NPfIT: engagement on electronic referrals will wait

Claire Mitchell, group programme director for Booking & Choice at the national programme, told delegates at Clinical Information Systems and Electronic Records and e-Health 2004 that engagement on electronic referrals had been happening at certain local levels, but will not yet occur on a national level.

“[One area] we have worked quite hard at is engagement. I am aware of comments in some of the press about lack of engagement,” she said. “My philosophy is ‘engage at the right time’. The worst thing is that you start to engage people, and there’s nothing there to show."

However, when asked when national engagement was likely to occur, she replied that it would be premature to make any announcements and that engagement in terms of a big, national campaign would happen “when we have sufficient communities using it, and we are satisfied, and enough have entered."

Mitchell was also careful to point out that engagement, rather than consultation, was the purpose of liaising with local GPs, and that the purpose of her role in the testing was in no way to take notes about what clinicians want from the new systems and the data spine.

For example, one question that had been brought up was that some GPs were uncomfortable with having the booking systems that allowed patients to choose the appointment they wanted installed in a public area.

Select numbers of local GPs in London and Yorkshire were piloting the system. “We are working with ten registered doctors," Mitchell confirmed. Existing systems were being upgraded to work with electronic referrals.

“It’s fair to say, most clinicians I have come into contact with have been sceptical,” she said. “Showing them what the system does demystifies it."

Mitchell also indicated that transferring paper and legacy record systems onto the spine was taking a lot of work: “What’s taking the effort is you need to register people and make sure your information stays up to speed."

Earlier in her speech, Mitchell spoke about the challenges of managing such a large project, and stressed that others getting involved was extremely important to success: “Getting governance right, getting chief executives involved, is one area we need to get right… having medical doctors involved, and clinical doctors involved, is absolutely key as well."

“Articulation of benefits” was crucial too, and was a hurdle that needed to be overcome: “There’s almost a fear of talking about benefits realisation."

When asked about what clinicians should do if they wanted to upgrade their PAS before electronic referral was implemented, Mitchell urged caution as IT systems will be undergoing a great deal of change. “We have to do an awful lot work in setting compliance. You have to upgrade the patient information systems to make this work. As we go through the coming years, the systems will be replaced. We are upgrading systems to comply."

Despite her declaration that national engagement will not happen until the system is in use, Mitchell emphasised that NPfIT is still open to queries. “Ask a question, and we will get that into an FAQ on the web."

E-Health Insider was a media sponsor of Clinical Information Systems and Electronic Records and e-Health 2004.