Improving digital services is at the heart of delivering the NHS Long-Term Plan but remains a huge challenge to deliver. The Department and NHS bodies still have a long way to go to deal with the proliferation of legacy IT systems across the health and care system and move on from their track record of failed IT programmes. The Department did not achieve a ‘paperless NHS’ by 2018, and this target has now been watered-down and moved back by six years. We are far from convinced that the Department and NHS bodies have learned the lessons from previous IT programmes. Without this, they risk repeating the mistakes that led to those programmes failing to deliver and taxpayers’ money being wasted. Successful delivery of the digital ambition for the NHS will require effective governance, realistic and detailed plans, sufficient investment nationally and locally, and clear accountability. It is six years since its 2014 digital strategy with the headline target to achieve a ‘paperless NHS’ and none of these vital components to make digitally-enabled care mainstream across the NHS are in place. Despite publishing its Vision for digital, data and technology in 2018, the Department still does not have an implementation plan for how this will be delivered in practice. Current governance and accountability arrangements are both overly complex and insufficiently defined. Local trusts are at varying levels of digital maturity and some are struggling financially. Unless national bodies do more to support trusts and local health and care systems in difficulty, then their progress in digital transformation is at risk of diverging further.
