Achieving changes in human processes to accommodate the IT revolution is perhaps the greatest challenge to the successful implementation of improvements in the quality and efficiency of healthcare, senior NHS figures say in an article published this week.

Otherwise, manual processes will simply be replaced with digital ones, they warn.

In a commentary article in the Journal of the American Medical Association (subscription needed), Dr Cyril Chantler, former chair of Connecting for Health’s (CfH) Shared Record development committee, Trevor Clarke, director of clinical services at Great Ormond Street hospital and Richard Granger, CfH chief executive say that good progress has been made on NPfIT.

"Much remains to be done. Many of the new hardware and software systems are not yet in place but should become available over the next three years, although there are still technical problems to be resolved," they say.

In a wide ranging summary of progress on the national programme, the authors conclude: “Perhaps the greatest challenge to successful implementation to improve the quality and efficiency of health care is the human processes that need to change to accommodate the IT revolution. Otherwise, manual processes will simply be replaced with digital ones."

They acknowledge the findings of the National Audit Office report, which called on CfH to "win the support of staff and to determine the changes necessary in the way the service is managed and care is delivered."

“Above all will be the need to provide sufficient training for staff, especially clinicians, to use the new systems,” the authors say.

The paper also discusses the deployment of the NHS Care Records Service (CRS) and measure being taken to ensure it is safe and secure. The authors emphasise that there are measures in place to tackle ongoing issues over confidentiality and privacy.