The technicians will bring us all the information we want, but it will not be any good unless we know what to do with it. Lyn Whitfield reports

'A properly networked NHS' is the goal of the revised information management and technology strategy for the NHS, issued last month.

Getting there will require further investment in computers and software, yet more new technology and the relentless roll-out of TLA (three-letter acronym) projects.

Yet none of this will make a difference unless staff can use both the 'boxes on desks' and the information they hold. As Martin Sotheran, head of delivery for the NHS Information Authority's ways of working with information project, says, IT training may be important but 'the real issue is information'.

Building the Information Core - implementing the NHS plan is known in IT circles as IfH2 because it updates the 1998 strategy Information for Health.

The earlier strategy set targets for ensuring that health service staff had basic IT skills. The new one puts flesh on the bones.

Basic IT training will be delivered through the European Computer Driving Licence, (ECDL) a 'logbook' system managed in the UK by the British Computer Society.

Candidates complete seven modules covering basic computing concepts and standard applications in up to three years. A certificate is awarded that is accepted across Europe.

Details of how the ECDL will be rolled out in the NHS are still under discussion. The NHS Information Authority may act as a consortium, buying training from a range of providers. But accreditation still has to be resolved.

David Lane, Royal College of Nursing adviser on informatics, also hopes that the ECDL will be adapted for the NHS - perhaps by adding a module for nursing or other competencies. But he echoes the wider point about using information.

'You can train professionals to use equipment and applications like word or Excel, and the ECDL will deliver that, ' he says. 'But the real issue for professional staff is how you translate that skill into practice. That means enabling nurses - and others - to identify what their information requirements are, to find that information and to use it. '

The NHS Information Authority has been working with the RCN and a wide range of professional organisations on getting informatics training into clinical training programmes.

Twenty-nine bodies signed up to Learning to Manage Health Information, a document issued by the NHS Executive in February 1999, that seeks to clarify aims and underlying philosophies.

The Academy of Medical Royal Colleges recently held a conference to discuss implementation, and plans could emerge later this year.

Still, there are obvious barriers to overcome before the 'properly networked' NHS is humming with activity. One is generational:

younger workers are (generally) more comfortable with IT than older ones.

But Mr Sotheran says the bigger barrier is NHS culture.

'People are going to have to change the way they work. The old idea of consultants having 'their' patients and those patients' notes being 'their' notes will have to change. '

Mr Lane agrees. Electronic patient records will give health professionals access to the same information in a way that is impossible when each profession has to keep its own paper records. But they will only be able to use that information to improve patient care if everybody speaks the same language and is willing to change existing ways of working.

Information for Health is being delivered by local implementation strategies.

These will have to be updated to take account of Building the Information Core by the end of next month and will then be evaluated nationally.

Two areas for 'improvement' are identified - involving clinical staff in the planning and implementation process and 'more innovative thinking' in developing health informatics.

The NHS Confederation supports the drive for more staff involvement. 'What we do not want to see is clever IT solutions to problems that have not yet been identified, ' says policy manager Gary Fereday. 'We need to find out what problems clinicians have and then use IT to solve them. '

The authority's ways of working with information programme has trialled a regional learning network in Trent. This set up an 'action learning set' involving 200 clinicians and taught them about informatics. In doing so, it created 'local champions' for change. The idea is being rolled out across England.

Meanwhile, Mr Sotheran wants local implementation strategies to be thinking broadly.

'We are saying to them, do not just go out and procure an electronic patient record.

Think about how the business, how healthcare is going to change.

'We know the technicians can deliver it. What we need are staff who will use it effectively. '