The Department of Health was advised to merge NHS Choices, NHS Direct and HealthSpace into a single agency a year ago by research it commissioned itself then did not publish.

The review of digital public engagement said NHS Direct and NHS Choices were viewed by the local NHS as not being “set up” to support it, and as expensive.

It recommended a single national agency to run one “national multichannel ‘front door’ to the NHS”. This could incorporate NHS Direct, NHS Choices and HealthSpace - which gives patients web access to their health records - and the choose and book appointments booking system.

Outgoing Dr Foster Intelligence executive chair Tim Kelsey and health policy consultant Hilary Rowell were commissioned to interview senior NHS staff, policy makers and ministers. Their report, Information, Insight and Interaction, is dated March 2009 but was not published, and has been released to HSJ under a freedom of information request.

It says there has to be “a re-invention of the relationships between the local NHS and the communities, partner organisations and individuals it serves”.

It says: “The impact of the quality agenda will not be sustained unless the people who use and pay for the NHS are also enabled to exert their power to take control of their own health and care and to drive service transformation.”

The report adds that digital services should be developed by primary care trusts, but information should also be made available through a national “front door”. PCTs also need support from a single digital agency.

Speaking this week Mr Kelsey said the financial challenge made engaging the public in digital information more urgent, as it would support quality and efficiency improvement.

He added: “The centre needs to help local NHS organisations understand the benefits of this in a way few of them do.”

The NHS Choices and NHS Direct websites have been further integrated in the past year but their roles have been developed as separately run “front doors”.

A DH spokesperson said: “The report recognises the success of both NHS Direct and Choices and it makes clear that integrated national digital services are essential to the long term future of the NHS.”

DH ignores own advice on digital engagement