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.

Last updated: 9 January 2013 04:52

CCG |  CSU |  HIS |  Survey

Fiona Barr

7 January 2013

Increasing engagement

Mark Clark, Imprivata171 weeks ago

The latest reforms represent an unprecedented structural shift in the way the NHS will work moving forwards and in particular, how it will tackle the need for innovation. Naturally, any change will bring uncertainty with it, but perhaps the best way to deal with this uncertainty is to improve communication between clinicians and IT decision makers.

For example, if users feel that their CIO/CCIOs are engaging them in new projects by allowing them to have an opinion and provide suggestions that will lead to solutions that help them improve the way they care for their patients, then they are more likely to have a positive attitude towards change. The failure rate of IT projects that are undertaken without clinical engagement is substantially higher than those that are developed based on input from care providers. Strengthening this channel of communication would ensure that care providers won't be left in the dark and will have a voice in the drive towards innovation, which is critical to meeting the ultimate goal of improving the efficiency and quality of care.

- Mark Clark, VP of International Sales, Imprivata





Ask the CCGs

Chris Frith172 weeks ago

A test of the NHS reforms would now be to ask staff in the CCGs and CSUs the same questions and compare the results. If they are not more positive the CB may have to consider being less controlling and push the control of the IT budgets closer to the users from CSUs.

It is only when the users of the clinical IT are in control of the money, as was pre 2004 in primary care that a competitive developing market will emerge once more but this would require the government to substantially change the GP contract which i believe they won't dream of touching until after the next election. In the mean time is the role of the NHS public employment rather than public service?





" this would require the government to substantially change the GP contract..

Mary Hawking172 weeks ago

..which I believe they won't dream of touching until after the next election"

Chris, the changes to the nGMS contract being imposed next year and thereafter mean that the government has *already* effectively torn up the GP "contract"!

The idea that they would consider giving any control to individual practices or even CCGs (if they survive the effects of changes on their Members - who are the practices) would seem to go against the current trend of devolving responsibility to the bottom - and control of even the most minor details (and finance) to the top!

Anyone else remember NLOP?

Another system based on the same principles.





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