Workforce is barrier to frontline digitisation, says NHS Confed report

Workforce and training are “significant barriers” to delivering a quality frontline digitised service, according to a report from the NHS Confederation.

Researchers captured the view of integrated care system (ICS) leaders through a survey, round table event and interviews, carried out between March 2024 and August 2024.

The resulting report ‘Frontline digitisation: creating the conditions for a digital NHS’, published on 6 August 2024, says that healthcare leaders believe that digital ambitions will not be realised unless the workforce is effectively supported.

NHS England’s frontline digitisation programme was introduced in 2021 to support the transition from paper-based to digital systems for patient information, clinical notes and access to data.

Although the NHS Confederation found that many ICSs have begun to see benefits of digitisation –  such as freeing up staff time, encouraging collaborative working, and promoting interoperability – it noted that there are also “complex challenges”.

The report identifies a tension caused by “striving to meet national goals while operating and delivering care in a system that is not fully capable of harnessing digital innovation”.

It also says that organisational readiness for electronic patient record (EPR) system convergence is not consistent throughout providers.

One of the most significant barriers to healthcare organisations achieving their frontline digital priorities is funding, the report says.

It adds that some organisations saw “significant disparities in funding across acute, community, and mental health providers, potentially providing a limitation to consistent patient outcomes”.

Bureaucracy is identified as another barrier to systems implementing frontline digital services at pace, with issues caused by short-term pots of funding and the cost of procurement.

Healthcare leaders called for fewer core targets, with ICSs given the autonomy to choose how to deliver them, more flexibility to meet the demands and needs of their local population, more capital funding for digital infrastructure and longer-term and multi-year funding cycles.

Rezina Hakim, senior policy adviser at the NHS Confederation told Digital Health News that the frontline digitisation programme is a “welcome and much needed initiative”.

However, she added that the NHS is “operating in a very financially challenging environment where innovation and transformation can be difficult to achieve”.

“While the frontline digital systems like EPRs promise to replace legacy systems and improve patient outcomes, many healthcare leaders are still having to struggle with issues such as outdated infrastructure, organisational readiness and engaging and training the appropriate workforce,” Hakim said.

Responding to the report, a spokesperson for the Department of Health and Social Care said: “Harnessing the latest technology will be crucial, and we will introduce an extra 40,000 appointments a week and double the number of CT and MRI scanners over the course of this Parliament”.

They added that the government’s ‘Fit For The Future Fund’ will “take the NHS out of the analogue and into the digital age and arm it with the cutting-edge kit it needs to cut waiting lists and get patients treated on time again”.

The NHS Confederation carried out a survey from January to March 2024, receiving 43 responses from leaders across integrated care boards (ICBs), acute, mental health and community providers.

It also held a round table event in February 2024 attended by 11 leaders across trusts and ICBs, and held seven interviews with healthcare leaders from ICBs, trusts and community providers.