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The governance of NHS IT could be facing another shake-up following the announcement that a major review of services is set to begin later this year.

Business chief Laura Wade-Gery will take over from Noel Gordon as chair of NHS Digital in September, and a major part of her new role will be to assess how NHS Digital, NHSX and NHSE&I approach digital transformation.

This comes just over a year since health and social secretary Matt Hancock set up NHSX to lead the digital transformation of the NHS. This came with some confusion over why another unit had been set up in the already complicated world of NHS IT.

The review – announced by the Department for Health and Social Care on Thursday – confirms what was already known by industry experts: the current NHS IT landscape isn’t sustainable.

It’s not clear what the potential outcomes of the review could be – but the announcement has caused some anxiety internally, senior NHS sources have told HSJ. There’s some concern the outcome is pre-determined and the future of NHS Digital could be at risk if it is decided that two tech units is excessive.

NHS Digital is already in the middle of a major redundancy programme, which was due to continue through to April 2021. However, it has been suspended due to covid-19.

The agency’s annual report – published last week – confirmed that a further £10 million has been spent on 158 redundancies this year, bringing the amount spent on redundancy packages over the past two years up to £21 million.

Over the past two years a total of 814 members of staff have left the organisation, cutting the overall headcount by 481 once new recruits are factored in.

Covid-19 has forced the NHS to make huge strides in the adoption of tech, many of which will have to be reviewed and refined as we move closer towards the new normal.

Barriers that were previously impossible to jump have been dropped significantly and the majority of GP practices in England have remote appointment capabilities.

However, it is impossible to predict what the future of NHS IT looks like. But what’s certain is the positive changes made in response to covid-19 must continue – and stable governance is need to ensure that.