The National Audit Office found that arrangements for ensuring trusts’ technology spending was consistent with the national strategy were still being developed.29 We asked NHSX what levers it had to influence trusts’ digital investments, and whether there were any circumstances where it would intervene in local systems if they were out of step with national strategies. NHSX told us that it wanted to implement “more nimble” spending controls, covering much more of trusts’ technology spending than the current business case approvals process for large projects. It explained that these controls will be used to ensure that the systems purchased by trusts were consistent with its standards and can speak to each other.30 NHSX told us that it was using procurement frameworks to save money, as well as to ensure that organisations are purchasing from a set of products that it has vetted and which it knows are compliant with the standards. We asked NHS Digital how it would manage the tension between achieving interoperability and increasing the number 24 Q24 & 29 25 C&AG’s Report, paras 10, 15 & 1.15, 26 Qq 50–51, 54 27 Q37 28 Q37 29 C&AG’s Report, para 12 30 Q 71 Digital transformation in the NHS 13 of suppliers in the system via the procurement frameworks. NHS Digital responded that interoperability would be a foundation condition for a vibrant, competitive market for healthcare technology.31 31 Qq 35, 54, 71 14 Digital transformation in the NHS 2 Funding and support to improve the NHS’s digital capabilities Supporting local organisations to improve their digital capabilities