The government’s plan to digitally transform the NHS is at risk of losing credibility as plans and funding remain “confusing”, The King’s Fund has warned.

In a report into the NHS digital health agenda, released today, the health policy think tank says plans for digital transformation are at risk from a lack of clarity, huge financial pressures and unrealistic targets.

“This agenda has been subject to a confusing array of announcements, initiatives and plans. Shifting priorities and slipping timescales pose a risk to credibility and commitment on the ground.”

The assessment follows the release of Professor Robert Wachter’s government-commissioned review of NHS IT earlier this month.

Among other things, Wachter recommended greater clinical engagement, pushing the government’s flagship NHS “paperless 2020” goal out to 2023, and more funding for digital transformation.

Responding to the review at Health and Care Innovation Expo in Manchester, health secretary Jeremy Hunt announced 12 “global exemplar” trusts, a new digital health academy, and bundle of targets, some recycled, to improve digital patient access.

However, he did not comment on whether more funding would be made available or whether he remained committed to the 2020 goal.

In its report, The King’s Fund supports the Wachter recommendations, but notes that the Department of Health has yet to formally respond to the review.

“Ministers and national leaders must now set out a definitive plan which clarifies priorities and sets credible timescales, generates commitment and momentum, and is achievable given the huge financial and operational pressures facing the NHS,” it says.

Hunt announced in February that £4.2 billion would be invested in NHS technology over the next five years, and since then the government has been under increasing pressure to reveal more details about how this money would be allocated.

Of the £4.2 billion, £1.8 billion has been allocated to the paperless 2020 goal, although Digital Health News revealed in April that about £500 million would be soaked up funding legacy contracts from the National Programme for IT.

How the remaining £1.3 billion will be allocated has not been made clear. The £100 million of “global exemplars” funding is the first, substantial new allocation of central cash since the two technology funds that were set up to support paperless initiatives in the last Parliament.

Despite this, the King’s Fund notes that, even for the exemplar programme, the funding requirements and timing remain unclear.

The think tank is also concerned that much of the money appears weighted towards the back end of the parliamentary period, with NHS organisations expected to achieve digital transformation within their own already severely constrained budgets.

“If the government is serious about achieving its vision, whether by 2020 or 2023, clarity is needed about the funding available to support this, as well as consideration of whether further funding will be required.”

Neither NHS England or the Department of Health have responded directly to Digital Health News’ questions on the Wachter report, including whether the government remained committed to the 2020 goal.

In a statement, NHS England said both organisations and NHS Digital were “now keen to work together and make these [Wachter] recommendations a reality as quickly as possible”.

“The recommendations will be reviewed with the National Information Board to incorporate them into our digital strategy.”

However, the statement said Wachter’s suggestion that digital transformation funding by phased out to 2023 will create a “boost to allow the vision of a digital NHS to start becoming a reality by 2020.”