Doctors losing enthusiasm for NPfIT
Kablenet.com
Published: 08 Feb 2005 17:35 GMT
The survey, in which pollster Medix received responses from 900 doctors over a week in late January 2005, shows that fewer are ready to get excited over NPfIT than in its previous survey of July 2004.
GPs are the most sceptical, with only 21 percent saying they are enthusiastic compared with 45 percent last July. The figure for other doctors is 51 percent, down from 65 percent in the same period.
Support for the prime elements of NPfIT has also slipped away. Only 11 percent of GPs now approve of the focus on the Choose and Book service, down from 29 percent, while approval for the National Care Record Service (NCRS) has fallen from 79 percent to 59 percent and the figure for electronic transmission of prescriptions (ETP) has gone from 57 percent to 50 percent.
Non-GPs were generally more supportive but have still showed disillusionment. Their approval of the focus on Choose and Book has fallen from 50 percent to 28 percent, for the NCRS from 88 percent to 73 percent, and for ETP from 72 percent to 62 percent.
Some more positive factors have emerged from the survey. When asked if they thought that NPfIT would improve clinical care, 50 percent of GPs say it would do so in the long term (more than two years), compared with 46 percent in the last survey (when there was no distinction between short and long term). The corresponding figure for other doctors is 68 percent, up from 60 percent.
Non-GPs are also more convinced it will improve their working life, with a figure of 56 percent, up from 53 percent. But GPs are becoming less encouraged, with the proportion agreeing with the statement falling from 34 percent to 27 percent.
In its summary of the report, Medix attributed much of the scepticism to poor consultation.
"The many problems recorded in this survey seem to spring from continuing poor levels of consultation," it said. "It may be that, as new services become available and can be seen and used, that decline will be reversed and enthusiasm reignited.
"However, the responses to Q7 (re the importance of individual consultation) and Q8b (re the need for early consultation) suggest that it would be dangerous to rely on that approach. It seems likely that, if levels of understanding of the advantages of NPfIT amongst individual front line doctors, especially GPs, were massively increased by rigorous, interactive, detailed and widespread communication, support and enthusiasm for NPfIT would strengthen.
"That should have a knock-on effect to other clinical staff and a consequential blossoming of the programme's prospects for success. But after more than two years of delay it will be a major challenge to overcome the distrust and cynicism that seems to be replacing enthusiasm in the minds of many doctors. That challenge must surely be addressed urgently."
In response, a spokesperson for NPfIT said the survey covers less than 1 percent of clinicians and that the commentary has highlighted the more negative features. Also, it has begun a new engagement programme to rebuild enthusiasm.
"We know there has been some discontinuity in our clinical engagement," the spokesperson said. "But we have recently adopted a new approach, appointing a number of senior clinicians to lead this engagement work.
"The Medix survey was conducted in the period after the appointment of these new clinical leads but well before their work has had the chance to penetrate at grass roots level.
"The new clinical leads are already building up momentum, developing new relationships between NPfIT and key clinical stakeholders and a range of approaches including joint activity with the British Medical Association. It will take time but their engagement is accelerating.
"NPfIT is about improving patient care. Over time NPfIT will bring about great improvements in the safety and efficiency of patient care and reduce the administrative burden on healthcare professionals. The survey recognises this: 40 percent of GPs and 68 percent of other doctors say NPfIT will in time lead to an improvement in clinical care."
The survey was commissioned by The Guardian, Computer Weekly, BJHC&IM and e-Health Insider.
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