Important lessons from Scottish NHSnet initiative

October 05, 2000

NHSnet in Scottish primary care: lessons for the future

The success of the implementation of a recent Scottish Office initiative, which linked 99% of Scottish general practices to NHSnet (an electronic network for health care professionals across Britain), is called into question in this week's BMJ. The study provides useful lessons for those embarking on a similar exercise in England and Wales.

Willmot and colleagues evaluated this initiative and found that, although 56% of practices were accessing NHSnet at least once a week, local variations in the way practices were connected to the network, costs they incurred and training they received all caused discontent and affected levels of use.

For instance, poor access discouraged people from using NHSnet in 19% of practices and caused 38% of practices to restrict its use. Some practices paid nothing for use, whereas others had to pay for calls. As bills escalate, these practices may start to restrict use, warn the authors. Training focused on administration rather than use of the internet and did not target healthcare professionals. Only 14% of attendees were general practitioners and 3% were practice nurses, say the authors. Interestingly, practices in areas that provided more detailed internet training locally were more likely to make regular use of NHSnet, emphasising the importance of targeting training.

Simply providing the necessary equipment to access NHSnet is not enough, say the authors. Comprehensive, appropriate education, targeted at the right individuals is also required to ensure that the potential of NHSnet to support evidence based practice is maximised. Important lessons should be learnt from the Scottish initiative, both in Scotland and by those embarking on a similar exercise in England and Wales, they conclude.

Madeleine Willmot, Clinical Effectiveness Coordinator, Forth Valley Health Board, Stirling, Scotland


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