Sir, Your report on the National Audit Office report on the Department of Health National Programme for IT in the NHS (June 17) rightly notes that alongside its considerable successes, the failure to win broad backing from NHS staff is the project’s “potentially fatal flaw”.

The programme can deliver as promised — provided there is engagement with frontline staff. We are, therefore, deeply concerned by the lack of involvement of the nursing (including midwifery and health visiting) community in the design and preparation for the programme. A function of the nurse is to act as information broker and advocate for the patient; this role is unrecognised in the programme. A recent survey by the Royal College of Nursing found that 88 per cent of nurses use a computer daily at work. Yet more than two thirds of respondents said they had little or no information about NHS IT developments and two thirds said that they had received no training. If this situation is allowed to continue there will be significant implementation difficulties and conflicts in practice.

The NAO report refers to consultation with doctors; yet nursing represents the largest user community of the NHS. Recent statistics from the Information Centre show that there were 404,161 qualified nursing, midwifery and health visiting staff employed in the NHS in 2005, compared to 122,345 doctors.

It is time for nursing to articulate the importance of its contribution and to play an active part in the next stage of the National Programme for IT in the NHS.

PROFESSOR DAME JUNE CLARK
Chair, RCN Information in Nursing Forum

RICHARD HAYWARD
Chair, British Computer Society Health Informatics (Nursing) Specialist Group

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