Staff buy-in must be key priority for NHS IT

Buy-in from local NHS staff and consultation on change management issues must be the key priorities, as the £2.3bn National Programme for NHS IT (NPfIT) moves into the implementation phase, says the Computing-led health service monitoring group.

Last week, the last of the five Local Service Provider (LSP) deals to manage regional roll out of the National Programme was signed. Suppliers now have 60 days to produce a detailed plan of how they are going to implement the systems.

A survey from the NHS Confederation, published last week, shows a high degree of readiness amongst health service organisations. Three-quarters of respondents either have assessed, or have plans in place to assess, their readiness for electronic bookings and integrated care records. Three-quarters have or are working on plans to involve clinicians with the applications.

But the support of front-line staff is still not guaranteed, despite the creation of Clinical and Public Advisory Boards in October to counter claims of a lack of involvement.

With the LSP contracts in place, now is the time to focus on local engagement, says Laurence Harrison, healthcare programme director for supplier trade body Intellect.

'Suppliers would have liked to have seen more comprehensive communications and consultation with clinicians regarding NPfIT and what it means for them - NPfIT have been concentrating on their priorities and have only scratched the surface of what needs to be done,' said Harrison.

'Now that contracts have been signed and work is beginning, the responsibility for consultation and communication falls to LSPs and they face a huge challenge to engage locally with clinicians regarding implementation plans and change management. Implementation will no doubt take place incrementally but as work progresses NHS staff should be brought into the programme and become more directly involved,' he said.

Support in local health communities can only be fostered by other front-line staff, says government IT expert Jim Norton.

'This is about practitioners at every level proselytising and driving through involvement at the local level. Whether it is nurses or doctors or administrators, getting a cadre of them on board and going out explaining why this matters is crucial,' he said.

Security expert Peter Sommer says time is running out.

'The anxieties the monitoring group expressed last summer remain undimmed - the programme is still in danger of being imposed on a wide range of health professionals without giving them much opportunity to say how they would like their affairs to be run,' said Sommer.

'Now is the last chance for this consultation can be done, and the problem is that good change management depends on getting buy-in before you've worked out what you want to do.

'There is a pretty high chance of the programme being an expensive disaster,' he said.

Dr John Powell, chairman of the British Medical Association IT committee, and not a member of the Computing-led monitoring group, says doctors' views cover the whole spectrum.

'You can find doctors who remember the problems of the past and aren't keen on the National Programme, but if you want you can also find doctors with an optimistic view,' he said.

Powell says there should be on-going evaluation as the implementation goes ahead.

'If we are investing all this public money, we have a right to know if it is doing what it is supposed to be doing.

'I would like to see some evaluation of the tangible benefits of the programme as it is being implemented so we can see it is working,' said Powell.

A spokesman for the NPfIT said: 'The successful LSPs have been required to provide an implementation plan and an engagement plan showing how they will engage with NHS organisations in their cluster.

'The LSP will then work directly with Strategic Health Authorities and NHS organisations to develop a detailed implementation plan. This will ensure the full involvement of all NHS organisations.'