Recommendation 5

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 as ‘high’ and 16% of trusts assessing it as ‘low’ in 2017. It is essential that trusts have the necessary digital skills if they are to improve their digital maturity and make national ambitions a reality, but these skills are in short supply. We are particularly concerned about the lack of skills in cyber-security, as legacy IT systems are especially vulnerable to attack. But despite these shortcomings and the variation between trusts, the Global Digital Exemplar programme has focused on improving the digital maturity of a small number of higher-performing trusts. NHSX’s focus is now moving to helping the less-advanced trusts to catch up. However, we are concerned that trusts may be unable to invest the £3 billion expected of them by the Department under its matched-funding arrangements. Our reports have illustrated the long-standing financial challenges facing many trusts. Recommendation: As part of the implementation plan, NHSX should work with NHS England & Improvement and NHS Digital to develop a more-focused package for those local health and care systems most in need of support for planning, funding and implementation, and with a clear basis for priority action.