NHS England’s CIO Will Smart has said the NHS needs at least another £4.2 billion of IT investment to finish the job of digitisation.

Speaking at the EHi Live trade show on Tuesday Smart said: “We got £4.2 billion a couple of years ago, we need at least that again if we are to finish the job.”

Some £4.2 billion was committed to NHS IT investment over five years by Secretary of State Jeremy Hunt in February 2016, but little of the money has yet found its way directly to NHS trusts or STPs.

A total of £385 million of the £4.2 billion has since been re-directed into the flagship Global Digital Exemplar (GDE) programme.

Smart said for further additional investment to be secured the NHS needed to be able to show to Treasury that existing investment was delivering big improvements in productivity, efficiency and patient safety.

He said that the GDE programme was key to demonstrating the benefits of investment in digitisation.

“If we look at GDEs that is a real example of us saying to organisations ‘here is some money, we think you can deliver excellence’,” said Smart.

He acknowledged that the GDE programme has been divisive.  “There has been some criticism that we are giving to the haves I think in some senses that is a fair critique.”

“But it will be a success at the end if we have 17 trusts at HIMSS level 7, and 17 further fast followers, and have begun to spread digitisation across the NHS.”

Smart added that the GDE and fast follower programmes were intended to eventually drive up the digital maturity of all NHS organisations.

Asked whether any of the GDEs are yet world class, Smart joked that he would take the party line: “I’m not saying any of the GDEs are world class. The Royal Free is of course exemplary [Smart’s former trust]… But we have some organisations verging on greatness Cambridge approaching HIMSS level 7.”

He then concluded: “But I think it would be naïve to say we are at world class standard yet.”

NHS England’s director for operations and information Matthew Swindells recently came out saying, “the best hospitals in the UK, in terms of using IT, are mediocre by international standards“.

Smart said that a fundamental challenge remained to drive up adoption of local innovation: “Still lots of people doing great stuff but not being spread and adopted – not every problem is a new problem. My challenge to everyone in this room is to change the way we think.”

Smart called for NHS IT leaders to stand-up and follow.

“We now need to develop followership.  Something may have been invented somewhere else but it can be good enough for me.  So, whether it’s the GDE blueprints, or something developed through lived experience, we have to perhaps a bit less proud and centred on ourselves.”

To achieve a step change in spreading innovation and adopting work done elsewhere, the NHS England CIO said it required “a much better ability to communicate the great things we need”, “a need to support local risk taking and innovation”, “technical architectures that enable the transfer of knowledge and innovation” and a drive to “standards, innovation and interoperability.”