Nurses ‘losing enthusiasm’ for NHS IT reform

The number of nurses across the UK who believe in the benefits of IT reform in the NHS is falling, says the latest Nursix survey published by the Royal College of Nursing.

Around 56% of nurses now say that IT reform is likely to improve clinical care and 49% agree that it will improve their working life. However, these figures are down from the 2004 survey, in which 70% and 59% of respondents agreed with the question.

"This may well be as a result of a continuing lack of personal consultation and engagement," says the survey report. "This is despite two years of assurances by the NHS that inadequate consultation was being remedied and abundant evidence, not least from other public sector IT projects, that poor consultation with end-users is a primary cause of project failure."

Over 4,000 nurses from across the UK took part in the third annual RCN survey on NHS IT developments, carried out by independent polling organisation Nursix, part of Medix UK.

Sharon Levy, informatics advisor to the RCN, told E-Health Insider that the third survey that the organisation had done showed the membership’s "frustration" with the current situation. "We don’t see enough progress across the UK… This obviously has implications within the current financial constraints and issues within the NHS. There are some concerns that nurses are raising there."

The survey found that 62% of nurses in England, Scotland and Wales said that they had had no consultation about IT reform. 87% of all nurses said that consultation on the electronic patient healthcare record with nurses was very important or fairly important.

Levy argued that the key thing to make nurses become more involved in electronic patient records and IT reform was that the new IT systems should consider the outcomes of their work.

He stressed there appeared to be a difference between the policy decisions being made to place responsibility on care from nurse practitioners, and an apparent lack of accountability on the care record.

"For too long we have seen nursing not being verifiable enough. If you are putting nursing actions, nursing data stats, nursing deployment on the record we will be able to track care gains from nursing input. All we can have is a medical intervention and health gains. It doesn’t do nursing any favours," said Levy.

"We have to understand that nurses aren’t trying to be mini doctors, they are trying to be maxi nurses."

The overwhelming majority – 95% – said that provision of training was important. Levy said that this, along with access to IT, needed to be tackled at trust level: "We don’t want to see nurses to be trained to be operators, just pressing the keys."

The survey covered England, Scotland and Wales, and found broadly similar results for all three countries. Northern Ireland was omitted from the survey as the response was too small to be statistically reliable.

It was also ‘remarkable’ that the findings were similar even if organised by job type, qualification date, or employer, said the survey report.

The apparent fall in enthusiasm is despite some attempts by Connecting for Heath, the agency heading the English NHS IT project, to engage the nursing profession.

In March, Connecting for Health organised its inaugural Nursing and Midwifery conference in London, which was full to capacity. They also announced they were registering 400,000 members of the RCN on the NHS e-mail service Contact.

Levy praised the work of CfH nursing clinical leads Barbara Stuttle and Susan Osborne, and stressed that the survey was not all negative and nurses still believed that IT "could provide the potential to support their work".

Levy said: "This is not just about teaching nurses to press buttons on a computer. Information and its use and management are central to nursing and delivering good patient care.

"We have got to give nurses the right training and support so that the NHS and patients see the benefits that IT could bring to healthcare. If nurses continue to be ignored, a huge amount of money and effort could be wasted in yet another failed public sector IT programme."

Dr Beverly Malone, general secretary at the RCN, said: "In the current financial crisis in the NHS it is hardly surprising that nurses are expressing reservations about the large and expensive national NHS IT programmes. Nurses will be by far the largest group of health professionals using NHS IT systems, yet they are hardly being consulted or informed about developments."

Barbara Stuttle, CfH nursing clinical lead, said that the agency was learning from the results of the IT survey.

"[We] hope that through our work, not only with the RCN, but other nursing bodies too, we can improve the results for next year by being proactive in working with and engaging in the design and implementation of IT.

"However, we should not forget that the work of NHS Connecting for Health is taking place during a great period of change in the NHS. The IT programme is a ten year programme, which is evolving the way forward gradually." 

She added that a ‘visioning day’ was being planned with the RCN in order to address engagement issues and strengthen the partnership between CfH and professional nursing organisations.

Documents

Royal College of Nursing / Nursix.com survey: Nurses and NHS IT developments [PDF, 209K]