Reforms will weaken IT services – survey

NHS IT staff opinion is divided over the impact of the latest reorganisation on local IT and information services, EHI Primary Care’s latest survey suggests.

The exclusive survey of more than 100 staff, most of whom currently work in primary care trust IT departments or for health informatics services, found that more than half (61%) believe the reforms will ‘weaken IT services’ in their area.

However, almost a third (29%) were more optimistic about the effect of the reorganisation triggered by the ‘Liberating the NHS’ reforms, predicting that they will lead to an improvement in IT and information services.

PCTs, which were responsible for local access to national IT systems, infrastructure services, and other IT and information support, will be formally abolished in three months’ time.

They are being replaced by clinical commissioning groups, which, in turn, will get IT and information support from new commissioning support units and other organisations.

The survey asked those respondents who knew that they would be working for a CCG, CSU, or other new organisation whether IT was being prioritised by their receiving organisation.

Just under a quarter (23%) said that IT was being seen as ‘a very high priority’ by their organisation, and a third (30%) said it has ‘some priority’. Only 13% said IT was being given ‘no priority at all’.

Roz Foad, chair of the British Computer Society’s Primary Heathcare Specialist Group, said she would have hoped that more than 23% of respondents would have reported IT as a high priority.

She added: “Certainly the Department of Health considers it central; hence the setting up of the NHS Information Centre and the GP Extraction Service.

“There are consequences to this that need to be worked through, including information governance, and it is the local organisations that will have to manage this.”

Maintaining and improving existing infrastructure was identified as the most immediate IT priority by the largest group of respondents (30%) who knew they would be working in the new structure. 

This was followed by improving GP systems (13%), investing in business intelligence (12%) and improving links with other NHS bodies (9.2%).

However, respondents also noted that immediate priorities included “convincing the CCGs we are worth keeping on” and “maintaining staff morale as we go through the recruitment process, downsizing in the process.”

No respondents suggested that improving links with social services or improving services for patients were being seen as priorities.

Only one respondent said their organisation was interested in communication tools for patients and the public, and none said they were investing in patient-held records.

But then, only 22% of respondents said they believed the reforms would lead to greater investment in IT and information services; while more than one in two respondents (60%) predicted the changes would lead to reduced investment.

One respondent said: “I expect investment to be reduced. This is the purpose of the reforms.”

The mixed responses may reflect current uncertainty about the new organisations, which are clearly taking time to find their feet.

Just 12% of respondents said their organisation had appointed an IT director and just 13% reported that senior IT staff were in place.

Only 7% said an IT strategy had been drawn up. And 43% of respondents did not know if these building blocks of IT had been set in place.

One respondent said: “The CSU has completed a number of tasks including appointment of a director and senior staff, has identified premises, has an outline strategy and has commenced key procurements.” But another said: “Nothing has been done.”

The survey found that attitudes to the reforms have changed little over the two and a half years since they were launched.

In 2010, more than 50% of the respondents to a similar EHI PC survey believed the reforms would lead to worse patient care, while 25% predicting that care would deteriorate greatly, and 28% predicted it would decline by a small amount.

This time, the poll found 55% of respondents were opposed to the reforms, with 20% expressing support for the government’s changes, and the rest declaring themselves ambivalent.

The poll was conducted in November and December 2012. Those taking part included senior managers (30%) managers (30%), directors (10%) and staff (30%). More than 60% had worked for the NHS for more than ten years and 27% for more than 20 years.

Read more about EHI Primary Care’s latest, exclusive survey in Insight.