Communications technology has become vital to the way hospital doctors work but concerns remain over patient confidentiality, research reveals.

The online survey, by medical defence body the MDU, shows that 99% of the respondents use some form of modern communications technology in their day-to-day work.

The most popular use of technology was for emailing other members of staff with 92% of doctors stating that they do this, while 64% track test results electronically and 63% use the internet to research patient symptoms.

Sixty eight per cent of hospital doctors also revealed that they had recommended a telephone ‘app’ or website to a patient, an indication of the perceived benefit to patient care.

However, many of the doctors surveyed also expressed concerns about the impact that modern technology could have on patient confidentiality, with 41% stating that they were concerned about this aspect of patient care.

Dr Mike Devlin, head of advisory services at the MDU, welcomed hospital doctors’ embrace of communications technology and its benefits but warned that technology brings new risks and threats.

“It is important that any technology employed does not threaten a hospital doctor’s ethical and legal responsibilities,” he said. “A full assessment of confidentiality and security of data should be undertaken and appropriate policies and procedures put in place.  In addition, doctors should ensure that the use of technology complies fully with any policy that their NHS trust may have in place, many of which do not allow patient-identifiable information to be held on personal IT devices or equipment.”

Other findings from the survey include 44% of hospital doctors use a smart phone; 64% of consultants use a laptop; and, 8% of hospital doctors are using Twitter for work.

Read tips on managing the use of communication technologies.

The original ‘vision’ for the National Programme for IT in the NHS will not be realised despite nearly £3bn having been spent on care records so far, a report concludes.

The National Audit Office study says the rate at which electronic care records systems are being put in place across the NHS under the National Programme for IT is falling far below expectations and the core aim that every patient should have an electronic care record will not now be achieved.

Even where systems have been delivered, they are not yet able to do everything that the Department of Health intended, especially in acute trusts. Moreover, the report says, the number of systems to be delivered through the Programme has been significantly reduced, without a commensurate reduction in the cost.

The £2.7bn spent so far on care records systems does not represent value for money, the report concludes. And, based on performance so far, the NAO has no grounds for confidence that the remaining planned spending of £4.3bn on care records systems will be any different.

The original aim of the programme was for every patient to have an electronic care record by 2010.

The systems the Department of Health contracted its suppliers, BT and CSC, to deliver are now not all expected to be in place until 2015-16. Even so, based on performance so far, it is unlikely that the remaining work in the North, Midlands and East, where just four of 97 systems have been delivered to acute hospital trusts in seven years, can be completed by 2016 when the contract with CSC expires.

Indeed, in order to meet the revised deadline, over two systems a month would need to be delivered in this programme area over the next five years.

Progress in delivering care records systems varies dramatically between regions. There has been more progress in London in some health settings, although no GP practices are now receiving a system through the programme and the number of systems in acute hospital settings has halved.

Where care records systems are in place, the report says, they are not yet delivering what the DoH had expected. In acute trusts, the systems are mainly providing administrative benefits, rather than the expected clinical ones, such as prescribing and administering drugs in hospitals. With a change of government, the DoH has now changed its approach and moved away from its intention to replace systems wholesale, instead, building on and using trusts’ existing systems. To do this the DoH estimates it will cost at least £220m to get the systems to work together.

Amyas Morse, head of the National Audit Office, commented: “The original vision for the National Programme for IT in the NHS will not be realised. The NHS is now getting far fewer systems than planned despite the Department paying contractors almost the same amount of money. This is yet another example of a department fundamentally underestimating the scale and complexity of a major IT-enabled change programme.

“The Department of Health needs to admit that it is now in damage-limitation mode. I hope that my report today, together with the forthcoming review by the Cabinet Office and Treasury, announced by the Prime Minister, will help to prevent further loss of public value from future expenditure on the Programme.”

Read the full report.

The NHS IT Programme is being scaled back to save £700m under revised government plans.

A Department of Health review has concluded that a centralised, national approach is no longer required, and that a more locally-led plural system of procurement should operate.

NHS organisations will be allowed to introduce smaller, more manageable change, in line with their requirements and capacity.

The review also concludes that retaining a national infrastructure will deliver best value for taxpayers. It says applications such as Choose and Book, Electronic Prescription Service and PACS have been delivered and are now integrated with the running of current health services and should be continued.

The cut comes on top of £600m of savings announced under the previous government, meaning the overall cost for the National Programme for IT for England will drop from £12.7 billion to £11.4 billion.

Health minister Simon Burns said: “Improving IT is essential to delivering a patient-centred NHS. But the nationally imposed system is neither necessary nor appropriate to deliver this. We will allow hospitals to use and develop the IT they already have and add to their environment either by integrating systems purchased through the existing national contracts or elsewhere.

“This makes practical sense. It also makes financial sense. Moving IT systems closer to the frontline will release £700 million extra in savings. Every penny saved through productivity gains will be reinvested to improve patient care.”

Commenting on today’s written ministerial statement, Professor Iain Carpenter, co-director of the RCP’s Health Informatics Unit, said: “Taking the decision to align IT systems more closely with the needs of the front line is a good idea in theory. The real challenge though will rest in making sure that we get the right health informatics structures in place.

“One of dirty secrets of the NHS is the regrettable state of medical record keeping. Earlier reports have been shown that this compromises patient safety and clinical care. If IT in the health service is going to regain the confidence of the medical profession then more emphasis has to be placed by the DoH on making sure that the new systems accurately capture the dialogue between doctor and patient. Everything else flows from getting that right.”

The BMA’s Dr Chaand Nagpaul welcomed a more localised approach but warned: “The provision and experience of IT for clinicians on the ground is likely to vary according to the level of support and resources available locally. It is important that successful national IT initiatives are not lost, and that innovation is not stifled.

“There still needs to be some central accountability to ensure consistent and equitable delivery, manage local implementation, avoid wasteful duplication of effort, and support local decision-making. For example, a nationally accredited list of systems would be helpful.”