Recommendations & Conclusions
24 items
2
Conclusion
Twenty-Second Report - Digital transfor…
The Department’s failure to ensure clear and transparent governance arrangements for digital transformation is putting the successful delivery of the Vision for digital, data and technology at risk. There are many organisations working at both national and local levels to deliver the digital transformation of the NHS. Yet governance arrangements …
Government response. 2020. Funding offered is determined by an objective formula, based on assessment of the Town Investment Plan. Feedback is provided on request. 2.4 In relation to funding decisions on the Towns Fund and similar local growth programmes, the department will …
HM Treasury
3
Conclusion
Twenty-Second Report - Digital transfor…
Without a proper implementation plan, the Department and NHSX cannot be sure that the £8.1 billion of taxpayers’ money being invested in the digital transformation programme will deliver value for money. The Department’s 2018 Vision for digital, data and technology is not an implementation plan as it does not set …
Government response. 22 Digital Transformation in the NHS Department of Health and Social Care and NHSX
HM Treasury
4
Conclusion
Twenty-Second Report - Digital transfor…
To deliver the digital Vision, NHS organisations’ IT systems must be interoperable. Many of the standards required to enable this are not yet in place, and much work is required before benefits, such as digital-image sharing, can be realised. NHSE&I increasingly seeks to plan and coordinate patient care through local …
Government response. 2021. The department will use the annual update to keep the Committee informed of the success of the Fund with evidence from the monitoring and evaluation process.
HM Treasury
5
Conclusion
Twenty-Second Report - Digital transfor…
We are concerned that patients and local health and care systems could be left behind if some less digitally-advanced trusts are unable to invest in the technology and skills they need to catch-up. There is wide variation in the digital maturity of trusts, with 13% of trusts assessing their capability …
Government response. 22 Digital Transformation in the NHS Department of Health and Social Care and NHSX
HM Treasury
6
Conclusion
Twenty-Second Report - Digital transfor…
The Department and NHSX lack the information they and local organisations need on which of the options for achieving digital transformation in local health and care systems achieves the best value for money. The Department considers that the £8.1 billion being invested in digital transformation will be sufficient to achieve …
Government response. 22 Digital Transformation in the NHS Department of Health and Social Care and NHSX
HM Treasury
1
Conclusion
Twenty-Second Report - Digital transfor…
On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department of Health and Social Care, NHS Digital and NHSX on digital transformation in the NHS.1
Government response. On the basis of a report by the National Audit Office, the Committee took evidence, on 14 September 2020 from the Department of Health and Social Care, NHS England, NHS Improvement and Health Education England. The Committee published its report …
HM Treasury
7
Conclusion
Twenty-Second Report - Digital transfor…
The NHS has not made the expected progress since its 2014 strategy and missed its main target to achieve a ‘paperless’ NHS by 2018.10 The 2018 target has since been redefined in a new target to reach a ‘core level’ of digitisation by 2024. We asked why a watered-down target …
Government response. 22 Digital Transformation in the NHS Department of Health and Social Care and NHSX
HM Treasury
8
Conclusion
Twenty-Second Report - Digital transfor…
NHS England & NHS Improvement (NHSE&I) increasingly seek to plan and coordinate patient care through partnerships of local health and care organisations, known as sustainability and transformation partnerships (STPs) and integrated care systems (ICSs). This makes sharing data between organisations essential to enable electronic patient records to be seen and …
Government response. 22 Digital Transformation in the NHS Department of Health and Social Care and NHSX
HM Treasury
9
Conclusion
Twenty-Second Report - Digital transfor…
We were particularly interested in one aspect of interoperability, namely the opportunities afforded by the cloud and cloud computing. For example, vendor-neutral digital image sharing through the cloud can benefit patients, radiologists and consultants. But suppliers might experience difficulties in providing these services to the NHS. NHSX told us that, …
Government response. 22 Digital Transformation in the NHS Department of Health and Social Care and NHSX
HM Treasury
10
Conclusion
Twenty-Second Report - Digital transfor…
The Department, NHSX and NHS Digital told us that the COVID-19 outbreak had shown how quickly and efficiently the NHS can introduce new IT services and adapt to new technologies.15 This view was echoed by NHS Providers, which told us in its written evidence that the pandemic had resulted in …
HM Treasury
11
Conclusion
Twenty-Second Report - Digital transfor…
Since 2016, management of the portfolio of national programmes to digitally transform the NHS has been overseen by the Department, NHSE&I and NHS Digital. The National Audit Office reported that these governance arrangements were complex. It found that problems included confusion caused by there being multiple stakeholders, funding held in …
HM Treasury
12
Conclusion
Twenty-Second Report - Digital transfor…
In May 2020, the new governance arrangements for NHSX had not been finalised.19 We received written evidence from NHS Providers, which told us that national governance and oversight arrangements remained fragmented and ambiguous, with many trust leaders still unsure where responsibilities sat between NHSX, NHS Digital and NHSE&I.20 The Department, …
HM Treasury
13
Conclusion
Twenty-Second Report - Digital transfor…
NHSX is not a statutory body and does not prepare financial statements for audit. We asked how the Department was tracking the performance of NHSX and ensuring that money was being well used given that NHSX was not audited. The Department explained that NHSX’s funding came from the budgets of …
HM Treasury
14
Conclusion
Twenty-Second Report - Digital transfor…
NHSX was responsible for the initial development of a new NHS COVID-19 app, before this responsibility transferred to the newly-established NHS Test and Trace. The app, which was initially due to be launched in May 2020, alerts people who have had close contact with someone who has tested positive for …
HM Treasury
15
Conclusion
Twenty-Second Report - Digital transfor…
The NHS Long-Term Plan includes some challenging ambitions for digitising the NHS, including the target that all trusts reach a ’core level of digitisation’ by 2024. However, the NAO found that there was no digital implementation plan which set out how digitally enabled care will be rolled out across the …
HM Treasury
16
Conclusion
Twenty-Second Report - Digital transfor…
In response to our questions about when there would be an implementation plan, NHSX told us that it had intended to produce a digital strategy during the first eight months of this year. It put out for consultation the vision part of its digital strategy in February 2020, which was …
HM Treasury
17
Conclusion
Twenty-Second Report - Digital transfor…
The National Audit Office found that arrangements for ensuring trusts’ technology spending was consistent with the national strategy were still being developed.29 We asked NHSX what levers it had to influence trusts’ digital investments, and whether there were any circumstances where it would intervene in local systems if they were …
HM Treasury
18
Conclusion
Twenty-Second Report - Digital transfor…
Patient records are fragmented across thousands of local organisations that provide patient care, including 227 NHS trusts and NHS foundation trusts, around 7,000 GP practices and around 18,500 adult social care providers.32 NHSX acknowledged that to deliver its digital strategy, local organisations would need the necessary skills and capacity, as …
HM Treasury
19
Conclusion
Twenty-Second Report - Digital transfor…
The Global Digital Exemplar (GDE) programme, run by NHSX, aims to create a cadre of high-performing trusts which other trusts can follow (in particular partner trusts, known as ’fast followers’). Despite the variation between the digital maturity of trusts, the National Audit Office found that the GDE programme had focused …
HM Treasury
20
Conclusion
Twenty-Second Report - Digital transfor…
In our 2018 report on the WannaCry Cyber-attack on the NHS, we found that the Department and its arm’s-length bodies were unprepared for the relatively unsophisticated WannaCry attack and had a lot of work to do to improve cyber-security for when, and not if, there was another attack.39 We asked …
HM Treasury
21
Conclusion
Twenty-Second Report - Digital transfor…
NHSE&I expects that trusts will need to contribute £3 billion, under matched- funding arrangements, between 201920 and 2028–29 to meet its current plans for a digital transformation.42 However, in their written evidence to us NHS Providers, the Royal College of Midwives and the NHS Confederation all raised concerns about the …
HM Treasury
22
Conclusion
Twenty-Second Report - Digital transfor…
Of the £8.1 billion estimated to be needed to deliver its digital transformation ambitions, NHSE&I expects that £5.1 billion will be funded by national bodies. This includes £2.2 billion of revenue funding, which covers day-to-day activities, and £2.9 billion of capital funding, which covers investments in new buildings or equipment.47 …
HM Treasury
23
Conclusion
Twenty-Second Report - Digital transfor…
The National Audit Office found that NHSX was unclear about the whole-life costs and benefits of the different approaches to digital transformation at a local level.50 For example, NHSX expected trusts to take one of three approaches to replacing their electronic patient records: • an enterprise-wide commercial system, which can …
HM Treasury
24
Conclusion
Twenty-Second Report - Digital transfor…
We noted that having a clear grasp of the costs and benefits of digital transformation will be essential to ensuring trusts are on board. We therefore asked what NHSX was doing to address this and help trusts see the long-term potential savings from its plans.51 NHSX recognised that engaging with …
HM Treasury