Lack of consultation and the threat to GPs existing computer systems are the biggest failings of the National Programme for IT and the ones that has angered most GPs, according to feedback from GPs who were questioned in the latest survey by Medix-UK.

Out of the 900 doctors who took part in the survey, 191 took the time to add additional comments of which 93 per cent were critical of the scheme.

Dr Mike North, a GP in Maylandsea, Essex and one of the GPs surveyed, told EHI Primary Care that GPs were not being listened to.

He said: "The meetings we have had have just served to further alienate GPs because we are patronised and it is made clear to us that this is government policy and we just have to roll over and get on with it."

Dr North said he listened to a presentation about Choose and Book at his PCT’s professional executive committee meeting last week.

He added: "I was asked, "How can we sell this to practices?" and my answer was that if you come up with something that’s been well thought out, discussed with GPs, piloted and shown to be an improvement then you have a realistic chance of getting GPs to use it. None of that has happened."

Similar experiences were reported by Dr Derek Greatorex, a GP in Kingsteignton, Devon, who also took part in the survey. He described the consultation held so far as minimal and perfunctory rather than a genuine dialogue between GPs and the programme.

Dr Greatorex added: "There’s an information gap and I am a member of our PCT’s professional executive committee so if anything is going on I should be in a position to know about it."
Dr Greatorex said the greatest concern locally was that GPs would have to abandon their present clinical systems. Dr Greatorex’s practice, like many in the south-west of England, uses Microtest, not one of the systems with which local service provider Fujitsu currently has a contract.

He added: "Although we’re told that we will have a choice the message that is coming through to us is that you can use our system for free and if you choose anything else you will have to pay for it."

Many GPs who took part in the survey raised concerns about the amount of money NPfIT would cost and questioned the priorities of the programme.

Dr Michael Gocman, a GP in north London, said money should first be spent on efficient systems to deliver discharge letters and investigation results from secondary or primary care rather than focusing on issues such as electronic booking of appointments.

He added: "It’s very sad that GPs haven’t been asked about any of this. We desperately need the basics sorted first before ideas like Choose and Book are implemented."

Dr Jonathan Chappell, a GP in Battersea, London, said he was concerned about being a passive recipient of a system that was not designed for his patients’ needs.

He added: "I feel very tense about what is going to happen and fear that well meaning IT people are going to decide what is best for me and my information needs in my consultations with patients rather than we who are at the coalface."

Dr Mark McCartney, a GP in Cornwall who took part in the survey, is also a Microtest user and said he was concerned about system choice and the confidentiality of patient information.
"As GPs we are data controllers and we take that responsibility very seriously. I have contacted the national programme because I have a patient who had read about the plans in the papers, was concerned about it and did not want their information passed on in that way. I am concerned that there will be no opt out for patients unless you are an MP or a member of the royal family," he added.

Dr June Betts, a GP in Hampton Wick, Surrey, said she was considering a sabbatical next year and was interested in working for NPfIT. She added: "I looked on their recruitment agency’s website and there were no clinical posts. They may well have filled all the ones they want as far as I know but I am worried that they haven’t got enough user involvement. We have no information here about what they are doing."