Keyboard and hand Daloni Carlisle

The Royal College of Nursing is to push IT up the agenda this year in a bid to make sure its members are engaged with the national programme.

Sharon Levy, the RCN’s Informatics Adviser, is setting out his stall on how nurses have not been engaged so far, what NPfIT needs to do and how the RCN intends to support that.

He says: "When you talk to nurses working for the NPfIT they think that the programme is not celebrated enough. We need to see more nurses knowing about the programme and appropriate mechanisms for them to influence how it is progressing for the benefit of both patients and clinicians."

"Not even heard of NPfIT"

"We need a Heather for every day of the week"

— Sharon Levy, Informatics Adviser at the Royal College of Nursing

In the RCN’s view the progress so far on engaging the largest professional group in the NHS has been poor.

An online survey by the RCN last year found that many nurses had not even heard of the national programme. While they recognised the potential benefits of new systems – including electronic patient records – they had major concerns about the profession’s involvement in their development.

"They felt they needed to be involved in the design of systems but were excluded from decision making," says Mr Levy.

So while the RCN welcomes the NPfIT’s new clinical engagement programme there is a feeling that this is too little too late. "The fact that there has to be a programme for clinical engagement is quite alarming," says Mr Levy.

Last November, Heather Tierney-Moore, chief nurse for the Sheffield Teaching Hospitals NHS Foundation trust, joined NPfIT as clinical nurse lead.

"We are encouraged by Heather’s appointment and think she is very brave to take this on. But she is only there one day a week. This is a big concern, especially compared to the medical involvement where there are two hospital doctor leads and two GP leads. We need a Heather for every day of the week."

Fair dos, though, says Mr Levy. The NPfIT is about to appoint a second clinical nurse lead from a primary care background. The name is due to be announced in April.

Meanwhile the RCN continues to meet with Ms Tierney-Moore to take forward its concerns.

A false economy?

"At the moment we are not sure what the new systems will do for the clinical work flow"

— Sharon Levy

"One of the key issues for our members is about the evidence base. We want to see how the national programme is based on best practice and the evidence relating to change management and whether the systems are the best ones to address the needs of nurses. At the moment we are not sure what the new systems will do for the clinical work flow," says Levy.

Training is another key concern. Last year’s survey highlighted this as an issue, with many older nurses fearing they would be left behind.

Mr Levy says: "If nurses are not confident and competent and if the right support is not there, then the discounts that the NPfIT has negotiated on the boxes on desks will be academic."

In primary care nurses are concerned about whether the systems will be fit for purpose. "Community nurses and health visitors are going to need mobile technology that gives patients access too."

The RCN is not sitting on the sidelines sniping, says Mr Levy. The organisation has developed an e-health strategy and is now looking at joint publications with Ms Tierney-Moore’s team to guide clinical nurses through the changes.

There will be a repeat of the on-line survey in he next few weeks, with the results ready for a major debate at the RCN congress in April. "Last year we held a fringe meeting with 50 people," says Mr Levy. "This year IT will be debated in the main hall by 5000 members."

Mr Levy’s views are, of course, well-rehearsed. Last time they were reported on E-Health Insider there were two responses: one in support of his view of an NPfIT that had failed to engage nurses and a second quite different world view in which nurses simply did not respond to invitations to get involved.

"I do have some sympathy with that," says Mr Levy. "But nurses work very hard and if you expect them to drop everything to come to a meeting and leave their colleagues to cover for them, well that’s simply not going to happen. They need support from managers and need an appropriate level of cover. Then you might see them engaged."