Select committee: Health and Social Care Committee

Digital transformation in the NHS

Closed Opened 13 May 2022 Closed 6 Sep 2023 8 recommendations 7 conclusions
Inquiry scope (the committee's words)
The Committee has launched a new inquiry focusing on digital transformation in the NHS. The inquiry will explore the current use of digital technology and examine how it needs to change in order to deliver an improvement in services and outcomes for patients. The inquiry will consider key aspects of NHS digital transformation such as digitalising health and care records for interoperability so that they can be accessed across primary, secondary and social care. It will also look at legacy IT systems in the NHS, and the interaction between digital transformation and clinical research. The inquiry will also consider how to prevent digital health inequalities and inform patients of the potential benefits of digital approaches to healthcare.

Where it stands

The inquiry is closed, opened 13 May 2022.

The committee has published 1 report, most recently Eighth Report - Digital transformation in the NHS on 30 June 2023.

The government's response

Published 6 September 2023. The deadline was 30 August 2023.

Summary written by Accountability Index from the government's response. It is not the government's own words.

The government states that it "largely agree[s] with the Committee's recommendations" and that its current package of work is "already delivering" on the areas highlighted.

  • On the NHS App, it points to a roadmap published quarterly on the NHS England website and says a range of promotional activity is "underway over the coming months".
  • On interoperability, final publication of the standards strategy is "expected in Winter 2023", and its priority for the coming year is a national federated network of Shared Care Records.
  • On DDaT pay, it does not commit to the DDaT Pay Framework. It says it is "working to improve recruitment and retention", including a review of pay measures, and that "the solution requires a broader approach" via an upcoming National Digital Workforce Plan.
  • On an accreditation scheme for third-party apps, it notes DTAC "in itself is not an accreditation scheme" and says a directory of products meeting DTAC standards "is planned for late 2023/24".

Read the government's response ↗ Report an error

Recommendations and conclusions 15 shown

1: Digital transformation of the NHS faces slow, uneven progress with significant challenges.

Conclusion · Eighth Report - Digital transformation in the NHS · Addressed to Department of Health and Social Care

Concluded (the committee's words)
Successive Governments have attempted digital transformation of the NHS. Progress has been slow and uneven, and there is now substantial variation between organisations. This attempt has the potential to be different, with clear intentions and funding to address factors that have frustrated progress in the past. These include the preponderance of “legacy” IT in the NHS, the skills of the workforce, and the challenges of building an inclusive digital health service. The Government will only succeed this time if it can respond robustly to all of these challenges.

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2: Demonstrate continued value of the new NHS App to existing and potential users.

Conclusion · Eighth Report - Digital transformation in the NHS · Addressed to Department of Health and Social Care

Concluded (the committee's words)
The pandemic provided a unique incentive to download the NHS App, because it hosted the Covid-19 pass. The new version of the App should bring benefits in terms of functionality, integration and personalisation, but it will require people to download it anew. The Department and NHS England announced improvements to the range of services available via the App in May 2023, but they need to ensure that people use them. The Department and NHS England therefore need to demonstrate the continued value of the App, particularly to existing users, otherwise they may increase functionality while decreasing the number of sign-ups.

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3: Publish timetable for new NHS App and comprehensive communication plan for its benefits.

Recommendation · Eighth Report - Digital transformation in the NHS · Addressed to Department of Health and Social Care

Recommended (the committee's words)
We recommend that the Department and NHS England set out in response to this report: (a) A timetable for introducing the new, “native” NHS App, and (b) Their plan for communicating the benefits and features offered by the new App to users of the current “portal” version. (c) Further detail of the proposed communications campaign on changes to the App announced in May 2023.

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4: Standards framework essential for improving NHS interoperability and health data sharing across systems.

Recommendation · Eighth Report - Digital transformation in the NHS · Addressed to Department of Health and Social Care

Recommended (the committee's words)
We support the Hewitt review’s recommendation that the Department, NHS England and ICSs should work together to develop a standards framework to be adopted by all ICSs. This should improve interoperability and data sharing within and between systems. This should include working closely with sectors that could feed into shared records in the future, including pharmacy, mental health and community health, to ensure that what is put in place meets their needs.

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5: Shortage of skilled digital professionals impedes NHS digital transformation and increases reliance on suppliers.

Conclusion · Eighth Report - Digital transformation in the NHS · Addressed to Department of Health and Social Care

Concluded (the committee's words)
A shortage of skilled digital professionals working in the NHS has been a barrier to digital transformation to date. Digital specialists can often command higher wages or better conditions in the private sector. This makes recruitment and retention to the NHS challenging, and leaves the health service reliant on third-party suppliers.

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6: Implement DDaT Pay Framework for NHS England specialists to improve recruitment and retention.

Recommendation · Eighth Report - Digital transformation in the NHS · Addressed to Department of Health and Social Care

Recommended (the committee's words)
To ensure that the NHS is able to recruit the best candidates and sustainably meet demand for DDaT specialists, now and in the future, we recommend that the Department apply to implement the DDaT Pay Framework for NHS England DDaT specialists, which would allow additional pay measures including bonuses/”capability based allowances” for staff.

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7: Integrate digital training throughout all wider NHS professional learning programmes for staff.

Recommendation · Eighth Report - Digital transformation in the NHS · Addressed to Department of Health and Social Care

Recommended (the committee's words)
Investment in the NHS’s specialist digital workforce needs to be matched by investment in the wider workforce’s forces digital skills. It is important that digital is understood as a thread that runs throughout healthcare, not as a specialist skill set that is only relevant to some staff and occupations. We recommend that when devising professional training, the Department work with NHS England to ensure that digital training is integrated throughout its wider learning programmes.

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8: Ensure staff have dedicated time for co-designing new NHS digital initiatives effectively.

Conclusion · Eighth Report - Digital transformation in the NHS · Addressed to Department of Health and Social Care

Concluded (the committee's words)
Without staff engagement in the entire process of introducing digital initiatives, digital transformation risks being perceived as an unwelcome, time-consuming imposition on an already over-stretched workforce. Co-designing digital initiatives with staff—including, but not limited to clinicians—is essential to ensure that these offer workable improvements to existing practices. The Department and NHS England must ensure that staff have the time and headspace to engage with this process.

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9: Significant digital skills gap in social care hinders sector transformation

Conclusion · Eighth Report - Digital transformation in the NHS · Addressed to Department of Health and Social Care

Concluded (the committee's words)
There is a digital skills gap in social care that, if unaddressed, will hinder the digital transformation of the health and social care sectors. As with training for staff in the health service, it is vital that digital skills are integrated throughout learning and development for social care staff, rather than being presented as specialist skills sets.

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10: Set out approach for cross-departmental working to address digital exclusion

Recommendation · Eighth Report - Digital transformation in the NHS · Addressed to Department of Health and Social Care

Recommended (the committee's words)
Responsibility for promoting digital inclusion does not rest solely, or even primarily, with the health service, and we are encouraged that the Department recognises the importance of cross-departmental working to address digital exclusion from its services. We recommend that it sets out its approach to cross-departmental working in response to this report and in its action plan for addressing exclusion.

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11: Ensure continued availability of non-digital channels for patient access to services

Recommendation · Eighth Report - Digital transformation in the NHS · Addressed to Department of Health and Social Care

Recommended (the committee's words)
Many patients could benefit from encouragement and support to use digital services that might not initially be their first choice, but there will be some patients who continue to prefer physical channels. The Department and NHS England must ensure that non-digital channels remain available, especially as it develops and implements its digital offer.

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12: Work collaboratively to understand best models for patient technology access and use

Recommendation · Eighth Report - Digital transformation in the NHS · Addressed to Department of Health and Social Care

Recommended (the committee's words)
The NHS is a universal service, and people should not be unable to access it because of wider challenges around access to technology, connectivity and digital skills. The Department should work with NHS England and other Departments to understand what models would work best for supporting patients to use and access technology in different settings both in and outside the health service (for example, in the community).

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13: Department recognises need for better communication on data security and digital healthcare benefits

Conclusion · Eighth Report - Digital transformation in the NHS · Addressed to Department of Health and Social Care

Concluded (the committee's words)
We are encouraged by the Department’s recognition that it needs to do better in both reassuring people about the security of data gathered by the health service, and communicating the benefits of digital healthcare. We need to see this matched with action that demonstrates progress. Specific communication over NHS data collection, and broader communications to encourage engagement amongst those less likely to use digital technology will require different approaches to target different audiences. Both should be underpinned by an understanding of who the people most likely to opt out are and why they do so.

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14: Lack of systematic assessment for third-party health apps results in quality failures

Conclusion · Eighth Report - Digital transformation in the NHS · Addressed to Department of Health and Social Care

Concluded (the committee's words)
Digital transformation can offer people more choice and control over their healthcare, and empower them to manage their health, and apps offer an accessible starting point for many. But whether peoples’ experiences with digital healthcare are positive depends in large part on whether they use an appropriate product. The Department and NHS England lack a systematic, consistent way of assessing and demonstrating whether a third-party health app reaches the necessary quality standards, and we heard that a majority of health apps currently available fail on aspects including clinical efficacy, security and cost. This is unacceptable: using an unsuitable health product can affect people’s health, and might make people less likely to opt for digital channels in future.

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15: Introduce comprehensive accreditation scheme for third-party healthcare apps with clear publicity

Recommendation · Eighth Report - Digital transformation in the NHS · Addressed to Department of Health and Social Care

Recommended (the committee's words)
The Department and NHS England should work together to introduce a more comprehensive accreditation scheme for third-party healthcare apps, in addition to the current approach of recommending specific apps on some nhs.uk webpages. Within this scheme it should be easy for people to check whether a healthcare app that they are using or considering comes recommended by the NHS. This scheme should be supported by publicity and communications that both promote the benefits of digital healthcare and explain the risks of using unaccredited apps, providing a clear steer on why using an accredited product matters and where to find them.

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Reports

1 report

Oral evidence sessions

3 sessions

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Date Session and witnesses Source
14 Mar 2023
Oral evidence session
Dr Tim Ferris · NHS England, Kathy Hall · Department of Health and Social Care, The Lord Markham CBE · Department of Health and Social Care
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11 Jan 2023
Oral evidence session
Chris Askew · Diabetes UK, David Ramsden · Cystic Fibrosis Trust, Dr Tim Ferris · NHS England, Jackie Gray · NHS Digital, Kathy Hall · Department of Health and Social Care, Liz Ashall-Payne · ORCHA, Simon Bolton · NHS Digital
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15 Nov 2022
Oral evidence session
Dr Paul Atkinson · Royal College of General Practitioners, John Dean · Royal College of Physicians, Karen Payne · NHS Dorset, Pritesh Mistry · The King's Fund
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Written evidence

70 submissions recorded

Submission metadata is shown here; use the source links to read the evidence on Parliament’s website.

Showing the latest 50 of 70 recorded submissions. Written evidence in the activity timeline uses this same preview. Browse the inquiry on Parliament.

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ReferenceDateSubmitter
DTN0074 14 Jun 2023 NHS England
DTN0073 7 Mar 2023 Kinetikos Health
DTN0072 7 Feb 2023 Ms Liz Ashall-Payne, ORCHA
DTN0071 11 Jan 2023 The King's Fund
DTN0070 6 Dec 2022 Parliamentary and Health Service Ombudsman
DTN0032 31 Oct 2022 British Medical Association
DTN0045 6 Sep 2022 Spirit Health
DTN0031 20 Jul 2022 Dr Kathrin Cresswell, University of Edinburgh
DTN0049 12 Jul 2022 TPP
DTN0015 5 Jul 2022 National Pensioners Convention
DTN0014 5 Jul 2022 Dr Helen Atherton, University of Warwick
DTN0013 5 Jul 2022 Healthcare Financial Management Association (HFMA)
DTN0012 5 Jul 2022 Boots UK
DTN0011 5 Jul 2022 JDRF
DTN0010 5 Jul 2022 The Organisation for the Review of Care and Health Apps (ORCHA)
DTN0009 5 Jul 2022 NHS Providers
DTN0008 5 Jul 2022 The Royal British Legion
DTN0007 5 Jul 2022 PAGB, the consumer health association
DTN0006 5 Jul 2022 BCS, The Chartered Institute for IT
DTN0005 5 Jul 2022 Royal College of Midwives
DTN0004 5 Jul 2022 MR RICHARD FOWLER, CIVIL SERVICE PENSIONER
DTN0003 5 Jul 2022 Mr Peter Duffy, Ex-NHS. Currently employed by Manx Healthcare.
DTN0002 5 Jul 2022 Thrive by Design - part of Leeds and York Partnership NHS Foundation Trust
DTN0001 5 Jul 2022 Liquidlogic
DTN0030 5 Jul 2022 Mr Daniel Solomon
DTN0029 5 Jul 2022 Department of Health and Social Care
DTN0028 5 Jul 2022 Royal College of General Practitioners
DTN0027 5 Jul 2022 Diabetes UK
DTN0026 5 Jul 2022 Professor Sue Latter, University of Southampton
DTN0024 5 Jul 2022 Highland Marketing advisory board (health tech industry and IT experts)
DTN0023 5 Jul 2022 Community Pharmacy IT Group
DTN0022 5 Jul 2022 Dr Frederick Konteh , University of Birmingham
DTN0021 5 Jul 2022 NHS Confederation
DTN0020 5 Jul 2022 The King's Fund
DTN0019 5 Jul 2022 Association of British HealthTech Industries
DTN0018 5 Jul 2022 The Company Chemists' Association
DTN0017 5 Jul 2022 Splunk
DTN0016 5 Jul 2022 Oviva
DTN0043 5 Jul 2022 PHG Foundation
DTN0042 5 Jul 2022 Professional Record Standards Body
DTN0041 5 Jul 2022 EKTG
DTN0040 5 Jul 2022 The LIFT Council
DTN0039 5 Jul 2022 GS1 UK
DTN0038 5 Jul 2022 Pharmacy2U
DTN0037 5 Jul 2022 Cystic Fibrosis Trust
DTN0036 5 Jul 2022 Royal College of Physicians
DTN0035 5 Jul 2022 Healthy.io
DTN0034 5 Jul 2022 Wellcome/EPSRC Centre for Interventional and Surgical Sciences
DTN0033 5 Jul 2022 Care England
DTN0060 5 Jul 2022 System CCEO

Who gave evidence

12 witnesses

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WitnessOrganisationSessions
Dr Tim Ferris · National Director of Transformation NHS England 2
Kathy Hall · Director for Digital Transformation and Head of the Joint DHSC/NHSE Digital Policy Unit Department of Health and Social Care 2
Chris Askew · CEO Diabetes UK 1
David Ramsden · Chief Executive Officer Cystic Fibrosis Trust 1
Dr Paul Atkinson · Chair, Health Informatics Group Royal College of General Practitioners 1
Jackie Gray · Executive Director for Privacy, Transparency, Ethics & legal NHS Digital 1
John Dean · Clinical Vice President Royal College of Physicians 1
Karen Payne · Topol Digital Fellow NHS Dorset 1
Liz Ashall-Payne · CEO ORCHA 1
Pritesh Mistry · Fellow The King's Fund 1
Simon Bolton · Interim Chief Executive NHS Digital 1
The Lord Markham CBE · Parliamentary Under-Secretary of State Department of Health and Social Care 1