Exclusive: CCGs given ultimatum over 'paperless' progress

The guidance, published today, is designed to help local health economies create “roadmaps” setting out how they intend to provide “paper free” care at the point of delivery by 2020.

NHS organisations that do not roll out universal digital care records by 2020 face having their funding to provide care removed, NHS England’s national director for patients and information Tim Kelsey has said.

Performance on the use of digital care records will be assessed against national data quality standards, which will form part of the Care Quality Commission’s inspection regime from April.

CCGs will lead on creating the roadmaps, but it is up to them whether they work individually or collaborate with other organisations to identify the footprint their plans will cover. Local commissioners will need to inform NHS England the footprint their roadmap will cover by November.

The data standards will be announced next month, while the roadmaps will need to be completed by April 2016.

Mr Kelsey, who is also chair of the National Information Board, said digital record keeping will become “a fundamental part of commissioning assurance”.

He added: “Organisations funded to provide NHS care who do not meet the digital standards that we say are imperative for safe, high quality care by 2020 won’t receive NHS funding. In a regulatory context, they won’t be licensed to treat NHS patients.”

The guidance, issued jointly by NHS England and the information board, will include details of how local health economies can meet a set of indicators, known as the “digital maturity index”, measuring their progress on becoming paper free.

Mr Kelsey said: “As we build up to the publication of the roadmaps we’ll get a much clearer view of exactly what kind of support is necessary, in which localities, and how best that can be delivered.”

He stressed that while standards will be set nationally, local health economies should decide how best to deliver digital patient records in their area.

He said: “People will have complete freedom to deliver whatever solution best fits their local circumstances with the promise of national support to help them do that.”

Many local health economies would require extra funding to achieve full digital coverage, but Mr Kelsey stopped short of saying that additional investment would be provided at this stage.

He explained: “We are not spending [current investment] on the right things. As part of the delivery of the roadmaps I think we are going to have to have a big conversation about ways in which we can support local health economies to make the right investments in the right places.

“For many, if not most, it will require additional funding or the reallocation of existing funding.

“I don’t really see how you couldn’t make the case [to government] that funding of some type should maybe be made available.”

Speaking ahead of the guidance’s launch at the Health and Care Innovation Expo, Mr Kelsey denied that a 2018 target for a “paperless NHS” had been missed, insisting that it was a “stepping stone” to 2020.

He said: “We are still committed to paper free services in primary, urgent, and emergency care services at the point of care by 2018. We’re focusing on 2020 because 2018’s the stepping stone along the way to 2020.”