comment: A new respect is needed if the national programme is to prove effective

Published: 06/05/2004, Volume II4, No. 5904 Page 15

The national IT programme's centralised approach appears to have delivered significant value for money through a series of robustly negotiated contracts.

However, it has done so while the government has preached the gospel of devolution. As a result, the national programme has appeared aloof and distant at times - particularly to clinicians (see the Big Story, pages 10-11).

To an extent this could not be helped. Planning change on a national scale demands an understanding of the broad requirements of the NHS. Approaching this through mass participation of NHS staff would have produced chaos and massively extended the programme's timescale. Using a focused group of people, including 200-odd clinicians, was sensible.

However, the greatest challenge was always likely to be selling this vision to the NHS.

The resignation of Professor Peter Hutton, the man charged with bringing doctors on board, is a worrying development. Whether the appointment of deputy chief medical officer Professor Aidan Halligan as the programme's joint lead, and the creation of a 'support academy' to help educate staff (see news, pages 4-5), can begin to assuage growing concerns around engagement will be the next big test.

But clinical engagement is not the only hurdle the programme has to jump. Neither is it helpful to believe the answers to every problem will and should be provided by the centre.

Trusts' readiness to deal with the implications of what the national programme is about to deliver is highly variable. Some of this variability is due to factors which trusts can and should take action on now. Raising the profile of IT and IT staff within individual organisations is crucial.

This can be done through the appointment of a board member with specific responsibility for IT. They can ensure the trust is up to speed on issues such as legacy management, staff training and relationships with the nationally procured contractors.

The common practice of asking the finance director to add IT to their growing portfolio is no longer acceptable in most cases.

The NHS cannot afford IT staff to be 'back-room boys' any longer. They need greater involvement, training and, in some cases, bigger salaries in return for the commitment required of them. Engagement efforts do not stop with clinicians.