23 Accepted

The National Audit Office found that NHSX was unclear about the whole-life costs and benefits...

Conclusion
The National Audit Office found that NHSX was unclear about the whole-life costs and benefits of the different approaches to digital transformation at a local level.50 For example, NHSX expected trusts to take one of three approaches to replacing their electronic patient records: • an enterprise-wide commercial system, which can have high upfront costs; • a “best of breed” approach, integrating different systems, which can have higher running costs; and • in-house systems built by the NHS. NHSX acknowledged that the NHS cannot afford to implement the enterprise-wide system in every trust. A 2019 survey of 186 IT leaders across the sector found slightly more trusts were developing an enterprise-wide approach compared with best of breed (at a ratio of 33:26)
Government Response Summary
The government agrees with the conclusion, recognising the importance of understanding whole-life costs and benefits. The new digital strategy, due in Spring 2021, will detail how to achieve this through baselines, tracking digital maturity, collecting cost/benefit data, and providing tools and guidance. A full economic assessment, already commissioned, will also be published with the strategy.
Government Response
Accepted
HM Government Accepted
4.1 The government agrees with the Committee’s recommendation. Target implementation date: Spring 2021 4.2 DHSC and NHSX fully recognise the importance of having a clear understanding of the whole-life costs and benefits of digital transformation across the health and social care system. This is crucial for effective decision making and to ensure value for money for the taxpayer. The new digital strategy will therefore set out how we plan to achieve this, at both national and local level. 4.3 The strategy will detail how we will: establish a clear baseline and track the digital maturity of organisations; collect robust cost and benefit data from local systems; and develop the relevant tools and guidance to support local systems in making confident investment decisions. It will also outline how we will track and assess the impact of digital transformation on patients, clinicians and services. 4.4 DHSC and NHSX have already commissioned a full economic assessment of the value of digital transformation across the NHS, which is due to be published as part of the new digital strategy in Spring 2021. This will consider the whole-life costs and benefits of different approaches and will provide a clear evidence base to drive future investment.
Addressee Bodies
HM Treasury
Timeline
Recommendation age 5.7 yrs
Report published 06 Nov 2020