Inability to recruit key staff and untested standards undermine NHS technology push

New Nuffield Trust report warns progress in NHS digital technology will grind to a halt without people who can actually design and use it on the ground.

Press release

Published: 31/05/2019

A Nuffield Trust report today warns that a serious lack of people with the right technology skills is undermining the national drive towards digitised care, and that the limits of the NHS pay system are getting in the way of efforts to address the situation.

‘Achieving a Digital NHS’ is based on analysis of unpublished progress assessments from NHS England, and interviews or focus groups with 60 digital leaders and front-line staff across six NHS trusts. It finds that in addition to restrictive criteria for top pay grades, which require qualifications digital staff do not need, poor prospects for promotion mean the NHS struggles to compete with the private sector for staff with digital skills.

Authors Sophie Castle-Clarke and Rachel Hutchings also warn that although shared standards for software were widely recognised as necessary, those rolled out by national bodies so far have been problematic due to unrealistic timescales for implementation, inadequate testing and a lack of guidance. Many felt the headings NHS Trusts are required to use for discharge summaries were impractical and time-consuming.

Trusts were ordered to meet a set of standards by last December which had not been finalised and which general practices were not ready to link up with. Senior digital leaders quoted in the report describe this as “a solution in search of a problem” and “a completely pointless exercise”. The report calls on national bodies led by the new NHSX to do more piloting of standards and set realistic deadlines.

The report also finds that:

  • The model of funding IT through one-off injections of capital funding is “short sighted”, and permanent financing is needed if progress is to be maintained. Short term funding requires staff to be on temporary contracts, making roles unattractive.
  • Leaders warned that the Model Hospital programme risked damaging the willingness of boards to invest in technology, by putting the focus on keeping costs low.
  • Trusts were being sent conflicting demands by up to four different national bodies – NHS England, NHS Digital, NHS Improvement and the Department of Health and Social Care.

Sophie Castle-Clarke, Digital Programme lead at the Nuffield Trust, said:

“The push for digital technology in the NHS has a higher profile than ever under Matt Hancock, but progress will grind to a halt without people who can actually design and use it on the ground. Analysts in the health service should be a profession on a par with doctors and accountants. If we want to attract these staff, who the private sector is all too eager to snap up, we need to offer proper pay and a clear pathway to progression.

“While the digital leaders we spoke to were often happy with the general direction of national policy, the new NHSX needs to be better at communicating what it is doing and setting realistic timescales. Making an NHS that really uses technology to its full potential isn’t an overnight job, and we need to get the basics right before we worry about becoming world leaders.”