Recommendation 2

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 are complex and confused. The Department, NHSX, NHS Digital and other stakeholders recognise that there is a lack of clarity over the roles of NHSX and NHS Digital and the overlaps in their work. The new Chair of NHS Digital is due to review the approach that has been taken to digital transformation, including the operating models being used across NHS Digital, NHSX and NHSE&I. However, we are concerned that governance arrangements for NHSX have still not been finalised over a year after it was set up. NHSX is not a statutory body and does not prepare financial statements for audit, and so there is little transparency over its spending and activity. It has spent an estimated £11 million on the first phase of the delayed contact-tracing app, and expects to spend another £25 million on the second stage. Given the taxpayers’ money involved, transparency is important to allow Parliament and the public to hold it to account. Recommendation: To improve clarity and transparency, the Department should: • Write to the Committee by spring 2021 clearly setting out the responsibilities for digital transformation of each national organisation, and communicate 6 Digital transformation in the NHS this to local organisations. • Publish an annual report of NHSX’s activity and the spending it controls and/or directs.