Evaluation of government commitments made on NHS digitisation

In 2020, the Health and Social Care Committee commissioned a review of the evidence for effective implementation and appropriateness of government policy commitments with regards to digitisation in the NHS.

A report entitled ‘Evaluation of Government commitments made on the digitisation of the NHS’ was recently published to share findings.

“Evaluations and judgements in this report are summarised by ratings which assess the government’s progress against specific commitments made regarding the digitisation of the NHS,” it states. It adds that the ratings in this report follow the same style used by national bodies such as the Care Quality Commission (CQC).

The approach to the evaluation was to analyse quantitative and qualitative data provided by the Department of Health and Social Care (DHSC) along with relevant non-departmental public bodies. In addition, relevant research evidence was included to establish causative links, and input included from patients, health and social care professionals, researchers, and more.

The evaluation identified nine key commitments across four broad policy areas. It set out to evaluate whether the commitment was met overall, or is on track to be met; if the commitment was effectively funded or resourced; if the commitment achieved a positive impact for people in receipt of care; and whether the commitment appropriate.

Area one: the care of patients and people in receipt of social care

Commitment one: by 2024, 75 percent of adults will be registered for the NHS App, with 68 percent signed up March 2023. This commitment has been met; but improvement is required with regards to funding and resource, impact and appropriateness.

Commitment two: by increasing digital connection and providing more personalised care, the government will support people to better monitor and manage their long-term health conditions at home, thus helping them live healthy and independent lives. All areas require improvement.

Commitment three: integrated health and care records will be rolled out to everyone, “providing a functionally single health and care record” that carers, people and care teams can safely use and access, with links to locally health records and shared care records. The report states that inadequate progress has been made on meeting this commitment; its funding and resourcing; and its impact. However, it is deemed to be an appropriate commitment.

Area two: the health of the population

Commitment four: through the Data for Research and Development programme, up to £200 million is to be invested to transform linkage and access to NHS health and genomic data sets for data-driven innovation and inclusive clinical trials. Meeting this commitment requires improvement, as does the impact of the commitment itself, but its funding and resourcing along with appropriateness is deemed good.

Commitment five: NHS Digital 2019 target to develop and implement a mechanism to de-identify data that is collected from GP practice. Here, appropriateness is judged to be good; but all other areas are said to be inadequate.

Area three: cost and efficiency of care

Commitment six: the government will aim to streamline contracting methods to simplify the process of selling technology to NHS buyers and leverage NHS power in buying. The report judges this commitment as requiring improvement across the board.

Commitment seven: routes to market will be consolidated and commercial levers strengthened for adpting standards through a new target operating model for procurement. As above, this commitment requires improvement across all areas.

Area four: workforce literacy and the digital workforce

Commitment eight: a national digital workforce strategy will be co-created with the health and care system setting out a framework for bridging the skills gap. This commitment received mixed results from the report; it is said to be an appropriate commitment, though meeting it is judged to be inadequate, as is its impact. Funding and resourcing requires improvement.

Commitment nine: recruitment retention will be enabled along with growth of data, technology and workforce in order to meet challenging demand projected by 2030, through graduates, apprentices and experienced hires, creating posts for an additional 10,500 full-time staff. In this area, the report finds the commitment inadequate in all areas.

Overall evaluation

Overall, the report says, the findings across the four policy areas are inadequate.

The evaluation recognises that significant progress had been conducted in digitising the health and care system, but some key commitments have either not been met or on track. The evidence they found indicated that “progress towards national standards and frameworks within the NHS is happening but is too slow overall.”

Within social care, the report highlights lack of direct support and funding. It also notes that although some of the commitments had set targets, they were not often realistic.

“Throughout this evaluation we found common issues, many of them inter-related, which hampered the delivery of commitments across all four broad policy area,” the report states. These issues include:

  • Poor progress towards national interoperability
  • Low digital maturity for many providers, particularly within social care
  • Insufficient planning around accessibility of digital products
  • Apparent lack of consideration towards particular challenges faced by social care providers and staff in digitisation due to lack of previous investment, with a very large number of providers (nearly 18,000) adding to the complexity of the task
  • Shortage of staff with the appropriate technical skills

The report commends the efforts of individual staff and providers in digitising systems and goes on to provide more detail with regards to the challenges highlighted in the report. To read the evaluation in full, click here.