NAO report highlights “complexity of the NHS digital landscape”

  • 25 June 2020
NAO report highlights “complexity of the NHS digital landscape”

The team behind a troubling report into digital transformation across the NHS in England have said they think it highlights the “complexity of the NHS digital landscape”.

Published in May, the National Audit Office’s (NAO) report concluded that local NHS organisations are facing “significant challenges” when it comes to working towards digital transformation.

Prior to the Covid-19 pandemic, the NAO looked into the state of digital services across the NHS in England and its readiness to deliver digital transformation, focusing on plans, governance arrangements, resources and technical challenges.

The report also concluded that while the main bodies plans for digital transformation are “ambitious”, the track record in the NHS has been “poor”.

One big issue reflected was that NHS England and Improvement expects the NHS will spend around £8.1 billion to deliver digital ambitions up to 2024, but this includes up to £3 billion expected from trusts for the period up to 2029. The NAO debates whether this figure is realistic.

David Williams, senior analyst at the NAO who worked on the report, said there were “challenges in estimating the costs”.

“Clearly there is a complex landscape involved which was eye opening,” he added.

Audit manager, Paul Wright-Anderson, who also worked on the report, echoed this, saying it was surprising to discover the “uncertainty” surrounding costs.

“I think it shows the complexity of the NHS digital landscape with so many organisations using different systems,” he added.

Part of the report includes six recommendations, including maintaining a comprehensive set of lessons for digital transformation from NHS and wider government experience, and ensuring that the expected technology plan for health and care includes an implementation plan with specific objectives and measurable actions that are required.

For director of heath, Robert White, he hoped that the NHS would to focus more on infrastructure.

“It [infrastructure] is less exciting than new innovation but innovation won’t come to fruition in the way imagined unless the right foundations are not in place,” he said.

Digital Health is running a journal club on the NAO report at 7pm on July 1. Jon Hoeksma, CEO at Digital Health, will chair the session which will also feature Paul Wright-Anderson and Yvonne Gallagher, who is the director of digital transformation at NAO.

It will provide an opportunity for NHS IT leaders to reflect on progress and lessons of the past decade and how to apply them to what comes next.


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  • From my experience with NHS IT since 1989 to the present, I have found that the majority of organisations fail to answer two key questions;
    Where are they? and
    Where do they want/need to be?
    The focus seems is on implementing “something” rather than undertaking an assessment which would answer the two questions above and also provide a guide as to what needs to be done before initiating an IT implementation.

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