Source · Select Committees · Public Accounts Committee
Recommendation 7
7
Rejected
Publish plans to reduce NHS paper reliance and set deadline to end fax machines.
Conclusion
Despite ambitions to improve productivity through the introduction of new technologies, the switch to digital in parts of the NHS has been glacially slow. Digital and technological improvements could have a transformative effect on the NHS. However, NHSE’s investment in technology over the period 2022–23 to 2024–25 stalled because funding was redirected to mitigate ICBs’ spending deficits. For example, a number of NHS trusts continue to rely on outdated IT equipment such as fax machines. The NHS currently lacks a consistent data infrastructure across its entirety and NHS providers vary in terms of technological maturity. NHS providers are often still too reliant on paper records but NHSE says it has a programme to address this over the next 18 months. NHS providers that have implemented electronic patient records have productivity levels that are 13% higher than those without them. recommendation Alongside its Treasury Minute response, NHSE should write back to the committee setting out its plans to reduce the reliance of NHS providers on paper within 18 months, including key milestones, and the proportion of NHS institutions it expects to be paperless at each milestone. A specific deadline should be set to end the use of fax machines within the NHS. 7 1 Funding and productivity Introduction
Government Response Summary
The government disagrees with the recommendation, arguing against providers being 'fully paperless' due to digital inclusion considerations. It reports that 91% of secondary care trusts have Electronic Patient Records, forecast to reach 96% by March 2026, and fax machines will be unusable by 2027 due to analogue switch-off.
Government Response
Rejected
HM Government
Rejected
The government disagrees with the Committee’s recommendation. It is right that all patient records in the NHS should be digitised. In 2025-26 Operating Planning Guidance, NHSE and DHSC has prioritised investment in: • running and maintaining the vital national IT systems; • NHS technology and digital to free up staff time, ensure all Trusts have Electronic Patient Record (EPRs), improve cyber security and enhance patient access through the NHS App. There are ongoing conversations with DHSC, HM Treasury and No10 on approval of investment plans for 2025-26, which include 160+ ongoing projects to install, upgrade and optimise EPRs. The government is working to reduce paper records; 91% of secondary care trusts currently have an EPR, forecast at 96% coverage by March 2026. The remaining 4% are advanced in their plans. In recent years, within the funding and priorities set by the government, we have invested in the adoption of the NHS App, EPRs and Federated Data Platforms. Our Spending Review bid includes major reforms to improve productivity such as the single patient record, modernising data platforms and major upgrades to the NHS App. The government is ensuring all providers proactively offer NHS App-first communications to patients through NHS Notify potentially reducing the cumulative volume of letters by c.500 million after 5 years. Trusts and ICBs are expected to restrict fax machine use, which will no longer be usable by 2027 when analogue phonelines are switched off. The government does not agree that providers should be fully paperless as some patient communications have to be sent by letter, committed to through digital inclusion and reducing health inequalities.