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Wachter review dismisses “unrealistic” 2020 paperless NHS push

Neil Merrett Published 07 September 2016

New findings call for clear plans for £4.2bn NHS digitisation funding by end of 2016, with further money sought to ensure digital maturity of all trusts by 2023


The NHS should shift its technology focus towards ensuring all trusts have a high level of digital maturity within the next seven years, rather than trying to meet an “unrealistic” target of ensuring a paperless NHS by 2020, according to a Whitehall-commissioned review.

Released to coincide with the Health and Care Innovation Expo in Manchester, the report – overseen by University of California Professor Bob Wachter - has set out how best to realise the potential of technology transformation in the NHS, and has several recommendations.

The findings reflect the wider views of the National Advisory Group on Health Information Technology in England, formed last year to advise authorities on how to better realise the potential afforded by technology transformation.

The review recommends that by the end of the current year, NHS England should set out a detailed plan for how £4.2bn of digitisation funding will be used with regard to ensuring trusts have required hardware, software and workforce development to meet operational and budget challenges.

“The £4.2bn the Treasury made available in 2016 to promote digitisation, while welcome, is not enough to enable digital implementation and optimisation at all NHS trusts,” said the document.

It therefore backed a phased approach that can be implemented in two parts.  The first of these phases, scheduled to run between 2016 and 2019, should see national funds combined with local resources to support trusts that are better prepared to digitise or undertake improvement at present.

“Another tranche of government funding (not yet allocated) will likely be needed to support a second stage,” said the report.

This second phase, anticipated to run for three years from 2020, would aim to ensure all NHS trusts have undertaken transformation plans and have a high degree of digital maturity by 2023 or face being out of compliance with national quality and safety requirements.

The report also recommends making interoperability a “core characteristic of the NHS digital ecosystem”, as well as appointing a national chief clinical information officer (NCCIO) that has a background in clinical care and informatics to oversee clinical digitisation.

Wachter’s report set out the following proposals:

  • Development of a number of trained “Clinician-Informaticists” to work at individual trusts with appropriate resources and authority to realise digital plans
  • Ensuring development of CCIO pool and larger number of trained health IT professionals or individuals with clinical care and informatics understanding
  • Setting out a long-term engagement strategy, including the likely implementation challenges of introducing a fully digital NHS

In the findings of Wachter’s review, the professor also noted that like any industry, installing computers without acclimatising the workforce that will support the technology served only to limit any potential operational benefits without better training.

On the back of these findings, Health Secretary Jeremy Hunt has announced a £10m package designed to create global exemplars of digitally advanced trusts and set up university-led NHS academy programme to improve technology skills for clinical staff and others working in healthcare.

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