NHS Confederation: Frontline digitisation: creating the conditions for a digital NHS (6 August 2024)

Summary

Digital transformation is a significant enabler towards improved productivity and efficiency in the NHS. This report from the NHS Confederation explores integrated care systems’ experience of frontline digitisation and highlights the reality, the common issues, challenges and areas of improvement to unlock the potential of a digitally responsive and modern NHS.

Content

Key points

• NHS England’s frontline digitisation programme was introduced in 2021 to support healthcare organisations to transition from paper-based to digital systems for patient information, clinical notes and access to data. Its aim is to reach a core level of digitisation following minimum digital foundations, where the health service and the people who use it have digital services and access to the data they need to effectively manage and improve health and wellbeing.
• Many integrated care systems (ICSs) have begun to see benefits from their frontline digitisation programme, such as freeing up staff time, encouraging collaborative working with partners and promoting interoperability. 
• Use of digital in healthcare is a significant enabler towards improved productivity, better access and efficiency in the NHS. Yet over time, NHS leaders across trusts and integrated care boards (ICBs) have raised the complex challenges associated with digitising the frontline, and the tension of striving to meet national goals while operating and delivering care in a system that is not fully capable of harnessing digital innovation.
• Electronic patient record (EPR) system convergence has forced a much-needed dialogue across trusts and wider system partners to consider the consolidation of clinical and administrative services at a wider level. However, transformation on this scale comes at a cost, and organisational readiness is not consistent throughout providers. 
• In our engagement with healthcare leaders for this report, workforce and training were seen as significant barriers to ICSs being able to provide and deliver a quality frontline digitised service. Leaders also recognised the need to invest in people and the workforce alongside the investment in technology, stressing that if the right balance isn’t achieved and the workforce isn’t effectively supported, digital transformation ambitions won’t be realised.
• Funding, both revenue and capital, was reported as one of the most significant barriers to healthcare organisations achieving their frontline digital priorities. Some organisations also saw significant disparities in funding across acute, community, and mental health providers, potentially providing a limitation to consistent patient outcomes. 
• Bureaucracy has stood in the way of systems being able to implement frontline digital services at pace, and many point to short-term pots of funding and the cost of the procurement process.
• The frontline digitisation programme has raised questions relating to the role of ICSs, their accountabilities for the programme and, specifically, how best to influence or lead multi-trust collaborations, due to the procurement and development of EPRs existing at a local level instead of at the ICS level.

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