News / Report rates digital progress in NHS as ‘inadequate’

Progress on creating a digital NHS has been rated as ‘inadequate’ by an expert panel of the Commons Health and Social Care Committee – with funding being identified as a key issue. In a hard-hitting report - Evaluation of government commitments made on the digitisation of the NHS – the panel looked at nine specific commitments in four key policy areas:

• care of patients and people in receipt of social care.
• health of the population.
• cost and efficiency of care.
• workforce literacy and the digital workforce.

In all but one case, overall progress was assessed as ‘requires improvement’ or ‘inadequate’. There were particular problems in rolling out integrated health and care records; de-identifying data on collection from GP practices; creating a national digital workforce strategy; and getting the right workforce in place.

Lack of funding was highlighted in several areas including increasing digital monitoring of vital signs in people’s own homes, where funding had been reduced, and integrated records.

And the way the NHS allocated funding for digital initiatives was challenging, the report says, with a need to streamline contracting methods. Many digital companies found the NHS commercial landscape complex and slow, while smaller providers lacked procurement expertise.

The expert group explored four questions for each of the nine government commitments. Was the commitment met? Was it effectively funded? Did it have an impact for people receiving care? And was it an appropriate commitment. Funding was found to be inadequate or requiring improvement for all the commitments apart from the programme to link health and genomic data.

The report said there has been ‘significant progress’ in digitalisation of the health and care system but that progress towards national standards and frameworks has been ‘too slow’. It picked out poor interoperability as a persistent issue that affected the NHS app as well as integrated records. There were also no effective plans to mitigate against digital exclusion.

The report also expressed concern about the workforce in both health and social care. The NHS is still awaiting a digital workforce strategy, which would be vital for further development, and social care had seen relatively low levels of training for staff. ‘We are not convinced funding is sufficient to ensure the wider health and social care workforce have adequate digital skills,’ it concluded. 

There were also significant staffing gaps among more specialist staff – the digital data and technology workforce – which led to an over-reliance on commercial consultancy. Again, funding around this was inadequate.  

According to Jane Dacre, chair of the expert panel and a professor of medical education at University College London: ‘What is particularly disappointing is that the government recognises that the digitisation of the NHS is essential to bring about real benefits to patients, for example by helping them to monitor and manage long-term health conditions independently. Yet time and again, promises have been made, but not delivered, hampering wider progress.

‘The aspirations to transform the NHS, supported by the right digital foundations, are to be applauded, however, our report finds evidence mainly of opportunities missed,’ she said.

Steve Brine (pictured), chair of the Health and Social Committee, said the expert group’s findings would support the committee’s own examination of digital transformation in the NHS. ‘Integration of the NHS with social care services is vital so it is concerning that these care settings appear to be frequently overlooked,’ he added. 

NHS Providers deputy chief executive, Saffron Cordery, said the expert group’s assessment of inadequate resources to deliver digital transformation would come as no surprise to healthcare leaders.

‘This is particularly true when it comes to funding for initiatives to deliver improvements in the cost and efficiency of care and to build a digital workforce,’ she said. ‘We cannot pretend though that funding and workforce challenges can simply be fixed by buying more laptops and tablets. The focus must be on getting the right digital skillsets and teams in place to deliver against these commitments.’

She added that ‘the raid on digital funding this year’, with money diverted because of the government’s decision to not fully fund 2022/23 pay award, was ‘short sighted and undermines a sustainable approach to digitising the NHS’.