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NHS Digitisation Progress Rated 'Inadequate'

The Government’s progress on digitising the NHS has been rated 'inadequate' by an expert panel report submitted to the Health and Social Care Committee (HSCC), which is currently examining digital transformation in the NHS.

The dispiriting verdict flies in the face of a Government policy paper in 2022 describing the digitisation of health and social care as "essential" to deliver the promise of improved and better-integrated services.

The independent panel of experts had been established in 2020 by the HSCC "to conduct independent evaluations of Government commitments in areas of healthcare policy, and enhance Committee scrutiny". The introduction to its report said: "Governments often make well-publicised policy commitments with good intentions to improve services for the public. While such policy commitments can be made frequently, it is often difficult to evaluate or monitor the extent to which these commitments have been, or are on track to be, met."

Health and Social Care 'Intrinsically Linked'

It noted: "It is clear that health and social care are intrinsically linked, and that the digitisation of health and care is essential to improve the outcomes, efficiency and effectiveness of both services as well as achieving the ambition of integrating health and care."

Areas evaluated by the panel included the delivery of integrated health and care records, the roll-out of the NHS app, and ensuring that the workforce had the necessary digital skills. Its evaluations give Care Quality Commission (CQC)-style ratings, from 'inadequate' to 'outstanding', against specific pledges on a range of policy areas, plus a final overall rating.

The Committee said: "The rating casts severe doubts on the Government's ability to ensure that health and social care systems have the digital foundations they need to meet the challenges they face."

Panel Chair Dame Jane Dacre, professor of medical education at University College London and a former president of the Royal College of Physicians, said: "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."

The panel's detailed overall ratings were 'inadequate' for nine commitments across four policy areas: the care of patients and people in receipt of social care, the health of the population, the cost and efficiency of care, and the digital literacy of the workforce and the digital workforce. 

Progress against four vital commitments of nine evaluated was rated 'inadequate':

  • Deliver an integrated health and care record for all patients 
  • Ensuring public and professional support for the use of general practice (GP) data for secondary uses 
  • Two commitments in the policy area of workforce digital literacy and the digital workforce, which together aim to ensure there is a sufficient number of staff with the requisite knowledge and skills to implement digitisation across the health and social care system
Furthermore, overall ratings only reached the 'requires improvement' for the remaining five commitments:
  • Roll-out of the NHS App and the use of digital home monitoring
  • Use of patient data for research and planning 
  • Two commitments relating to the purchasing of digital technologies

Key Commitments Not Met and Progress 'Too Slow'

The HSCC said: "Despite some encouraging progress, the expert panel found that key Government commitments on workforce and the use of patient information were either not met or were not on track to be met. 

"The Panel found that overall progress towards improving the digital capabilities of the NHS was too slow, and often lacked support and funding. The experts concluded that social care was often missed out in commitments, stifling progress across the health and care system."

Dame Jane said: "Time and again, promises have been made but not delivered, hampering wider progress. For example, using data sharing to improve research and planning, which we’ve rated as inadequate. However, worryingly, we have seen no clear plan for how the Government will address public and provider concerns regarding sharing personal data, which is crucial to address in order for this to be successful.

"We heard about issues with interoperability between systems and providers, making it difficult for all parts of the system to communicate effectively, leading to delays and efficiency losses.”

"Evidence also highlights challenges in recruiting, retaining and building the specialised digital workforce, yet Ministers have delayed a strategy focused on delivering a digital workforce."

Care Settings 'Frequently Overlooked'

Steve Brine, Conservative MP for Winchester and chair of the HSCC, said: "Integration of the NHS with social care services is vital, so it is concerning that these care settings appear to be frequently overlooked."

Responding to the report, Saffron Cordery, deputy chief executive of NHS Providers, said its conclusions would "come as no surprise to leaders".

She added: "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."

Dame Jane concluded: "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."