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Part of NHS Digital annual report and accounts 2018 to 2019

Chief Executive's introduction

Current Chapter

Current chapter – Chief Executive's introduction


It is a privilege to serve the NHS at this unique moment in history, when advances in biology and technology are aligning to create phenomenal new opportunities to deliver transformational products and services. We are inspired and energised by the impact that we know these will have on patients, clinicians and medical research, as well as our many other stakeholder communities across the health and care system, in industry and in the third sector.


Image of Sarah Wilkinson, Chief Executive

This has been an extremely rewarding and an extremely demanding year. Through the intense hard work and commitment of staff across our organisation, and the continuing delivery of world class products and services, we have strengthened our reputation and extended our impact across the system.


We run more than 80 core national systems, and we continue to operate these at extraordinarily high levels of availability and performance. Our most critical services ran at an average of 99.95% availability over the year. Given the scale of the NHS, it is no surprise that we manage more traffic than some of the major national credit card systems and we operate, as far as we can ascertain, one of the largest email systems in Europe.

We are also incredibly excited about the new products and services that we have delivered and the impact that they have had. More than 200,000 people have downloaded the NHS App since it went live on New Year’s Eve, 45,000 of whom have proven their identity and obtained an NHS login that they will be able to use to access multiple services in future.

Our NHS 111 online service has now been used more than 1 million times and the NHS e-Referrals Service currently handles over 70,000 referrals every working day, up from 40,000 at the start  of  2018. Our Electronic Prescription Service  handled  more  than 690 million  prescription  items in 2018-19 and, from February, we included schedule 2 and 3 controlled drugs in the system.

We delivered new services for our colleagues working in medical research, in particular in support of large-scale clinical trials. We commenced a new partnership with Great Ormond Street Hospital focused on addressing long-standing digitisation gaps through smart use of data analytics and commodity technology. We worked with GPs and colleagues in NHS England to reshape the market in primary care IT services.

In addition to the publication of many large-scale open data sets, we disseminated data to over 450 customers in support of more than 1,100 projects across the NHS, academia, industry and the third sector, having reviewed each request in detail to ensure legality, appropriateness, and the compliance of planned handling and management approaches with information governance laws, policies and standards.

We have produced more, and more sophisticated, official statistical series. We have delivered new APIs, worked with international partners to  extend  open data standard  definitions, and provided ever-stronger cyber security services, guidance and support, extending live monitoring to more than 840,000 devices.

These achievements are exciting because of the incredible impact that we know they have on the lives of patients and clinicians, but they also provide clear evidence of our increasing capabilities as an organisation and therefore our ability to have even greater impact in future.


We have also  completed  the first wave of our organisational transformation program this year. This has been challenging, particularly because it came on top of a very packed delivery agenda. It was clear that we needed to shift the expertise within our organisation towards the new digital, data and technology skills required  to serve an NHS that is increasingly ambitious about the power of technology and increasingly dependent on it to generate critically-needed efficiencies.

Sadly, this has meant that we have said goodbye to many dedicated, committed and long-serving colleagues. Staff across our organisation have handled this challenge with remarkable fortitude and professionalism. We will continue this journey over the coming year.

As we look to the future, it’s clear that much of our focus must be on leveraging the power of the extraordinary data within this system.


Each patient must have digital access to all aspects of their medical record. Clinicians must have immediate access to data from all care settings. Our world-leading medical research communities must have access to the internationally-unique richness of NHS data, which has the power to yield new insights into disease, support the development of new drugs, and, ultimately, transform and save lives.

Virtually every industrial sector is currently  working to build new understanding and vision through increasingly sophisticated approaches to analysing and understanding data. The organisations who run the NHS nationally and regionally, the Life Sciences sector, our academic medical research communities and health-focused charities are increasingly dependent on the insights available from clinical data to support the development of new products and services. The NHS in England, with its 70-year history and responsibility for 55 million lives within a single system, is an internationally unique source of knowledge.

At the same time, we are acutely aware of the criticality of enabling patients to control who can access their data and for which purposes. Many citizens consent to their data being used to enrich knowledge and understanding on the basis of trust in our diligent and robust custodianship of that data.

This responsibility sits heavy on our shoulders. We understand the responsibilities of being asked to act as key data custodians for the system, and the criticality of not breaching that trust in any way.

Progress in this complex, multi- stakeholder system depends on partnership and collaboration. Throughout the course of the year, we have worked to strengthen our existing alliances and build new ones.


We entered into an ambitious bi-lateral partnership with Health Data Research UK (HDR UK) and joined their multi-party Health Data Research Alliance this year. We are working closely with them across a number of endeavours aimed at expanding the quality, richness, coverage and impact of health data.

We are strengthening our ties with Genomics England and working together to deepen the incredible insights available from genomic data, particularly when combined with other phenomic data, at individual and population level.

We are working to deliver more sophisticated standards, platforms and services to Chief Clinical Information Officers (CCIOs) and Chief Information Officers (CIOs) across the NHS. It is our goal to serve and support them and thus enable them to deliver world-class technology for their communities, locally and regionally.

We will continue to focus on delivering excellence in technical design, engineering and the operation of live services through skill, passion, commitment and hard work, inspired by the opportunity to improve the lives of patients and clinicians.


Sarah Wilkinson

Chief Executive

NHS Digital

Last edited: 29 November 2019 11:54 am