London School of Hygiene and Tropical Medicine interviewed a range of key senior NHS staff in financial, IT and clinical roles.

As with the 2005 study, the respondents feel that local financial deficits are having a serious impact on the success of the programme. This new survey found that, as financial problems continue to worsen, local managers can't focus on implementing the system because of competing financial priorities and uncertainties about the programme.

There is ongoing concern about a lack of clarity and poor communication from Connecting for Health, the agency responsible for delivering the programme. Some people feel disempowered and frustrated because decisions are being made by this agency and local IT service providers without consulting key NHS staff.

With the announcement of the new IT programme in 2002, many NHS Trusts stopped investing in their existing systems. This study highlights how delays now mean that existing technology may not be fit for purpose and some staff feel this represents an unacceptable risk to patient safety.

Professor Naomi Fulop of the School of Social Science and Public Policy at King's College London comments: 'We have found that NHS staff support the goals of this programme and believe in the benefits of IT modernisation. But they have a number of serious concerns, in particular potential risks to patient safety. It's crucial that patient information is stored and accessed via a robust, secure IT system. While the delays continue, IT networks are becoming outdated and there is a real risk that patient care could be compromised.'

The NHS IT programme is the largest civilian IT programme in the world with projected expenditure of over £12 billion. The main features of this system include a new broadband networking service, electronic booking and a nationally accessible summary of patient records.

Other issues that were identified in this study were a lack of faith in the patient booking system and there was a general questioning of whether the original goals of NHS-wide connectivity could ever be achieved.

Dr Jane Hendy of the Tanaka Business School at Imperial College London says: 'We recommend that Connecting for Health urgently address the current uncertainty experienced by trusts and take responsibility for advising about interim decisions. Against other competing financial pressures, trust managers need assistance to prioritise IT modernisation, with solutions that can be delivered quickly, are value-for-money and are consistent with the programme's overall goals.'

Dr Barney Reeves of the Clinical Trials and Evaluation Unit at the University of Bristol adds: 'The concept of the NHS IT programme remains visionary and hospital staff in the NHS urgently need the facilities that it will bring. It will be a disaster if the opportunities afforded by the programme are jeopardised by the challenges associated with implementation.'