Source · National Audit Office

Digital transformation in the NHS

This report considers the readiness of the government to deliver its ambitions for digital transformation in the NHS in England.

Published: 15 May 2020 Recommendations: 6 Type: Value for Money NAO confirmed: 6 Department: Department of Health and Social Care
Dept: Department of Health and Social Care Topics: Digital transformationDigital, data and technologyHealth and social careLegacy systemsNHS nao.org.uk → PDF →

Recommendations

6 items
5 accepted 1 partially accepted 6 implemented

Recommendation 1

Addressee: Department of Health and Social Care · Source location: Page 13, point a

The Department and its arm’s-length bodies should:
a) Maintain a comprehensive set of lessons for digital transformation from NHS and wider government experience. This should include lessons about digital transformation where organisations vary in their digital maturity and reliance on legacy IT and data. Future plans should be tested against these lessons.

Response position: Accepted

Delivery: Implemented · 12/2021 · Confirmed by NAO

Recommendation 2

Addressee: Department of Health and Social Care · Source location: Page 13, point b

b) Ensure that the expected technology plan for health and care includes an implementation plan with specific objectives and measurable actions that are required. The plan should include milestones for the implementation of all standards required for interoperability and must take account of the varied readiness of NHS organisations. The plan should be realistic about the time and investment required. It should also be clear about the responsibilities of local organisations, and the support available to them.

Response position: Accepted

Delivery: Implemented · 12/2021 · Confirmed by NAO

Recommendation 3

Addressee: Department of Health and Social Care · Source location: Page 14, point c

c) Collect more data to enable a better understanding of the full cost of delivering digital transformation and prioritise the work programme. Essential work to lay the foundations of digitisation and interoperability (including data standardisation) should be done before investment in newer technologies. There should be robust assessment of the whole-life costs and benefits of different approaches to implementing electronic patient record systems.

Response position: Accepted

Delivery: Implemented · Q1 2022/23 · Confirmed by NAO

Recommendation 4

Addressee: Department of Health and Social Care · Source location: Page 14, point d

d) Alongside the implementation plan, develop specific resources and plans for high-risk issues:
• Establish a resource to provide bespoke support to trusts in managing the adaptive change required for digital transformation.
• Prepare a communication plan to ensure trusts, clinical staff, suppliers and the public are kept informed about what is happening and what is expected of them.
• Strengthen the incentives and levers to encourage local organisations to invest sufficient resources in digital transformation.
• Prepare a strategic workforce plan to support digital transformation.
• Prepare plans for determining specific national requirements for clinical records, data quality, and privacy and how they will be met.

Response position: Partially accepted

Delivery: Implemented · Q3 2022/23 · Confirmed by NAO

Recommendation 5

Addressee: Department of Health and Social Care · Source location: Page 14, point e

e) Simplify and strengthen national governance arrangements. This should include further work to provide national bodies with the levers and monitoring capability to ensure local NHS organisations and suppliers comply with national standards for existing and new technology, and for data.

Response position: Accepted

Delivery: Implemented · Q2 2025/26 · Confirmed by NAO

Recommendation 6

Addressee: Department of Health and Social Care · Source location: Page 14, point f

f) Use digital maturity assessments of local organisations to gather additional information. NHSX should continue these assessments, which provide the only comparable information about trusts’ progress and identify common areas of strength and weakness. The assessments could also collect information on the costs and benefits of electronic patient record systems.

Response position: Accepted

Delivery: Implemented · Q1 2023/24 · Confirmed by NAO

Public Accounts Committee follow-up

1 report

The Public Accounts Committee examined this NAO report and published its own recommendations. The government responds to PAC recommendations via Treasury Minutes.