Docs call for clinical review of NPfIT

Doctors have voted for a clinically-led review of the National Programme for IT in the NHS and called on the British Medical Association to campaign for local IT solutions.

The BMA’s annual representative meeting in Liverpool supported calls for an independent review, for NHS Connecting for Health to release money for local clinical system purchase and for it to concentrate on developing specialty professional standard clinical datasets.

Dr Gordon Matthews, a consultant orthopaedic surgeon at Buckinghamshire Hospitals NHS Trust, told the ARM that doctors at his trust were still having difficulties with Cerner’s Millenium system three years after its installation.

He added: “Since the NCRS went live our trust has been unable to collect electronic data on surgical complications or outcomes other than death; and I’m informed it’s not possible to re-programme Cerner Millenium.

“We are now struggling to install a piecemeal system to run in parallel with CRS to provide some clinically useful data.”

He said a review led by clinicians was essential to ensure the NHS got the clinical solutions it needed.

Dr Paul Flynn from the BMA’s Central Consultants and Specialists Committee said he had been brought in by the BMA to help doctors at the Royal Free Hospital in London following the implementation of Cerner Millenium.

He told the meeting: “I saw doctors who were enthusiasts for IT turning to complete despair. I have seen doctors almost in tears because of how frustrated they are at being prevented from doing their jobs by the IT system.”

Dr Deidre Hine, chair of the BMA’s Working Party on IT, told the meeting that the BMA was already insisting on a clinically led review in its discussions with the Department of Health.

In a debate on data sharing and confidentiality, representatives backed calls from GPs for an opt-in approach to the transfer of patient identifiable data.

They also condemned the government for its failed attempts to make data sharing easier through clause 152 of the Coroners and Justice Bill, which was eventually dropped by justice secretary Jack Straw.

Dr Gill Beck from the Buckinghamshire division congratulated the BMA for its part in stopping the move but said the BMA needed to continue to fight to protect patient confidentiality.

“This potential access to 50m medical records remains extraordinarily tempting for the surveillance-obsessed UK government that we have got, and they have a proven track record for reneging on their promises,” she added.

Dr Grant Ingrams, co-chair of the Joint IT Committee of the Royal College of GPs and the BMA’s GP committee, told the conference he was being asked for advice from GPs on almost a daily basis about request for access to patient data.

“Sometimes these requests are legitimate but more often than not the proposed extraction is unlawful and totally inappropriate,” he said.

However, professor Michael Rees from the BMA’s Medical Academics Staff Committee, warned an opt-in might have a detrimental effect on legitimate research.

He said: “If we are going to go for a full opt-in system, then we have to be in a position to discuss the issues with patients. If we haven’t got the time to do that and patients automatically opt out of research then we will be doing a great disservice to our patients.”

However, Dr Ingrams said he did not believe an opt-in approach was inconsistent with research. He also disagreed with an A&E consultant who said an opt-in might lead patients to withhold vital information, while unconscious patients would not be able to give their consent.

Dr Ingrams added: “Patients should have the right to make poor decisions and just because you’re unconscious doesn’t mean you shouldn’t still have a right to privacy.”

Doctors representatives also attached the DH’s support for patients to rate their doctors on websites.

The ARM claimed this had the potential to mislead patients and reduced “the complexity of patient care to that of holiday and consumer item user reviews.”