1. Previously, reaching national targets regarding the implementation of EPRs was primarily the responsibility of local trusts. The National Program for Information Technology (NPfIT) has now decided a more centrally controlled approach is needed. What do you think about this decision?

Prompts: explore wider organisational factors specific to the NHS that have hindered IT implementation?

2. In 1998, Information for Health set out six levels of EPR development. By April 2002 it was reported that only 3% of trusts (five in total) had complete EPR systems in place – way under the hoped for target. In trying to achieve some level of EPR implementation - can you give me any insights into how (the trust) got on?

3. What do you think were some of the barriers to implementation, and what could the trust could have done differently to achieve a higher level of EPR development?

Explore the relationship between Trust Managers and the information system in use.

Explore the role of wider organisational pressures – such as achieving operational targets.

4. In terms of preparing for the new LSP solutions what do you think needs to be done at (trust)?

Prompts: explore the change management associated with planning for the LSP solutions - setting goals, staff consultation, training etc. Explore any structural changes and strategy documents (obtain if available).

Prompts: explore the role of leaders and super-users - the organisational impact of key players.

Prompts: explore how motivated, efficacious, and involved they are.

Explore the organisational impact of their personal investment (or lack of it).

7. Across the trust, how much agreement do you think there is about the importance of achieving NCRS?

Prompts: explore organisational commitment to implementation – across the trust and within different groups.

The role of constant change in management teams and the NHS generally.

Explore whether high levels of change has impacted on IT focus and staff commitment? Explore the perceived commitment of different groups.

Prompts: explore issues of ‘organisational fit’ and goal conflict – other pressures and priorities.

Differing agendas – how the EPR implementation programme needs to address the priorities of ‘everyman’ - trust, SHA, and National Program.

Explore the role of in-house IT innovations and their future.

Explore perceptions of what NCRS should deliver against what is perceived as being rolled out. Any organisational divide between mangers/clinicians/IT staff’s expectations and the deliverables?

9. What are the consequences of achieving the NPfIT goals – electronic patient records that support an integrated care records service?

Prompts: explore positive and negative outcomes - national and organisational. Explore impact on staff roles, relationships and patient care.

Prompts: explore how the meaning of success is defined, at what level, and for whom – the trust, the LSP or the National Program?

Prompts: explore factors they consider necessary for success – such as staff relations, clinician engagement and finance.

How these can be factors be achieved and whether they think these factors will be forthcoming?

Prompts: explore whether they think NPfIT will deliver long term – and the consequences of (non) delivery.

Prompts: explore both positive and negative responses.