NHS staff buy-in is essential for project success

The National Programme is more or less certain to sign its first contracts next month. Few people believed it would manage to be on time when Richard Granger was appointed director general of NHS IT a year ago. But if the deals are signed next month the celebration will be muted.

There is still an undercurrent of resentment towards the whole programme. Some NHS IT managers and suppliers still argue that setting national standards but leaving the NHS to build systems locally would be a better way forward, because of the public sector's record on IT procurement and the intricacies of NHS work.

Unfortunately, something like this was tried with the 1998 strategy Information for Health. It is now seen as over-ambitious and was certainly hamstrung by a lack of money and general management support and complex procurements that did nothing to improve the pool of suppliers.

Its failure seems to have persuaded most NHS IT managers to support the National Programme as 'better than what went before'. However, a survey earlier this year by the Association of ICT Professionals in Health and Social Care (Assist) found only 49 per cent thought it would deliver 'real benefits' to their organisations.

It also found considerable scepticism about timescales, workload, resources and the capabilities of the companies likely to win the big contracts.

Granger's bullish attitude soon convinced observers he would get his contracts signed. But what will they really deliver?

A key issue will be the attitude of staff on the ground. General managers have started showing much more interest in IT recently, because they realise they will need it to deliver the government's modernisation programme.

However, another recent survey found most doctors have not heard about the National Programme, even though their leaders have been warning it will fail unless they are involved.

Engaging clinicians has become a priority and the National Programme has moved to involve some high profile doctors, including Peter Hutton, chair of the Academy of Royal Medical Colleges.

But Hutton is generally seen as an advocate of reform and he also sits on the board of the NHS Modernisation Agency, which is being drawn into aligning the IT programme and the modernisation agenda.

The new IT programme may win over some doctors - GPs who get access to tests and services currently locked up in secondary care, for example. But it may alienate others by pushing the trend towards protocol-delivered care and team working. Sorting through those subtly different agendas to make sure the IT delivers real change will make getting the contracts signed look like the easy bit.