This report is informed by a recent survey and series of insights calls, which combined represent over 140 unique NHS trusts. The findings inform NHS Providers' ongoing activity on behalf of members, including our Digital Boards development programme.

  • Trust leaders are operating in an exceptionally challenging environment as they work to progress digital transformation within their organisations and systems. Despite the challenges, trusts are making steady progress across key areas, with most progress reported across: frontline digitisation – particularly electronic patient record system (EPR) implementation and improvements; cyber security assurance; and improvements to IT infrastructure, data and intelligence functions.
  • Digital transformation is no longer solely the responsibility of the trust digital lead; instead, it is increasingly seen as a shared priority for the whole board. 75% of respondents agree that their board is engaged and actively promoting the digital agenda.
  • However, progress and board engagement with the digital agenda is not consistent across trust type, with respondents bringing attention to lower board engagement from mental health/ learning disability trusts, and the additional barriers facing these trusts around funding constraints, a more challenging EPR landscape and difficulties procuring technology that meets complex patient needs, including privacy and security concerns.
  • Only 54% of trust leaders said they were very confident (22%) or confident (32%) their trust will meet the minimum digital standards by 2025, including the need for all providers to implement an EPR.
  • Trust leaders have responded positively to the clear ambition set out in NHS England's (NHSE) What good looks like (WGLL) framework, with 24% reporting that WGLL is fully embedded in their digital work and/or strategy. Progress on WGLL is aided by central support to advance national priorities like frontline digitisation. This compares to much lower reported adoption of other NHSE digital policy and guidance documents.
  • Key barriers to advancing faster and further remain. The top three barriers for progressing digital were:

    - funding and financial constraints (73%),
    - operational pressures impacting clinical engagement training and adoption of technology (50%),
    - and inadequate infrastructure (poor wi-fi, computers, multiple log ins) (38%).

  • While the provider sector has made great strides in recent years, additional support is needed to achieve the shared ambitions for digital transformation. This includes increased investment, a change in the funding model and mechanisms for digital to enable sustainable, strategic investment and central support on supplier relationships.

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