NHS organisations facing “significant” digital transformation challenges

A report by the National Audit Office (NAO) has concluded that local NHS organisations are facing “significant challenges” when it comes to working towards digital transformation.

Prior to the Covid-19 pandemic, the NAO looked into the state of digital services across the NHS in England and its readiness to deliver digital transformation, focusing on plans, governance arrangements, resources and technical challenges.

The report, published on May 15, concluded that while the main bodies plans for digital transformation are “ambitious”, the track record in the NHS has been “poor”.

“Local NHS organisations face significant challenges in working towards digital transformation. This includes outdated IT systems that do not connect to other systems and competing demands on their resources,” the report states.

“The Department [of Health and Social Care] and its arm’s-length bodies need to set a clear direction for local organisations and to ensure resources are directed to the right priorities nationally.

“Doing so will require financial investment, but the government does not have a reliable understanding of how much funding is required. It will also require strong governance and accountability for delivery, which are not yet in place and which are to be led by a new unit, NHSX, which has no statutory footing.”

The report also concludes that national bodies must manage a number of “significant risks” which includes “insufficient skills” and embedding interoperability.

The conclusion adds: “Unless the Department and its arm’s-length bodies address these issues far more effectively than they have managed previously, then they are unlikely to achieve value for money for the up to £8.1 billion they estimate will be spent on digital transformation between 2019-20 and 2023-24.

Six recommendations are also included in the report. They are:

• Maintain a comprehensive set of lessons for digital transformation from NHS and wider government experience
• Ensure that the expected technology plan for health and care includes an implementation plan with specific objectives and measurable actions that are required
• Collect more data to enable a better understanding of the full cost of delivering digital transformation and prioritise the work programme
• Alongside the implementation plan, develop specific resources and plans for high-risk issues
• Simplify and strengthen national governance arrangements
• Use digital maturity assessments of local organisations to gather additional information

In response to the report, Meg Hillier MP, chair of the Committee of Public Account, said: “The Department of Health and Social Care knows what a digital revolution could mean for NHS patients. However it hasn’t drawn up the detailed plans needed to make one happen.

“NHS systems were originally supposed to be sharing data seamlessly by 2005.  Fifteen years later, the NHS hasn’t even established a complete set of standards for trusts and the IT industry to follow.

“The NAO report shows that not enough has been learnt from previous failed IT strategies. Meanwhile, continuing dependence on obsolete systems leaves the NHS open to another WannaCry style cyber-attack”.

Digital Health Intelligence’s NHS IT Leadership Survey 2019 is referenced to across the report. In particular it cites how the 2019 survey of 186 IT leaders found that 77% considered that their organisation’s IT budget was insufficient to meet business priorities.