Freed: ‘We throw away money on digital bets’

Benefits from digital are there for the taking, suggests James Freed, deputy director of the NHS Digital Academy. 

But throwing money at technology, and “cutting corners” on workforce and implementation, doesn’t work.

Ahead of his appearance at Digital Health Summer Schools 2026, Freed explains why it’s time to focus on the things that really make a difference.

Last year, you expressed concern at the “high numbers” of NHS staff citing digital technology as a reason why they’re leaving the sector, with up to 75 per cent having a skills gap. Why has this situation been allowed to develop?

‘Allowed’ suggests that people know about it and accept it, but I’m not sure people recognise this.

I think it’s basically down to the fact that we have got high ambition when it comes to digital, but we don’t have the budget to do it well, so what we tend to do is cut corners.

You can’t cut corners on the amount of money that you give to Cerner or to Epic, but you can cut corners on change management, education, resilience, customisation and leadership. You know, all the stuff that matters more to successful implementation than the technology.

While we have this mismatch of ambition and capacity – and I use the phrase to mean everything from people to cash and capability – we’re going to throw away lots of money on bets that fail to meet our expectations.

How can we improve user experience and release benefits from digital?

The biggest thing that impacts user experience is reliability and speed. So again, not to do with the product itself, but to do with investment in devices, Wi-Fi, bandwidth, network speed.

We know from looking at the correlation between digital maturity assessment and productivity that the [measure] with the highest correlation with productivity is whether organisations have a policy on device refresh. If organisations take it seriously that everyone should have a modern-day device to operate at work, they are on average 37% more productive than organisations that don’t have that policy.

Digital literacy is the easiest single thing to address. Just one hour’s EPR training a year can improve staff satisfaction

The second highest [correlation between digital maturity and productivity] is digital literacy. Organisations that have got a high digital literacy are on average 33% more productive than organisations that don’t.

Digital literacy is probably the easiest single thing to address.

We’ve got a good data set with the usability data from electronic patient records. We know from looking at that, that anything to do with the product – how it’s designed, what it does, its functionality and user interface – probably only accounts for about 30% of user satisfaction.

Small amounts of training can make a big difference. Just one hour’s training a year on average can improve staff satisfaction by 17 points. Twenty hours or more makes some increased difference, but nowhere near as much as that first hour.

Which digital technologies should we prioritise?

If you’re asking what every organisation in the country should be spending money on this year, I don’t’ think I can answer that question. And the reason is because every organisation is in a slightly different place. They’ve got their own priorities and strategies.

What I would say is, if organisations don’t have good quality infrastructure, I’d start there. So decent Wi-Fi, decent network speed, decent devices.

If they don’t have a digitally literate workforce, I’d start there.

And then, before going anywhere near AI – which presupposes high quality data – I’d make sure the data quality was good.

The electronic patient record is the main interface to get clinical perspective and clinical data into a form that others can see. So I would prioritise an EPR over anything on top of an EPR.

There’s a general belief that we need to throw the kitchen sink at digital technologies, doing as many things with as many different digital technologies as possible. I think that’s a mistake because it forces an investment in a large number of digital technologies and an underinvestment in all of them when it comes to implementation, which is where we have our big deficit.

There are more opportunities for digital technologies than there have ever been. The key is not doing everything; it’s doing the things that are going to make the most difference and doing them well and realising that benefit.

Something we are not good at in the NHS, is measuring the benefits that we bring about. There’s a ‘because it worked somewhere, it’s going to work everywhere’ kind of model. A good first step would be consistent and standardised measures of benefit.

How important is it to professionalise and standardise digital roles in the NHS?  

It’s super important, partly to give people an understanding about the expectations on them. And when I say ‘people’ I don’t just mean people in these roles, I also mean their organisations and line management, because if you don’t have a language around specific skill sets, how on earth do you hire to those roles?

Whilst we’ve got variation [in the meaning attached to job titles] it’s really difficult to try and help people improve.

It’s only this year we’ve said there’s an expectation on digital, data and technology staff to join a professional body and register with the Federation for Informatics Professionals. I think we will see a fairly rapid standardisation of language. We’ve already got 14 job families and 79 job roles specified and defined. Building on the language that we’ve got with the FEDIP and the professional bodies that contribute to it, is a good stepping stone.

In the NHS, only about 3% of our staff are digital and data professionals. We’re operating about 100,000 products on a staff based of about 35,000 digital professionals. That’s three products per person.

We’re not going to suddenly triple the size of the DDAT workforce. So how do we balance our ambition [with] our constraints and [create] a model that helps us deliver the biggest benefit in the shortest time? That’s ultimately what our goal’s got to be.

What hot topic do you expect people to be talking about at Summer Schools? And what would you like them to talk about?

They’ll be talking about AI – and I’d rather they talked about workforce, because it is something that will make a huge amount of difference and it is within their gift. It doesn’t require hundreds of millions [of pounds] of investment. People can make a difference now within their existing resources.

James Freed will be appearing at Digital Health Summer Schools 2026, the premier learning and networking event for digital health leaders, 16-17 July at the University of Nottingham. 

The event is supported by Digital Health Networks  sponsors Altera, AWS, CereCore, Dell Technologies and AMD, Imprivata, InterSystems, Microsoft, and Salesforce.

Register here.