A report published alongside Jeremy Hunt’s announcement that the NHS should be paperless by 2018 has underlined the difficulties the NHS faces in hitting the target in just five years.

Announcing his desire for a paperless NHS by 2018, the health secretary highlighted a government commissioned report which calculated improved use of IT could deliver £4.4bn of savings annually.

But ministers did not mention that the report, by accountancy firm PwC, estimated it could take a decade to fully realise these savings.

The report, A review of the potential benefits from the better use of information and technology in Health and Social Care, found that the majority of the “priority actions” which needed to be taken to deliver the commitment “were of low to medium cost to implement, and were possible to implement in a 3-5 year period”.

However, it said: “Some of the priority actions and further actions would take 5-10 years or more to deliver the full set of identified benefits.”

The report warned achieving the savings would depend on a raft of conditions being met and would require “concerted action and commitment of bodies from across the health and social care system”.

Ministers would also need to ensure the availability of “funds to cover one-off investment costs in technologies, information gathering or reworked organisational processes”.

Mr Hunt, speaking following the launch of his plans yesterday, openly admitted the target would be extremely difficult for the NHS to achieve, comparing the reaction of his civil servants to that of the infamous fictional mandarin, Sir Humphrey Appleby from Yes Minister.  

He told a Policy Exchange event: “There have probably been two moments [in my ministerial career] where, in Yes Minister terms, my civil servants have thought that in a Sir Humphrey-like way that what I’m about to say is ‘brave’.

“I think today is perhaps the second of those brave moments.”

Other members of the audience at the event, including IT industry experts and leading health figures, also warned Mr Hunt’s ambition would be very hard to deliver.

Meanwhile, Mr Hunt also further outlined how he envisaged a fully digitalised patient record system would work.

Digital patient records will not be held in a centralised data base but “probably housed” in GP surgeries, he said, adding that a central system would not be used, “partly because of the security risk”.

He said: “I want to recognise the validity of Labour’s ambition in what they were doing [with the National Programme of IT]. But one of the things that was wrong about it was the central data base, partly because of the risks to security.

“The home, although nowhere is really home in the technology world, for these records will probably reside in GP surgeries.”

He explained that the GP system would be “the heart of where the technology system will work…where you will give your permissions”. This was because the GP surgery “is the place through which most people access the NHS”.

After GPs have implemented the systems, the next step will be to allow patients and clinicians access to anything that has happened to the patient in secondary of tertiary services throughout the NHS via the GP record, he explained.