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Monday 18 May 2020

NAO raises NHS digital transformation concerns

NAO logoThe National Audit Office (NAO) has published its report on the state of digital services in the English NHS and its readiness to deliver digital transformation.

The NAO states the budget for digital transformation between 2016-17 and 2020-21 was £4.7bn. NHS England and NHS Improvement (NHSE&I) expects the NHS will need c.£8.1bn to deliver its digital ambitions, comprising £5.1bn from national bodies between 2019-20 and 2023-24 and £3.0bn funded by NHS trusts between 2019-20 and 2028-29. A further £1.6bn is allocated to live services between 2019-20 and 2023-24, mostly committed revenue funding.

The report says the NHS will need to undergo digital transformation but that previous attempts to deliver this, including the National Programme for IT (NPfIT), have been expensive and largely unsuccessful. Restructuring of objectives since 2014 has made it difficult to assess recent digital transformation initiatives, e.g. the paperless NHS target by 2018, but the NAO says the NHS has not made the expected progress. It also says that recent investment in digital transformation has been insufficient, highlighting that at a local level less than 2% of trust expenditure is on technology compared to the recommended 5%.

NHSX logoAlthough the NHS Long Term Plan (see NHSX details vision for NHS Tech Plan and work back) establishes the objective of digitally enabled care being rolled out across the NHS, there is currently no digital implementation plan. NHSX intends to publish a technology plan in autumn 2020; however, the NAO says national governance arrangements for digital transformation are confused and have been delayed by the pandemic.

Plans for achieving the longstanding aim of interoperability in the NHS are under-developed according to the NAO and have been made more complicated by the goal of increasing the number of technology suppliers to the NHS. The report also says moving to cloud presents challenges at a local and national level, and that it remains difficult for trusts to fund digital services from revenue budgets.

The NAO calls on the Department of Health and Social Care and its associated bodies to learn from previous digital transformation initiatives; to establish specific and measurable objectives; to improve data on the cost of digital transformation; and simplify and strengthen national governance arrangements.

Digital transformation is clearly a substantial challenge, but the COVID-19 crisis has demonstrated the NHS can move at speed to implement new technologies when required. In many ways, implementing a long-term and sustainable technology strategy will be more challenging. 

Posted by: Dale Peters

Tags: nhs   strategy   investment   government   healthcare  

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