The review of NHS IT organisations by Laura Wade-Gery has finally been published, and as exclusively revealed by Digital Health News, recommends the axing of NHS Digital and NHSX.

Instead, the review says that NHS England and Improvement must take over responsibility for digital and data within the wider transformation agenda and embed it at all levels. The decision to implement the core recommendation was announced by NHS England and Improvement CEO, Amanda Pritchard, to staff on November 22.

The review states that despite much good work, digital transformation is currently fragmented across the system, split between different agencies and is “often overshadowed by requirements of the day-to-day”.

It continues: “Many senior leaders see digital as a separate not embedded enabler and there needs to be greater clarity on the roles of national, regional and local in driving transformation.”

The review goes on to state there is “variable commitment, experience and interest amongst senior leaders in digitally enabled system transformation, with too few integrative leaders able to effectively bridge managerial, clinical and digital”.

Further problems are identified in fragmentation on data and technology, resulting in “lack of clarity on target state data and technology architecture”.

This serves as prelude to the review’s punchline: “It is therefore the review’s conclusion that the centre of the NHS (defined as NHSEI, X and D), as currently constituted, and despite considerable progress and the best intentions of many people, remains too far away from being able to achieve the goal of a digitally enabled health system that makes use of modern technology and data sharing to create joined up services to support all citizens and improve outcomes.”

The review’s key organisational recommendations are that NHSX be evolved into the strategy function of a new Transformation Directorate within NHS England and Improvement, while NHS Digital is embedded with NHS England and Improvement ‘as its tech function and as the NHS centre for excellence for technology’.

Former Tesco boss, Wade-Gery was appointed as chair of NHS Digital in July 2020 and asked to lead a review of NHS IT organisations by then health secretary Matt Hancock. Consultants McKinsey were paid over £600,000 to carry out the review which has been awaiting publication since last November.