Funding of NHS England’s flagship scheme to target digital investments at the least digitally mature trusts is looking increasingly uncertain, ahead of Thursday’s crunch Autumn Statement, set to cut public spending and hike taxes.

NHS England’s levelling up initiative, which divided NHS hospital trusts into five levels of maturity, was intended to boot-strap the least digitally mature trusts by targeting national investments that would then have to be matched with local funding.

But several NHS sources have told Digital Health News that over the past couple of months many trusts have been told they will only get a smaller amount – some speak of 40-50% reductions – or will no longer get funds at all.

Sources indicate that reduced national funds are being prioritised for the approximately 19 so-called group zero trusts who have no electronic patient records (EPRs) and no business case, followed by the 11 group one trusts who have no EPR but are in implementation or procurement.

The 132 trusts in group two, who are building out clinical functionality of an existing system, are likely to be the hardest hit by a further squeeze on digital investment funds.

Trust CIOs who spoke to Digital Health News on background, spoke of having worked up plans ready to go that were now on hold until clearer guidance on funding was provided by NHS England.

The primary frustration was of uncertainty and confusion, with a lack of guidance coming from NHS England’s Transformation Directorate.

Any cuts in provider digitisation funding would almost certainly make it impossible to achieve already ambitious targets for 90% of NHS trusts to have fully-featured EPRs by December 2023.

Though the NHS is expected to be spared the very worst of spending cuts, under austerity 2.0, slower digitisation would likely severely hamper attempts to use digital and data to drive efficiency and productivity savings across the health service.

No details have yet been published in the open about the levelling-up strategy, which groups trusts are in or what levels of investment they might receive.

Steve Barclay, back for a second stint as Secretary of State for Health and Social Care, told the NHS Providers conference in Liverpool today that investment in technology remains a priority for the NHS and that some big updates are coming soon to the NHS App, including the ability to book a Covid jab.