Chapter 5: Digitally-enabled care will go mainstream across the NHS

5.1. Virtually every aspect of modern life has been, and will continue to be, radically reshaped by innovation and technology – and healthcare is no exception. Sustained advances in computing and the democratisation of information are driving choice and control throughout our daily lives, giving us heightened expectations around digital services. Technology is continually opening up new possibilities for prevention, care and treatment. Premature babies, who would have died ten years ago, live long and healthy lives; people who would have been house-bound in pain now walk thanks to new drugs; and genomic testing is increasingly available to help diagnosis and treatment. The NHS is a hotbed of innovation and technological revolution in clinical practice.

5.2. This country has a rich heritage of pioneering research and invention in healthcare. Around 25% of the world’s top 100 prescription medicines were discovered and developed here. As a priority launch market for new cancer drugs, the UK is one of only three countries (with Germany and the USA) to have access to more than 40 of the 55 oncology medicines initially launched between 2012 and 2016 [177].

5.3. Good progress has been made in achieving the ambitions set out in the Five Year Forward View and the Wachter report, with many new or enhanced digital and technology systems and services delivered over the last three years. Citizens have access to high quality NHS information and digital services through the transformed website. Citizens and health professionals can access over 70 apps that have been assessed and approved via the NHS Apps Library. WiFi is being installed across the NHS estate. The national roll-out of the NHS App has begun, and will provide citizens with access to NHS 111 online, their GP record, the ability to book appointments, update data sharing preferences and register for organ donation, all from their computer or smart phone.

5.4. The Electronic Prescription Service (EPS) is now used in 93% of England’s 7,300 GP practices, with more than 67% of their prescriptions delivered via EPS. This has improved patient experience and saved the NHS £136 million in the three years from 2013 to 2016. People can book hospital appointments online via the NHS e-Referral Service, which now covers every hospital and every GP practice, creating expected savings for the NHS in excess of £50 million a year.

5.5. The Global Digital Exemplar (GDE) programme has supported 16 acute, seven mental health and three ambulance trusts to lead the national drive to make our hospitals the most IT-advanced in the world. Seventeen, soon to rise to 24, trusts have been designated ‘Fast Followers’ to work with and learn from the GDEs so these advances can be spread through the NHS. The Local Health and Care Record (LHCR) programme has started the work to create integrated care records across GPs, hospitals, community services and social care. Digital innovation hubs are set to provide a world class environment for clinical research, reinforcing England’s position at the forefront of life sciences invention and innovation.

5.6. However, we have not yet enabled the wholesale transformation of the NHS that patients have a right to expect. As set out in Chapter One, the way we deliver care remains locked into the service model largely created when the NHS was founded in 1948. Technology will play a central role in realising the Long Term Plan, helping clinicians use the full range of their skills, reducing bureaucracy, stimulating research and enabling service transformation. People will have more control over the care they receive and more support to manage their health, to keep themselves well and better manage their conditions, while assisting carers in their vital work.

5.7. The NHS is made up of hundreds of separate but linked organisations, and the burden of managing complex interactions and data flows between trusts, systems and individuals too often falls on patients and Digital services and data interoperability give us the opportunity to free up time and resources to focus on clinical care and staying healthy.

5.8. In ten years’ time, we expect the existing model of care to look markedly different. The NHS will offer a ‘digital first’ option for most, allowing for longer and richer face-to-face consultations with clinicians where patients want or need it. Primary care and outpatient services will have changed to a model of tiered escalation depending on need. Senior clinicians will be supported by digital tools, freeing trainees’ time to learn. When ill, people will be increasingly cared for in their own home, with the option for their physiology to be effortlessly monitored by wearable devices. People will be helped to stay well, to recognise important symptoms early, and to manage their own health, guided by digital tools.

Practical priorities will drive NHS digital transformation

  • Create straightforward digital access to NHS services, and help patients and their carers manage their health.
  • Ensure that clinicians can access and interact with patient records and care plans wherever they are.
  • Use decision support and artificial intelligence (AI) to help clinicians in applying best practice, eliminate unwarranted variation across the whole pathway of care, and support patients in managing their health and condition.
  • Use predictive techniques to support local health systems to plan care for populations.
  • Use intuitive tools to capture data as a by-product of care in ways that empower clinicians and reduce the administrative burden.
  • Protect patients’ privacy and give them control over their medical record.
  • Link clinical, genomic and other data to support the development of new treatments to improve the NHS, making data captured for care available for clinical research, and publish, as open data, aggregate metrics about NHS performance and services.
  • Ensure NHS systems and NHS data are secure through implementation of security, monitoring systems and staff education.
  • Mandate and rigorously enforce technology standards (as described in The Future of Healthcare) to ensure data is interoperable and accesible.
  • Encourage a world leading health IT industry in England with a supportive environment for software developers and innovators.


177. IQVIA. (2018) Global Oncology Trends 2018 – IQVIA. Innovation, Expansion and Disruption. Available from: