Source · Select Committees · Public Accounts Committee
Recommendation 26
26
Rejected
NHS still lacks consistent data infrastructure and technological maturity, delaying productivity gains.
Conclusion
We asked what was being done to improve productivity through the use of new technologies. NHSE told us the NHS currently lacks a consistent data infrastructure and that NHS providers varied in terms of their levels of technological maturity.50 NHSE said that it was putting modern technology into some of its providers that “have lived on paper”. While it still had work to do to complete the programme, its aim was to do so over the next 18 months.51 NHSE told us that the NHS providers that have already implemented electronic patient records have productivity levels that are 45 Q 3 46 Q 31 47 Q 38 48 C&AG’s Report, para 4.21 49 Q 3 50 Qq 79, 80 51 Q 79 16 13% higher than those yet to implement them.52 We note that the then Secretary of State for Health first challenged the NHS to go paperless in 2013, setting a target date of 2018.53 52 Q 10 53 Jeremy Hunt challenges NHS to go paperless by 2018 - GOV.UK (Press release 16 January 2013) 17
Government Response Summary
The government disagrees that providers should be fully paperless, stating that some patient communications must be sent by letter and outlines investment in national IT systems, EPRs and the NHS app.
Government Response
Rejected
HM Government
Rejected
The government disagrees with the Committee’s recommendation. 7.2 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. 7.3 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. 7.4 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. 7.5 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. 7.6 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. 7.7 Trusts and ICBs are expected to restrict fax machine use, which will no longer be usable by 2027 when analogue phonelines are switched off. 7.8 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.