Fit for the future: What can the NHS learn about digital health care from other European countries?

The rapid increase in the use of technology during the Covid-19 pandemic shows that digital health technology will be a fundamental part of health system recovery and for preparing for the future. In this report, we examine the approach that five European countries have taken to implementing digital technology and draw out learnings for the NHS.

Given the rapid rise in the use of technology during the Covid-19 pandemic, digital health has gained renewed emphasis and urgency after years of slow progress. Across the world, digital technology and data are considered essential for creating sustainable health care systems and improving the health and wellbeing of the population. It is already clear that technology will play a key part in recovery from the pandemic, and in preparing health care systems for the future, however, understanding the factors that lead to success is important.

Building on earlier research into the use of digital technology in England’s acute sector, this report examines the approach that five European countries have taken: Denmark, Finland, Sweden, Estonia and Portugal. Although solutions cannot be simply transposed from one health system to another, all five countries have successful experience that may offer useful learning for the NHS.

We find that those countries which have made significant progress, benefit from having an overarching policy focus on digital. Digital health is inseparable from the wider approach to digital in both public policy and society, with a clear link between digital health and wider societal and health care goals, wellbeing and prosperity. Country context and culture are especially important. We saw that in countries where digital technology is widely used to access public services, the use of digital technologies to support health care is less controversial, and is widely expected and accepted. Cultivating public confidence and trust in the use of health care data must be a priority.

Governance and leadership are also key. Many of the countries we studied have devolved regional responsibility for health, but clear governance of where data are held, how they can be accessed and by whom, is essential. It is important to establish clear and consistent national leadership, and to be clear about the roles and responsibilities of different stakeholders. It is essential to ensure that digital health care solutions are co-designed and implemented collaboratively with end users. This should include a focus on understanding the factors that support people (including both staff and patients) to use technology, recognising the importance of cultural and organisational change.

As with the NHS, the Covid-19 pandemic has had a significant impact on the use of digital technology in multiple countries. The existence of a digital health infrastructure has assisted countries’ responses to the pandemic by providing, for example, a platform for accessing test results. Respondents reported that the pandemic had helped to highlight the benefits to patients and health care professionals. Helping to maintain this shift into the long term is a significant goal to aim for.

Suggested citation

Hutchings R, Scobie S and Edwards N (2021) Fit for the future: International learning on digital health care Research report, Nuffield Trust