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Report

A digital NHS?

An introduction to the digital agenda and plans for implementation

In recent years, the digital agenda in health care has been the subject of an array of promises and plans, ranging from the Secretary of State’s challenge to the NHS to ‘go paperless’ to the commitment set out in the NHS’s Five Year Forward View to ‘harness the information revolution’. But have expectations been set too high? And is there sufficient clarity about the funding available to achieve this vision?

This report looks at the key commitments made and what we know about progress to date, grouped under three broad themes:

  • interoperable electronic health records

  • patient-focused digital technology

  • secondary use of data, transparency and consent.

It identifies barriers to further progress and opportunities for delivering on the digital agenda.

Key findings

  • Digital technology can transform how patients engage with services, drive improvements in efficiency and care co-ordination, and help people manage their health and wellbeing.

  • For historical reasons, the acute sector is furthest from achieving the goals set out under this agenda, in contrast to general practice where use of digital clinical systems is near-universal. Delivering large-scale digital transformation involves risks for NHS leaders (particularly in acute trusts); they should receive more support and tolerance from regulators and commissioners.

  • To maximise uptake, patients and the public need to be aware of the benefits of digitisation, while being reassured about data security and use.

  • Clinicians and frontline staff must be involved in designing and rolling out new technology.

Policy implications

  • Achieving the digital vision requires more realistic deadlines, given the backdrop of unprecedented financial and operational pressures facing NHS organisations. The government should adopt the Wachter review’s recommendations about extending the timetable to 2023.

  • In doing so, the government needs to take care to preserve the momentum that has been generated towards building local data-sharing arrangements and increasing the uptake of online services for patients.

  • Greater clarity is urgently needed about funding to support this agenda, including when the money already announced will be made available and how it can be accessed.

  • There is a risk that focusing too narrowly on cost savings and ‘going paperless’ could detract from the ultimate aim – to improve outcomes, efficiency and patient experience.