The Public Accounts Committee (PAC) has warned there is a significant risk that digital solutions are being treated as a “cure-all” in the government’s plans to reduce NHS waiting times.
In its latest report, the PAC said despite spending £2.2bn of capital funding on diagnostic transformation and a further £1.0bn on surgical transformation, NHS England (NHSE) has missed its recovery targets by significant margins and too many people are still waiting too long for tests and treatment.
The PAC warned that this need for change comes at a time of major structural reform in the NHS, including NHSE being abolished and a 50% headcount cut across integrated care boards (ICBs). It says that these unfunded reforms, which will result in the loss of c. 18,000 administrative posts, could have a significant negative impact on patients and the NHS workforce and will lead to wasted effort.
It says the integration and sharing of digital records across the NHS remains a key weakness in the system. It also raises concerns about access to and interoperability between digital resources, as well as issues of hardware availability and connectivity.
The PAC calls on NHSE and the Department for Health and Social Care (DHSC) to set out:
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how the elective care transformation programmes are practically affected by the ‘analogue to digital’ shift in the 10 Year Plan;
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how it will solve the problem of legacy IT equipment and ensure that the IT systems used in different parts of the NHS are properly connected; and
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whether the 10 Year Plan itself has sufficient funding to deliver the digital transformation required by the plan.
During an oral evidence session in September 2025, Sir Jim Mackey (CEO of NHSE) admitted that record sharing across the system remained a key issue. He said digital foundations have been laid through the electronic patient records (EPR) programme but warned that the landscape is evolving rapidly.
Mackey said they needed to work out what role the centre (DHSC) should play in managing the proliferation of health technology being made available to and interacting with the NHS, such as consumer-led health devices. This includes developing a healthy market and moving away from big capital, central bidding processes and into more agile and rapid processes.
The PAC also states that it is “sceptical that digital change can satisfactorily reach all patients as there is likely to always be a part of the population who find digital technology and tools too difficult to use”. As TechMarketView commented when the 10 Year Plan was published, with digital platforms like the NHS App becoming increasingly important routes to NHS services and information. Much stronger attention needs to be paid to accessibility and user capability, with a focus on digital inclusion and equity.
Although the NHS backlog numbers are showing signs of improvement in some areas, they are still far too high. The structural reforms currently underway risk derailing this progress and disrupting digital transformation efforts. Too often digital solutions, particularly AI, are being seen as a panacea for an effective NHS – these technologies will be transformative, but their true potential will not be achieved without a balanced approach to securing the digital foundations.
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