No components for successful NHS digitisation in place

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The House of Commons Public Accounts Committee (PAC) has concluded that the NHS has a long way to go to move on from their “track record of failed IT programmes over almost two decades”.

The Department of Health and Social Care outlined in its 2014 digital strategy a plan to achieve a “paperless NHS” by 2018; it has still not achieved this target, which has been “watered down” and pushed back by six years. This effort follows an “expensive and largely unsuccessful” previous attempt at rolling out modern, integrated IT systems across the NHS in England between 2002 and 2011.

Now, the PAC has warned that the department and NHS bodies could be on the path to repeating the same mistakes which led to those failures.

“The [department] and the NHS have a long way to go to deal with, and move on from, the legacy of their track records of failed IT programmes over almost two decades,” the report said.

In 2020, “none” of the necessary components for a successful delivery of the digital ambition for the NHS (effective governance, realistic and detailed plans, sufficient investment, and clear accountability) are in place, the committee concluded. For instance, two years on from the publication of the department’s 'Vision for digital, data, and technology' plan, there is still no implementation plan. Meanwhile, local trusts are at varying levels of digital maturity and governance and accountability arrangements are convoluted and poorly defined.

According to NHS England & NHS Improvement, the NHS will need around £8.1bn to deliver its digital ambition: £5.1bn from national bodies and £3bn from trusts. However, it is unclear where struggling trusts will find this funding.

The PAC noted that the response of the NHS to the Covid-19 pandemic shows the potential for organisations to quickly adapt to new technologies.

“After 18 years of failed attempts to digitally transform the NHS you would hope that the one success that could be claimed was the learning and change to ensure those failures are not repeated,” said Meg Miller, chair of the committee. “Incredibly, still, none of the components essential to successful delivery of the digital ambition for the NHS are in place, and instead the government presses on with expensive and unproven strategies and contracts that cost the taxpayer millions but don’t deliver.

“The response to the pandemic demonstrates it is possible to reset and adopt new digital solutions and technologies. But there needs to be a clear strategy that works with local trusts and acknowledges the financial pressures they are under.”

The report called for NHSX to urgently publish an implementation plan for meeting NHS digitisation targets and for the Department of Health and Social Care to set “realistic” targets and to improve clarity and transparency.

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