Information in practice

NHSnet in Scottish primary care: lessons for the future

Madeleine Willmot, clinical effectiveness coordinator, ^a Frank Sullivan, professor of research and development in primary care. ^b

^a Forth Valley Health Board, 33 Spittal Street, Stirling FK8 1DX, ^b Tayside Centre for General Practice, University of Dundee, Dundee DD2 4AD

Correspondence to: M Willmot madeleine.willmot{at}fvhb.scot.nhs.uk

Objective: To evaluate the primary care communications initiative, which introduced NHSnet to primary care in Scotland.
Design: Semi-structured telephone interviews, postal questionnaire.
Setting: All 15 Scottish health boards, random sample of 1 in 3 of all Scottish general practices.
Participants: Information management and technology managers of health boards, 355 practice managers in the general practices.
Main outcome measures: Variations between health boards in styles of project management, means of connection to NHSnet, costs to general practices, and training provided. Practices' levels of participation in initiative, initial use of NHSnet, and factors acting as incentives and disincentives to use of NHSnet.
Results: 99% of Scottish general practices agreed to participate in initiative. Health boards varied significantly in project management styles (from minimal to total control), the nature of the networks they established (intranets or direct connections), costs to practices (from nothing to £125 per general practitioner per year), and training provided (from none to an extensive programme). In 56% of practices someone accessed NHSnet at least once a week. Practices varied considerably in amount of internet training received and staff groups targeted and in the intention to provide desktop access to NHSnet through a practice network.
Conclusion: The initiative has successfully introduced a network that links Scottish general practices, health boards, and hospital trusts. However local variation in this "national" initiative may affect its use in primary care. Health authorities and general practices in England and Wales may wish to note these findings in order to avoid unhelpful variation.