Further comment and analysis on the National Audit Office report in the NHS's National Programme for IT has been flowing....
E-Health Insider editor Jon Hoeksma have provided a more detailed critique of the NAO report into NPfIT's progress, and how far it covers clinicians' concerns, under the title Healthy optimism?
The British Computer Society (BCS) has written a press release BCS Notes that Nursing IT Skills are Vital to National Programme, according to National Audit Office Report
Nursing IT skills and involvement are vital to the success of the National Project for IT according to a recent National Audit Office (NAO) report, which has been welcomed by the British Computer Society (BCS) and the Royal College of Nursing.
According to the joint BCS Health Informatics (Nursing) Group
response to the report, many nurses at present lack the skills necessary to engage with the developments that the project will bring. The importance that the report places on education to ensure that all nurses have access to these opportunities is considered vital to the ultimate success of the project and has been widely praised by both organizations.
Dame June Clark, (Chair of RCN Information in Nursing Forum) said 'Nurses are the largest single professional grouping in the NHS, and are key to the success of the programme. Lack of involvement in the specification and design of the systems will mean that the systems will fail to “fit”, much less support, nursing practice, and therefore risk being rejected by nurses
Also highlighted is a call for organisations within the NHS to play their part fully in implementing the programme’s systems; a key priority that must utilise nurses and their skills to ensure that clinically credible, safe and effective systems are introduced across the NHS.
In conclusion, the response states that ‘winning the support of staff is vital, and with nurses consisting of largest single professional group in the NHS, their involvement is vital. The National Project for IT is a great opportunity for improving the patient experience and revolutionising the way that care is delivered in the 21st century. With transparency and a constructive dialogue between clinical staff and NHS Connecting for Health, the investment will be worthwhile’.
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The British Computer Society (BCS) is the industry body for IT professionals and a Chartered Engineering Institution for Information Technology.
The BCS is responsible for setting standards for the IT profession. It is also leading the change in public perception and appreciation of the economic and social importance of professionally managed IT projects and programmes. In this capacity, the Society advises, informs and persuades industry and government on successful IT implementation.
This was based on a "A joint response to the National Audit Office report on The National Programme for IT in the NHS by the British Computer Society Health Informatics (Nursing) Specialist Group and the Royal College of Nursing.
Nurses broadly welcome the NAO report into NPfIT programme.
Richard Hayward (Chair of BCS Health Informatics (Nursing) Specialist Group) said "It is important that we look to how to make the programme a success in the future rather than focus on the failings of the past. The need for Clinical engagement and leadership is emphasised in the report. Since many nurses at present lack the skills necessary to engage with these developments, we welcome and support the importance that the report places on education and look to the NHS to ensure that all nurses have access to these opportunities.
Dame June Clark, (Chair of RCN Information in Nursing Forum) said 'Nurses are the largest single professional grouping the NHS, and are key to the success of the programme. Lack of involvement in the specification and design of the systems will mean that the systems will fail to “fit”, much less support, nursing practice, and therefore risk being rejected by nurses. Moreover, since nursing is critical to patient outcomes, it is critical that the EHR contains appropriate nursing data; without it outcomes cannot be properly identified, or patient safety improved. What is needed now is a real commitment to involving nurses in the programme and major investment in education.”
The British Computer Society Health Informatics (Nursing) Specialist Group and the Royal College of Nursing IN Group broadly welcome the National Audit Office Report published on 16th June 2006. It is acknowledged that the report is mostly retrospective, exploring the procurement phase and cannot explore the future value for money.
"The main implementation phase of the programme and the realisation of benefits are mainly a matter for the future and it will therefore be some time before it is possible to fully assess the value for money of the programme.”
The report praises NHS Connecting for Health for the speed of procurement and whilst this is acknowledged, it is questioned if clinical involvement was sacrificed in the achievement of this speed. The skills required for procurement are very different from those of implementation. Change management and redefining how healthcare is delivered will need to be explored in detail to ensure that patient care is of the highest order. Financial constraints and cost savings must be secondary to improvements in the patient experience.
The report makes 3 key recommendations:
• Ensuring that the IT suppliers continue to deliver systems that meet the needs of the NHS, and to agreed timescales without further slippage.
• Ensuring that NHS organisations can and do fully play their part in implementing the Programme’s systems.
• Winning the support of NHS staff and the public in making the best use of the systems to improve services.
Suppliers will need to work closely with clinicians as well as NHS Connecting for Health to ensure that implementation is effective in supporting frontline staff. The role of the Clinical Leads is identified as a positive influence and it is suggested that this should be made a full time post for Nursing, given the importance of dissemination highlighted by the report.
Ensuring that NHS organisations fully play their part in implementing the programmes systems is a key priority that must utilise nurses and their skills to ensure that clinically credible, safe and effective systems are introduced across the NHS. There is an apparent perception that the programme is focused on the provision of systems for acute hospital trusts, and indeed the implementation has been patchier in this sector. There has been a great deal of successful provision in the primary care sector, although access to this by community nurses in particular continues to be problematic.
Winning the support of staff is vital, and nurses are key to this as the largest single professional group in the NHS. Champions must be found to support the clinical leads in celebrating the successes of the programme. It is too easy to find fault in a programme of this size and highlighting the benefits both to staff and patients in terms of improved outcomes must be a priority to ensure that there is support from clinical staff across the NHS and private sector. This must be reinforced by transparency in the timetable of roll out from NHS Connecting for Health
The report highlights that
“The Department, NHS organisations and NHS Connecting for Health should put in place training and development programmes to strengthen capability, including project management and IT skills available to the wider NHS, continuing its work with the Office of Government Commerce.
The shortage of such skills is an immediate risk to the timely implementation of the Programme, and strengthening capacity in these areas will be a long-term asset for the NHS.”
In a time of difficult financial constraints, education and training tend to be low on the list of priorities. The emphasis place on the need for continuing education is welcomed and supported wholeheartedly by both groups.
The Health Minister Lord Warner told the national local medical committees’ conference that a task force would be set up to speed up the delivery of the National Care Records Service and improve clinical engagement. He said that the taskforce will be chaired by a layperson and involve a cross section of clinical representatives including deputy chief medical officer Professor Martin Marshall and will develop a “detailed implementation plan” for speeding up delivery of the NCRS.
Lord Warner told the conference: “I understand fully the concerns and reservations some doctors have about electronic patient records. We will fully consult with all professional interests and patients on the nature of the summary record and the confidentiality safeguards. But now is the time for leadership in this area and by that I mean clinical leadership as well.”
It is imperative that this taskforce represents all interested parties: suppliers, clinical staff including nurses and the professions allied to medicine as well as doctors, professional bodies as well as NHS Connecting for Health staff.
This is a great opportunity for improving the patient experience and revolutionising the way that care is delivered in the 21st century. With transparency and a constructive dialogue between clinical staff and NHS Connecting for Health, the investment will be worthwhile.
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