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NHS Digital told it 'needs to do better' after critical review

Internal review highlighted areas where NHS Digital must improve to support plans for digital healthcare services

An internal review of NHS Digital has identified a series of problems in the organisation, including a lack of clarity around its purpose, insufficient collaboration with frontline health service activity, and using out-of-date technology.

The “capability review” invited external consultants to assess NHS Digital’s ability to support NHS England’s Personalised Health and Care 2020 strategy for delivering better digital healthcare services.

NHS Digital – formerly known as the Health and Social Care Information Centre – was set up in April 2013 to provide a range of specialist data services and support wider plans for digital healthcare, in particular delivering a paperless NHS by 2020.

While the review itself has not been published in full, NHS Digital’s response has been released in a report titled Fit for 2020, outlining the key findings of the review and the organisations’ responses.

NHS Digital chairman Noel Gordon said in a letter accompanying the report that “there are areas of excellence alongside parts of our organisation where we need to do better”.

The review included criticism such as a lack of awareness around NHS Digital’s role and functions; concerns about the organisation’s ability to deliver the requirements of the 2020 strategy; and a “distance” from the NHS frontline, with a tendency to “transmit” information instead of “engaging”.

Concerns were also raised about having the right skills among the organisation’s 2,700 staff, and problems caused by “using out-of-date technology in key areas” and that “adoption of innovative digital solutions and automation is often too slow”.

The report paints a picture of an organisation struggling at times to fulfil its role in a complex healthcare system, and needing to reform the way it works in areas such as commercial capability, data services, digital culture, business architecture and IT delivery.

The review was conducted before the NHS was hit by the WannaCry ransomware attack in May 2017, but it highlighted the need to improve the organisation’s cyber security capabilities.

On 14 July, the government provided £21m of extra security funding to the health service, in part to improve NHS Digital’s national monitoring and response capabilities.

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However, Gordon also pointed to NHS Digital’s successes in developing and running national IT systems such as NHSmail2, the electronic prescription service and the NHS Spine.

“We recognise the importance of changing the way we work, of building and sustaining trust and confidence in all that we do, and of working in partnership to ensure that the total value of our collective effort to transform the way health and care services benefit from using data and technology exceeds the sum of the separate parts,” said the report.

“The commitments [in this report] will consolidate our role as the key delivery partner for health and care data and technology services, and restore our voice and influence on behalf of the health and care service.”

The task of implementing the recommendations of the Fit for 2020 report is likely to fall to incoming NHS Digital CEO Sarah Wilkinson, formerly chief digital, data and technology officer at the Home Office, where she led a large-scale digital overhaul of the department.

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