Concern over User Involvement in Health Service IT Proposals

The British Computer Society has criticised the proposed National Health Service IT upgrade programme for too much centralisation.

'While we have no doubt that effective IT can both significantly reduce medical errors and improve patient care, we see some issues to achieving this which are not being fully addressed by the Department of Health's recently published strategy,' says Glyn Hayes, chairman of the BCS Health Informatics Committee and a former GP.

The BCS believes that the current proposals centre on establishing the office of a director general of IT, which will set up preferred supplier consortia using big and mainly US companies and combining facilities management with specialist applications from current NHS IT suppliers. But the BCS warns against simply providing systems without allowing for significant local user involvement in introducing them.

A real problem comes from NHS staff's lack of awareness of the real potential of IT, plus a lack of enthusiasm and even fear of IT systems, the BCS says. This common problem, found in many industries, can only be resolved by education and training, it says.

Dr Hayes points also to 'a patchy information culture in the NHS'. 'Trust boards frequently hand IT over to finance departments - and a natural result is emphasis on the management of resources rather than direct patient care,' he says.

'Although the new strategy proposes the appointment of chief information officers at strategic heath authority level - which we very much welcome - we feel that qualified, experienced IT management also need to be employed at the individual trust board level to have the necessary impact on day-to-day care.'

The BCS says it recognises the 'significant successes' in NHS IT so far - and has some concerns that these could be lost in the new approach.

These successes include primary care computing, where it says the UK leads the world; several acute sector initiatives; and all areas where an information culture has clearly been nurtured. These are excellent examples for the future, the BCS says.

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