A lot has changed in that period. The reach and scope of our technologies is now, in many areas, starting to fulfil – even surpass – what we hoped we could achieve in 2013.
The NHS App wasn’t even a gleam in the NHS’s eye 10 years ago. Now, we have more than 26 million verified users and more than 41 million confirmed NHS login accounts, offering a single point of access to an ecosystem of digital health and care services. In 2021-22, there were more than 1.2 billion visits to the NHS website, the largest source of health information in Europe. For tens of millions of people, digital services are now the standard way to access National Health Service advice and treatment.
10 years ago, we envisaged linking up the NHS’s unrivalled datasets and building public trust in using these resources. Today, we are developing new Secure Data Environments that will provide researchers with the data they need, while increasing protection of patients’ personal information. We are committed to developing these new ways of sharing data safely.
We’ve long held the aim of supporting the life-sciences sector more effectively. This year, we helped support the fastest ever recruitment to a large-scale randomised trial, using routine NHS data to help the NHS-Galleri team recruit 140,000 volunteers between January and August from a standing start.
New data flows are transforming the quality and reach of services. During the pandemic, we were able to identify those most at risk after a COVID-19 infection on a national scale and target them with therapeutics and monitoring in their homes. Live data dashboards, offering open data to the public and secure patient-level insights for authorised health and care staff, are now a standard part of our support to the system.
The sheer scale of our operations would have been hard to anticipate a decade ago. The NHS Spine, the infrastructure that allows information to be shared securely between clinicians, handled 1.4 billion transactions a month last year, about 3 times the traffic in 2014. In 2021-22, health and care staff sent 299 million chat messages, made 31.7 million video calls and scheduled 66 million Microsoft Teams meetings.
There is still much to do.
We are still coming to terms with the enormous impact of COVID-19 on communities, families and individuals. The health and care system itself is facing unprecedented challenges in its wake – treatment backlogs, staff shortages and the realities of dealing with persistent health inequalities in an ageing population. But there is no doubt that the pandemic was a critical opportunity for digital transformation. Our health and care system responded to the biggest health crisis it has ever faced with a concentrated burst of innovation. We rapidly developed digital infrastructure, data flows, point-of-care systems, advanced data analytics and connectivity that made it possible to keep health and care services running effectively, to test and vaccinate an entire population and to develop our understanding of and, eventually, control the virus’s effects.
The pandemic pushed people online, transformed patient expectations of what was possible digitally and changed clinicians’ ways of working. We’ve seen mass adoption of digital services by the public and by the health and care workforce. It significantly advanced our agenda, but we must now deliver the functionality – the personalisation, usefulness and responsiveness – that people already expect from digital services in other areas of their lives. Frontline staff simply do not have the time to deal with systems that are not fully joined up or don’t fully meet their needs. If we are unable to justify our place on people’s smart screens or in the workflows of desperately busy health and care professionals, we will lose it.
That means a renewed commitment to putting data, digital and tech at the heart of transforming the NHS. While we have made progress in some areas, we are still working on issues we had targeted in 2013 in others. We knew 10 years ago that social and community care needed better digital technology and better integration with national services. That is still a problem. We knew in 2013 that we needed to build public trust in the use of data, and particularly the use of patients’ GP data. Our public engagement around the GP Data for Planning and Research programme continues the effort to build the understanding and trust required to use that data more effectively. We have been talking for many years about giving clinicians and carers access to secure, shared patient records. While we have made big strides (our Access Record HTML product now covers 98% of GP practices, for example) there is still much to do. We are still trying to implement functional electronic patient record systems, the basic prerequisite for a digital NHS, in some trusts.
Last year, the Wade-Gery review outlined the new operating model and cultures that will support digital transformation through the next, crucial period. By bringing NHS Digital, NHSX and NHS England and Improvement’s programmes together in the new Transformation Directorate in NHS England, we are putting digital transformation at the heart of the NHS.
We are taking digital out of its silo and ensuring that the goal of delivering a digital data and technology-driven NHS, orientated around the citizen, is central to all NHS strategy, prioritisation and resource allocation.
As the Secretary of State’s plan for digital health and social care made clear this June, that necessitates the improvement of digital skills, leadership and culture across all levels of the health and care system. At the centre, it requires agile, multidisciplinary teams focussed on patient and user needs. We must continue the sort of flexible, productive joint working between national, regional and commercial partners that was so effective in response to the pandemic. And we must work closely with integrated care systems to understand what infrastructure, standards and unified services are required to support their priorities – and what space they need to innovate themselves.
If we can get this right, we will start to see the virtuous cycles of use and continuous improvement that drive the most transformative digital change. We are already seeing this in some areas. For example, the massively increased use of the NHS login service in 2021-22 (1.1 billion logins), led to 8.5 million people updating their contact information. That feeds through to our Personal Demographics Service, ensuring professionals have better information and making digital (and non-digital) services more useful for the patient.
When we look back on 2021-22 in 10 years’ time, we may well see it as a turning point. We’ve been talking about ‘digital transformation’ in the NHS for a long time. Last year, we began to see transformative change, both in NHS structures and in the use of digital services, that, at last, seem to justify that billing.
None of this would have been possible without the expertise, dedication and teamwork of everybody at NHS Digital and in our partner organisations. We want to thank our teams not only for the achievements outlined in this annual report, but also for the significant contribution they made to this country’s response to the pandemic and for the strides we have taken in the NHS’s use of digital technology over our 10 years of existence. As we approach the merger with NHS England, we’re acutely aware that some of our staff are uncertain about how the new organisation will operate. But it is clear that data and digital technology is central to the future of the NHS and that our teams will continue to be central to delivering that future. We’re looking forward to the next 10 years.