• NHSX plans to upgrade “hopelessly old laptops and clunky hardware”
  • Says quarter of trusts “still have no electronic patient record”
  • Wants “much lower spend threshold for central approval”

NHSX has proposed a new set of priorities for improving technology, to do something about “hopelessly old laptops and clunky hardware”, and to enforce standards via tighter spending controls.

The agency this afternoon published its “tech plan” for consultation, setting out five priorities, described as missions, and several “enablers” (see attachment).

The enablers include trying to achieve “decent hardware”, on which the proposals said: ”Much of the frustration currently felt by staff is the result of hopelessly old laptops and clunky hardware.”

It also proposed to implement 5G mobile networks across the NHS, and create a new electronic prescription service to cover all care settings and medicine types.

The plan, which will be finalised in the summer after consultation, formalises several aspirations which have been put forward for or by NHSX over the past months.

New spend controls to enforce standards

NHSX will set out to make systems work well together by setting “clear, open standards” so “everything will slot together and systems will be able to communicate”.

But it said these will need tougher enforcement than in the past — and it will do this by requiring more spending decisions to have national sign off.

Enforcing standards “has proved difficult to do in the past,” it said. “The centre has, for example, repeatedly mandated the use of the NHS number as the unique identifier of patients, without success.

“So we will establish a new system of spend controls to ensure that tech is compliant. This will involve a much lower spend threshold for central approval, the deal being that the process will be quicker and smarter than it is at present.”

It also proposed: “So that information can be shared between social care and health systems we will do two things: set a core record standard for social care so that there is consistent information recorded for all people in social care, and — where possible — set the same open standards in social care as those used in health.”


It said spreading existing IT is the main priority, and that the vision of a tech-driven NHS is “impossibly distant” for many staff and patients.

There is plenty of research and innovation happening “but scaling is too difficult” and the system needs to “do a much better job of sharing best practice”, it added.

The document stated: “There is a huge number of exciting and increasingly proven digital products being developed, inside the NHS, outside and in the social care system. The barriers to adoption and scale are too high.”

It added: “A small number of providers have reached high levels of digital maturity. A quarter still have no electronic patient record. In social care a third of organisations are still largely paper-based.

“Some parts of the system ensure that their hardware and networks are up to date and functioning; others wait for the centre to pay for this for them. Most are somewhere between the two.”


On funding, the document acknowledged the NHS needs “clarity about who is responsible for paying for what”, and added: “Providers need to know their obligations, and where they can expect help from the centre. We will set this out as one of the elements of the Tech Plan.”

It said: “We recognise that many providers will struggle to generate the scale of funding required to digitise themselves. The digital aspirant programme will be the next chapter in how the centre helps them over this step.”

NHSX said the “vision” document is part of the first of five phases of consultation, which at a later stage will include a delivery plan for 2020 to 2024.

The document said: “The future of the NHS and social care depends on getting technology right. The only way the NHS can stay true to its founding principles in a world of rising demand, rising costs and expectations is to use technology to transform itself.

“If we can get this right, there is huge potential to improve outcomes, the experience of patients, people in care, and staff, and productivity”.

Other ambitions in the plan include:

  • Identify and support successful innovative technology in health and social care;
  • Funding for the digitisation of providers will be targeted through new digital aspirant programme;
  • Supporting development of locally led shared care records and plans across the health system;
  • Ensuring data can be accessed in an ethical, safe, secure and trusted way for research;
  • Develop solutions of communication of test results to patients;
  • Develop a process to act on issues reported from the patient safety incident management system;
  • Support digital tools and services to reduce the need for face-to-face outpatient appointments; and
  • Establish a new team to scale innovations in health and social care.