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Government’s lack of clear plan for digital NHS poses risk to ‘credibility’

The King‘s Fund warns that the government’s plans for a digital NHS lack clarity around funding and priorities

The King’s Fund has called on ministers and national NHS leaders to set out a “definitive plan” for going digital, with “credible timescales” and clarity around priorities.

The report by the health policy think tank, published on 22 September 2016, warns that confusing messages around when and how the NHS is expected to go digital could pose a risk to achieving its goal.

“This agenda has been subject to a confusing array of announcements, initiatives and plans. Shifting priorities and slipping timescales pose a risk to credibility and commitment on the ground,” the report said. 

“Ministers and national leaders must set out a definitive plan which clarifies priorities and sets credible timescales, generates commitment and momentum, and is achievable given the huge financial and operational pressures facing the NHS.” 

The report follows Robert Wachter’s review of NHS technology, which was published earlier in September 2016. The US professor’s review found the mandate by NHS England that all NHS organisations must be paperless at the point of care, with integrated electronic patient records in place by 2020, is unrealistic and should be put back to 2023. 

He also warned that an “aggressive push” to digitise the secondary care sector by 2020 was “more likely to fail than succeed”.  

Confusion around funding 

Funding continues to be another issue. In February 2016, health secretary Jeremy Hunt announced a £4.2bn investment in a “paperless NHS” over the next five years. However, the full breakdown of where the money is coming from and how it will be spent is still unclear.   

The King’s Fund said the proportion of the funding announced by Hunt that “constitutes ‘new money’ remains unclear, as do the criteria and route of access for local areas and expectations for what this funding will deliver”.

“What has become clearer in recent weeks, however, is that this new money is ‘heavily weighted’ to the back end of the parliamentary period, and national bodies have told local leaders that they should ‘have a plan for how you will proceed if we are unable to meet your IT requests’,” the report said. 

Earlier in September, Hunt promised funding of up to £10m each to the 12 NHS trusts that have been selected to become centres of digital excellence, as part of a “global exemplars programme”. 

However, the King’s Fund said while the money is very welcome, “it remains to be seen as to when and how this money will be made available”. 

It also echoed Wachter’s review, which said the current funding won’t be enough to digitise the secondary care sector. 

“If the government is serious about achieving its vision, whether by 2020 or 2023, clarity is needed about the funding available to support this, as well as consideration of whether further funding will be required,” said the King’s Fund report. 

Changing deadlines and priorities 

The push for going digital was first set out by health secretary Jeremy Hunt in 2013, when the goal was to be paperless by 2018. In 2014, the deadline was extended to 2020.  

While primary care is much further ahead than secondary care, with all practices now offering patients access to their full GP record, the King’s Fund said only 5.2% of GP patients are aware that their practice offers this and only 0.9% of patients have used it. 

The King’s fund said simply making services available isn’t enough to ensure uptake and that raising awereness and simplifying the technology is important. 

“The low uptake of online services by patients in primary care and slow progress on a number of other fronts demonstrate the difficulties for the NHS, first in getting the technology right and then in unlocking the benefits so the technology in place is used to full effect,” the report said. 

It also highlighted the importance of getting clinicians on board if the NHS is to succeed in its digital transformation. 

“Historically, the NHS has struggled to work with technology partners in ways that put the needs of clinicians and patients first. This manifests itself in clunky systems for entering clinical data, or in alerts so numerous that clinicians end up ignoring them or turning them off,” the report said. 

Matthew Honeyman, policy researcher at The King’s Fund, said while digital can transform the NHS, it won’t succeed without a clear plan.

“Ministers and NHS leaders must articulate a clear and compelling vision that conveys the benefits of digitisation to the clinical staff who will be central to implementing it, as well as provide certainty about the funds available to support it,” he said. 

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