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NHS Digital merges with NHS England – what does this mean for the health service’s IT?

For the NHS Digital merger to work successfully, wider change in the NHS approach to technology will be required, experts say.

By Sophia Waterfield

NHS Digital has now merged with NHS England, with the latter taking responsibility for all its activities including running national IT systems that support health and social care. But the ‘jury is out’ on whether this is the right move to secure the future of the National Health Service’s digital transformation, experts told Tech Monitor.

The merger was officially completed yesterday, and NHS England announced that Health Education England would also be merged from April. This means that the central NHS body will also be accountable for its healthcare workforce having the right skills.

NHS Digital's NHS app, asking "How are you feeling today?"
NHS Digital, which was originally formed in 2005, is closing its doors. (Photo by Thomas Holt/Shutterstock)

The merger follows the recommendation of Laura Wade-Gery’s review, ‘Putting data, digital and tech at the heart of transforming the NHS‘. In the paper, Wade-Gery said that NHS England needed to create a new “transformation directorate at the heart of the NHS to drive transformation“. NHS Digital would be embedded into the new directorate as the NHS tech function.

NHS England says that bringing NHS Digital into the central team will mean supporting integrated care systems to work in more “efficient ways”. It also claims the move will improve diagnosis and treatment for patients as well as help the NHS to understand and improve its services.

“This merger will reduce duplication, bringing the NHS’ people, skills, digital, data and technology expertise together into one organisation,” an NHS England statement says. “This will help us to collaborate more effectively and allow local organisations to benefit from a wide range of specialist support and expertise.”

All current contracts with NHS Digital will automatically transfer to NHS England under UK regulation.

NHS Digital merger could mean ‘isolated systems and legacy approaches

Originally formed in 2005, NHS Digital set the digital healthcare strategy to join up the national health service’s fragmented operating model.

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It ran systems including Spine for the NHS, which kept patient data in England secure, and was also responsible for the Electronic Prescription Service, the Summary Care Record, e-referral service, and the Child Protection Information Sharing System. It also created the NHS App and was heavily involved in the creation of the NHS Covid-19 app.

Jaco Vermeulen, CTO at BML Digital and consultant CIO across the NHS and private healthcare services, told Tech Monitor that the journey for digital healthcare under NHS England could change rapidly: “Digital healthcare will be bundled into general administration,” he explains.

“Unfortunately, within NHS England they severely lack the structure, skilled resources and model to likely create an effective joined digital healthcare operations and technology strategy, and then subsequently execute technology, modernisation and innovation in the right way.”

While the Digital arm of the NHS was successful in some ways, Vermeulen says that it was still constrained by the NHS as a whole.

“NHS England needs to define a unified digital healthcare operating model and structure that has modern, standardised and integrated technology embedded as a key enabler, along with the right technology leadership and expertise,” he warns.

NHS structural shift must be echoed in clinical practice

But others believe the merger could be beneficial, particularly for joined-up and remote care delivery.

NHS surgeon and founder of health tech start-up Cinapsis, Dr Owain Rhys Hughes, argues changes also need to happen in clinical practice to really benefit patients: “Bringing together data and technology is key to driving this transformation in a sustained and collaborative way, and one which generates the best outcomes for patients,” he says. “However, to be truly successful we must ensure this structural shift is effectively echoed in day-to-day clinical practice.”

Rhys Hughes told Tech Monitor that clinicians needed to be supported to adopt new technologies and work collaboratively, so the existing silos could be eliminated: “This organisational merger could mark a positive step-change in how we deliver care – but we must ensure its central promise of collaboration is one that can be delivered system-wide.”

Dr Melinda Rees, consultant clinical psychologist and chief commercial officer at mental health support platform Psyomics concurs: “More than ever, front-line clinical staff need support from the centre to deliver optimal and timely care – my hope is that the patient remains front and centre of the merger time frame and strategy,” she says.

Digital skillsets could be lost in NHS redundancies

As with any merger, there are concerns that skilled workers could be lost. NHS Digital employed around 6,000 members of staff, which included large numbers of contractors, reports Digital Healthcare News. However, NHS England is expecting to reduce its headcount by 40%, with the outlet reporting voluntary redundancies are underway and that interim CEO Simon Bolton has left.

This is a concern when digital skills are already limited across the health service, says Iain O’Neil, managing partner for healthcare at digital transformation consultancy TPXimpact: “There is a real need to continue to grow the in-house capabilities of the NHS when it comes to technology and data,” he says.

However, Pete Wilson, CTO of public sector EMEA at software vendor Pegasystems, believes that digital tools, while not the solution to NHS redundancies, could help NHS teams to develop their own automated processes to cover obstacles: “Artificial Intelligence and low code are not panaceas when the service needs more doctors and nurses, but they can make a valuable contribution and their adoption would enable the new organisation to deliver early success,” he adds.

Read more: NHS Digital launches £9.5m innovation framework for GPs and commissioning groups

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