Survey shows waning support for NPfIT

Waning enthusiasm from doctors for the National Programme for IT (NPfIT) is recorded in a Medix survey of medical opinion prepared for E-Health Insider and other media.

Only 30% of GP respondents say the programme is an important priority, compared to an all-time high of 70% in a similar survey in November 2004. A parallel decline is recorded among non-GPs whose rating of the programme as an important priority has dropped from a high of 80% to 45%.

Although 23% and 35% of GPs and non-GPs respectively said they were enthusiastic about the programme, the ratings stood at 56% and 75% four years ago.

Asked to rate the programme’s progress, the vast majority (71%) scored it as poor or unacceptable. No respondent checked the box for ‘excellent’ and only 1% thought NPfIT was making good progress.

Connecting for Health, the agency responsible for the programme, says the results of the survey do not appear to reflect the general picture on the ground or chime with other recent comprehensive surveys.

The Medix survey is the latest in a series that started over four years ago. It was conducted at the end of October and beginning of November, gathering the views of 1,064 doctors – just over 1% of the medical profession in England – comprising 44% GPs and 56% doctors practising in other areas, predominantly hospitals.

In both groups, large numbers of respondents maintained a positive belief in the programme’s potential to deliver benefits for patients, with 48% of GPs and 60% of non-GPs foreseeing a positive effect on clinical care in the longer term. About half of these respondents also believed there would be benefits in the next year or two.

However, the doctors were divided on the question of whether there would be improvements in their own working lives with 50% of non-GPs seeing the potential for gains in the longer term – but only 27% of GPs holding the same view.

There was a continuing high degree of pessimism about the effect on patient confidentiality of the Care Records Service (CRS), which will see much wider use of electronic records. Over three quarters of GP (76%) and more than half (55%) of the non-GPs felt the new service would make confidentiality worse.

On the upside, however, 47% of the total sample thought the CRS would enable better decision making by giving clinicians access to up-to-date information.

Some of these enthusiasts appear to believe that some loss of confidentiality might be price worth paying for better information. Nearly half (44%) of respondents who had answered positively to the question about improving clinical decision making felt that some additional risk to confidentiality with the advent of the CRS would be acceptable.

Among the specific NPfIT initiatives, Choose and Book continued to be most controversial. There was evidence of substantial numbers of GPs becoming familiar with the choice and e-referral programme; 74% said they had some experience of using the service and, of these, about half used it for more than 40% of referrals.

Among free text comments recorded by the survey it was hard to find anyone with a good word to say about Choose and Book, though some respondents conceded it was a sound idea in principle and others thought local implementation, rather than the national application, was the source of problems.

“Hopelessly slow and wasteful of resources”; “out of focus and off-plot for the tasks in hand” and “unsupportable and a colossal waste of resources and clinicians’ time” were among the comments made.

A copy of the survey was sent in advance to Connecting for Health and a spokesperson commented: "NHS Connecting for Health engages in active and ongoing consultation with a wide range of clinicians, across all elements of the National Programme for IT, both in the development of systems and in their ongoing use. Only today [Thursday 15 November] 200 clinicians gathered in London to meet with the programme’s senior management.

"We take the views of the public, patients and front-line NHS staff very seriously. We would view these results in light of what patients tell us. For example on the positive contribution Choose and Book has made to patient referral times and the early signs from those areas introducing the Summary Care Record about the improvement this will make to patient safety.

"In the light of all of this wider experience and evidence, the results of the Medix survey do not appear to reflect the general picture on the ground or chime with other recent comprehensive surveys.”

Link

8th Medix Survey re the NHS National Programme for IT

Linda Davidson