Hidden assumptions and their influence on clinicians’ acceptance of new IT systems in the NHS

Abstract

The UK National Health Service (NHS) is embarking on the largest investment programme in Information Technology (IT). The National Programme for IT (NPfIT) in the NHS is the biggest civil IT project in the world and seeks to revolutionise the way care is delivered, drive up quality and make more effective use of resources of the NHS. Despite these high expectations, the NHS has historically experienced some high profile IT failures and the sponsors of the programme admitted that there remain a number of critical barriers to the implementation of the programme. Clinicians’ reluctance to accept new IT systems at a local level is seen to be a major factor in this respect. Focusing on such barriers, this paper reports research that explored and explained why such reluctance occurs in the NHS. The main contribution of this research derives from the distinctive approach based on Kelly’s Personal Construct Theory (PCT) to understand the ‘reluctance’. The argument presented in the paper indicates that such reluctance should be viewed not as deliberate resistance imposed by clinicians, but as their inability of changing their established group personal constructs related to ISDD activities. Therefore, this paper argues that the means that could occur to reduce the ‘reluctance’ are creative rather than corrective or normative. The research took place in a NHS Trust and the paper pays considerable attention to technological, behavioural and clinical perspectives that emerged from the study. The research was conducted as a case study in a NHS trust and data was collected from two local NHS IT project. The main research participants in this study were: (a) IT professionals including IT project managers and senior IT managers; and (b) senior clinicians.