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Digital transformation of NHS ‘inadequate’; more funding needed

The transformation of digital services in the NHS has been “inadequate”, according to a report for the National Audit Office.

The National Audit Office (NAO) said that the process has been “slower than expected” and is uncertain whether current funding will even allow it to meet the Government’s ambitions.

Improving digital services in the NHS and implementing new ways of working is a huge challenge and the previous attempt to do this, between 2002 and 2011, was both expensive and largely unsuccessful, the NAO said.

It said part of the challenge was a shift in national strategy between centrally managed and ‘hands-off’ approaches, which has increased the number of legacy systems.

There has also not been enough money invested in the transformation to meet the targets set out by the Government in 2016. NHS England & NHS Improvement (NHSE&I) said at the time that the £4.7bn that was allocated was not going to be enough to deliver everything.

NHSE&I now estimates that up to £8.1bn will be needed to fund progress on the project between the years 2019 to 2024.

The report indicates that these estimates are based on limited data and it is uncertain if even that level of funding would be sufficient and there is a risk trusts would be unwilling or unable to fund the £3bn needed from them.

It also found that spending on IT and technology at NHS and foundation trusts was collectively around 2 per cent of expenditure, compared with a recommended 5 per cent.

“The track record for digital transformation in the NHS has been poor, with key targets such as a ‘paperless’ NHS by 2018 not being achieved,” Gareth Davies, head of the NAO, said.

“Local NHS organisations in particular face significant challenges, including outdated IT systems and competing demands on their resources. The delivery of healthcare will continue to change and it needs to be supported by modern, integrated and up-to-date information systems.

“To meet this challenge, the Department (of Health and Social Care) and its arm’s-length bodies need to develop a better understanding of the investment required, set a clear direction for local organisations, and manage the risks ahead. If they don’t, they are unlikely to meet their ambitions for digital transformation and achieve value for taxpayers.”

MP Meg Hillier, chairwoman of the Public Accounts Committee, warned that the health service’s continued reliance on older IT systems also made it vulnerable to a cyber attack similar to the WannaCry incident in 2017, which led to widespread disruption across the NHS. 

“The Department of Health and Social Care knows what a digital revolution could mean for NHS patients. However, it hasn’t drawn up the detailed plans needed to make one happen,” she said.

“NHS systems were originally supposed to be sharing data seamlessly by 2005. Fifteen years later, the NHS hasn’t even established a complete set of standards for trusts and the IT industry to follow.

“The NAO report shows that not enough has been learnt from previous failed IT strategies. Meanwhile, continuing dependence on obsolete systems leaves the NHS open to another WannaCry-style cyber attack.”

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