Recommendation 11

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 multiple budgets across organisations, and unclear lines of commissioning, funding, delivery and accountability. The NAO concluded that these issues contributed to slow delivery and transformation within the NHS. It found that previous attempts to improve these arrangements had been unsuccessful for a variety of reasons, for example, because accountability for managing development costs and for achieving programme benefits were shared across different organisations. The Department set up NHSX in July 2019 to lead digital transformation across the NHS to resolve conflicting priorities and confusions 13 Q48; C&AG’s report para 14 14 Qq 52–53 15 Qq 74 & 78 16 DGT0011 - NHS Providers, para 3; DGT0021 - The Nuffield Trust submission, para 5, 17 Q 31; NHS Long-Term Plan, NHS England, January 2019 Digital transformation in the NHS 11 and take overall responsibility for digital transformation.18