National Programme for IT in the NHS (NPfIT) is at risk despite costing millions

The new National Programme for IT in the NHS (NPfIT) is at risk despite costing millions, because staff locally have been left feeling disengaged in the process, says a study in this week's British Medical Journal (BMJ).

NPfIT - which will provide new information and technology systems, such as a centralised patient record that can be accessed across England - "promises far-reaching benefits for patients and throughout the NHS", say the study's authors.

But when they examined how well the programme was being implemented at four hospital trusts in England, they found that front line staff felt heavily demoralised about the project. And managers felt there was so little communication and consultation from NPfIT headquarters that it posed a threat to getting the programme up and running.

Researchers chose the hospitals for having various typical conditions – size, financial health, star ratings, etc. They talked to 23 senior managers and clinical staff involved in putting the programme in place in their hospitals.

They found that, although the Government allocated an extra £2.3bn for NPfIT in 2002, there was uncertainty amongst staff about when NPfIT systems would be implemented in hospitals, and what funding would be provided to support this at a local level. This uncertainty is deterring trusts from getting on with implementing local support systems, the researchers discovered.

Some trusts reported that local, existing IT systems for radiology and pathology urgently needed replacing– but these have been put on hold as implementation of NPfIT is phased in across the country. "Such delay may mean a risk of system failure, but buying a temporary solution is seen as costly", say the researchers.

Many participants felt that local managers and challenges arising from local circumstances were not understood or ignored – leaving them feeling disempowered, and uncertain how to promote to staff a system without detailed information about its local application. As the implementation of NPfIT will mean considerable disruption for staff and difficult interim arrangements, this is a crucial problem, say the researchers.

Staff have shown a willingness to overcome the technical problems of getting NPfIT working, say the researchers, but it's time the National Programme's headquarters engaged with managers and health professionals to implement this programme. NPfIT's success depends on it, they conclude.

Contacts:
Until Friday 5 August: Dr Jane Hendy, Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, UK
Tel: +44 (0)207 927 2964
Mob: +44 (0)7967 751323