A new index will rate NHS providers’ technological capabilities and eventually be part of the statutory regulatory regime, an NHS England director has told HSJ.

  • NHS England begins gathering baseline data for a digital maturity index to rank providers’ technological capabilities
  • The index will eventually become part of the statutory regulatory regime
  • NHS England said its existing index is too supplier focused and does not provide enough information on meaningful use or interoperability

A first iteration of the digital maturity index is scheduled to be published later this financial year, NHS England director of digital technology Beverley Bryant told HSJ ahead of unveiling the plans at the EHI Live conference tomorrow.

It will be based on information collated by NHS England, which is sending questionnaires to NHS organisations this month to gather baseline data about their existing digital capabilities.

Beverley Bryant

Beverley Bryant said the new index should not be seen as a ‘punishment’

The move follows NHS organisations, led by clinical commissioning groups, being told to form clusters across local health economies to draw up “digital roadmaps” outlining how they plan to achieve a paperless at the point of care NHS system by 2020.

CCGs were due to inform NHS England which organisations were in their clusters by the end of October. Organisations will receive their self-assessment questionnaires once NHS England has been told which cluster they are in. Areas are then due to publish their roadmaps, which will be “refreshed annually”, by April, according to National Information Board guidance.

The move comes two years after the national commissioning body launched the clinical digital maturity index, in partnership with private provider Digital Health Intelligence.

But NHS England has decided the CDMI does not give a full enough view of how well organisations are using technology or how well they join up with others.  

Ms Bryant told HSJ it was not good enough for NHS organisations to simply have digital solutions, such as e-prescribing software. They had to demonstrate meaningful use.

The new index will also place significant emphasis on interoperability, which existing indexes were unable to fully address, Ms Bryant said.

Ahead of unveiling the plans at a health technology conference in Birmingham, she said: “We have worked with [Digital Health Intelligence on the CDMI] for the last few years but it’s very much an assessment of software bought rather than usage.

“You can be quite high up on the CDMI and only actually be using the software in a couple of specialties. What we are interested in is full use.

“The other model in place is the HIMSS [electronic medical record adoption] model, which is a good tool…but it does not deal with interoperability across care settings.  Our ability to measure progress [on interoperability] is really important.”  

She said the new index would first be used to benchmark how far the NHS has got on its “journey to a paperless system by 2020”, then to make case for funding (see box below) and eventually for the Care Quality Commission to use in inspections.

Ms Bryant said: “Ultimately we will have an assessment linked to CQC quality inspections, but we are not there yet.”

She said NHS England needed to strike a balance between developing an index that stood up to “robust audit” and not putting too much of a “bureaucratic burden” on providers. 

NHS England has been working with Leeds University, academic health science partnership UCLPartners, and 35 other organisations to develop the new index. Eight trusts have been piloting it including Humber, Salford Royal; and University Hospital Southampton foundation trusts.

Tech funding plea forms key plank of NHS’s spending review bid

Funding for technology projects is at the heart of NHS England’s submission to the Treasury’s spending review.

NHS England executives view frontloaded investment in technology over this parliament as vital to delivering on the £22bn of efficiencies which underpin delivery of the Five Year Forward View as well as plans for a paperless NHS by 2020.  

Ms Bryant said she could not comment on the details of NHS England’s bid to the spending review, the results of which will be announced by the chancellor on 25 November. But she outlined the basis on which it was making its case for more technology investment.

She said: “We have made an estimate…based on a mixture of CDMI and the HIMSS electronic medical record adoption model scores [across NHS organisations] and international comparisons and we think the NHS is roughly 45 per cent through the job [of becoming paperless].

“But that is not an evidence base that is solid. [The new index] will help us quantify and benchmark where we are.

“We need to make sure that people do not see this as a punishment and their assessment has to be really good. They need to be honest, then we can understand and quantify the size of the job.”

Securing funding for technology projects has been a significant problem for NHS England. Last year it was only able to allocate £43m of the original £240m from the integrated digital care fund after it was raided by the Department of Health to bolster a winter pressures fund. This followed money being held back from the nursing technology fund.

Digital Health Intelligence director Karl Grundy told HSJ: “Our focus is on the continued development of CDMI as the authoritative measures of NHS digitisation. The CDMI benchmarks are the most complete and detailed measures of the IT systems in use across the NHS, combined with the most accurate market data.

“CDMI details exactly what systems are installed in use in what NHS organisations, when they were bought, who supplied them. It provides census level data on all trusts rather than a sample.  All data is verified on a rolling basis.”

The CDMI will remain free to access for NHS organisations.

NHS England to rate providers on tech with new index