Readers back reformed NPfIT

The National Programme should not be scrapped although it should be reformed, a major survey by E-Health Insider and Doctors.net.uk has concluded.

The poll on the future of electronic health records in England was run last month in response to the publication of the Independent Review of Health and Social Care IT and the Conservative Party’s response.

Although the Conservatives did not call for the programme to be scrapped, they called for much of its central architecture to be "dismantled" and for its multi-billion pound local service provider contracts to be renegotiated in favour of more local control over IT decision making.

Respondents to the survey, which has been released today to coincide with the start of the Conservative Party conference in Manchester, broadly backed this approach. EHI readers, in particular, backed interoperability rather than centrally purchased systems as the way forward.

Jon Hoeksma, editor of E-Health Insider, said: "The support given to the national programme was surprising, but it probably reflects a growing recognition that the NHS needs to get good IT systems in place.

"Doctors, NHS IT professionals and suppliers all want a national programme. Just not the one that they have got."

Doctors were keener than IT managers and suppliers for the national programme to be scrapped. Indeed, more than half (54%) of the GPs who took part through Doctors.net.uk agreed that the programme should be ended, in comparison with 43% of consultants and just 25% of junior doctors.

Just 22% of EHI readers working in the NHS and 28% of suppliers felt the programme should be ended. But an overwhelming majority – in excess of 80% in all groups – wanted it reformed.

In line with this, two thirds (66%) of EHI readers felt that centrally purchased, common systems were not the best way to develop detailed electronic patient records; and 86% felt a wider range of interoperable systems using standards to share data would be.

Doctors were less clear on this point. But then, doctors had different views from other groups on why progress on implementing IT in the NHS has been so slow.

EHI readers were much more likely than Doctors.net.uk readers to blame “centralised policies” (with 24% and 16% picking this as the biggest obstacle) but fewer blamed “political interference” (13% and 25%). Doctors were more likely to blame lack of consultation with clinicians in designing systems (46% and 29%).

Asked about the importance of the different things that the national programme is trying to do, there were some clear differences of opinion.

There was overwhelming support among all groups for detailed care records and Summary Care Records except among GPs (only 9% of whom rated SCRs as “very important”), but much less for Choose and Book, particularly among GPs (only 3% of whom rated it “very important”).

Asked about the Clinical 5 for hospital systems, there was strong support for a patient administration system and order communications.

But EHI readers were much keener on e-prescribing than Doctors.net.uk readers (with 12% and 5% picking this as “most critical to clinical care”). Doctors were more anxious to see discharge letters with clinical coding in place (27% to 8%).

"The survey shows that reforming the programme may not be as straightforward as some of its opponents suggest," Hoeksma added. "The principles of Dr Glyn Hayes’ independent review are well supported, but a further round of highly-politicised change is not."

More news: The survey also revealed strong support for the NHS’ personal health record platform, HealthSpace; and a lack of support for companies like Microsoft and Google holding health records.

News analysis: Read more about the survey and the comments that respondents made on it in our news analysis: Put cross here.