NHS trusts are looking to “sweat” their current IT systems instead of invest “in new toys” as they struggle with efficiency saving demands.

An exclusive eHealth Insider survey, more details of which are published today, shows that board level and senior IT managers are expecting to see their budgets cut significantly over the coming year, and to have to make significant job losses.

It also suggests that their focus is on “keeping existing systems up and running” or on delivering basic infrastructure upgrades, rather than on major investments.

However, a quarter of those who responded said their trusts were planning to deliver a major patient administration system or electronic patient record upgrade.

Free text comments suggest that trusts in this position are planning major projects to achieve foundation status or deliver big efficiencies.

Yet responses to another question, on what is influencing IT strategy, suggests trusts are struggling to take a strategic approach to investment.

Only one person said NHS Connecting for Health was still the “main” influence on strategy, while eight said the trust board and nine individual departments and clinicians.

Just three picked “local commissioners”, suggesting the government’s latest reform programme, which is intended to pass power to GP commissioners and ginger up the provider market, is yet to have much effect.

EHI ran the survey through April and picked up 102 responses in total. A quarter (24) of these were from people who identified themselves as directors or senior managers of IT.

They were asked a series of more detailed questions about investment plans in the grim financial climate, in which trusts are expected to make £20 billion efficiency savings over the next four years.

One in five senior managers said their trust’s main focus was to achieve foundation status, and another four in ten said it was to “achieve/maintain financial balance by cutting costs.”

In line with this, a third said their main priority was to keep current systems up and running or to deliver basic infrastructure upgrades. “[The focus is the] exploitation of current systems, rather than ‘new toys’,” one wrote.

Just under half of respondents said they didn’t need a new EPR, because they had bought through NPfIT or invested themselves. Two more said they would wait for NPfIT and two more that they would tender, but another two said their trusts were “unwilling/unable to invest”, and seven said they were “looking towards a portal to connect existing systems”.

“We were intending to buy a system to integrate key systems to support clinical care. Now we have no budget, but still the same demands from staff,” one respondent wrote. “It’s an impossible task. Coupled with that is a whole raft of new systems from community that we will have to support.

“The pathfinder [early GP commissioning consortia] requirements mean far more analysis is needed from these systems… but we don’t even know how they work yet! GPs will not be getting the information the DH says they need, as we just can’t produce it.”

Other respondents suggested that they would see increased IT investment eventually, and that when it came it would be allied with “properly constructed business cases” for change. And there is clearly a big appetite for more IT.

Almost 90% of respondents were interested in virtualisation (18), wireless networks (12), e-prescribing and order communications (16 and 14), and data warehousing and Business Intelligence (15). There was also interest in digital dictation and speech recognition, check-in kiosks and patient communications.

There was also a big appetite for mobile devices. More than half of respondents were enthusiastic about investing in mobile devices such as iDevices (10) and BlackBerry smartphones or similar PDAs (13).

Read more coverage of the survey in the Insight section.