The digital leaders of NHS England say that one year on much progress has been made against the recommendations made by Dr Robert Wachter.

And in a robust defence of the key concept of investing in the most advanced digital trusts, the central tenet of the Global Digital Exemplar Programme, national chief clinical information officer (CCIO) Keith McNeil, says that the NHS has for too long settled for mediocrity.

“The NHS has had a habit of rewarding failure, it’s about time we rewarded success and effort.  Time for us to stop rewarding failure.”

He added: “We won’t do that by miring ourselves in mediocrity.”

He said that the key role the GDEs are providing is setting the bar for other NHS leaders.  “GDEs are setting the bar and saying this is where we need to be on the digital agenda.”

McNeil added: “Digital products and computers don’t deliver transformation. People do. As I walk around there is a real thirst and hunger for this.  Our challenge in the CCIO office is to make sure what we do nationally is make sure it makes a difference.”

Asked by an audience member from a non-GDE trust what less digitally mature trusts can do, McNeil said the answer was leadership.  He acknowledged he was drawing on his own experience as chief executive at Cambridge University Hospitals NHS Foundation Trust, where he’d driven the procurement and implementation of the ambitious eHospital programme.

“The bottom line is that some are less digitally advanced they haven’t invested in IT.”

McNeil said that the answer to digital transformation was about getting the leaders in place. “I would say one thing need to do is get that transformational leadership in there.”

“Their leaders have got to stand up and do right what is good for their trust and do what is right, allocating resources to improve their systems, no matter how difficult that is.”

Also on the panel, was Will Smart, NHS chief information officer (CIO), who offered slightly less blunt advice.

“What can you do in a less mature environment?  Look for the great things you can do in your community. Don’t reinvent the wheel, learn from others.”

Smart opened by acknowledging that when they were announced 12-months ago the response to GDEs was mixed.

“That was not widely and universally welcomed 12 months ago, feeling we were focusing on people who already had the money.  Since then we’ve also launched mental health exemplars and are now working with ambulance and locality based GDEs.”

Dylan Roberts, chief digital and information officer for Leeds City and head of the Local Authority CIO Council, suggested that the picture on digital maturity was much more mixed.  “We’ve got the view that Paperless 2020 has been delivered in pockets across the country – just delivered in pockets and different settings.”

The challenge, he stressed, is to learn from what has already been done by others, and the way to do this was through the various professional and best practice networks that exist.

“There are great networks out there: CIOs across local authorities, the CCIO and CIO Networks, the BCS, and there is a lot of work to join those networks up. We need to make trade-offs and work out how we can join up these networks and work together.”

Eve Roodhouse, acting executive delivery director NHS Digital, said that joining up of national and local, and developing regional support team was the model for the future for NHS Digital.

“We need to work together and foster best ideas wherever they come from.  Need to listen to the NHS at all levels and we need a continuous honest conversation about what is working and what’s not.”

Roodhouse concluded: “We want to work alongside you, not apart from or against you”.