BOTH the Tories and Labour are promising “digital” will save the NHS — but in the real world, this technophile talk sounds empty, because the government’s “big contracts” watchdog warns the NHS’s main IT programmes are in real danger of failure.

This year, Health Secretary Steve Barclay said that “supporting innovation and the adoption of the right digital health technologies” is key to NHS recovery after the pandemic.

Barclay thinks digital is the answer to doing more with less, arguing “we know” that “digitally mature NHS trusts operate with approximately 10 per cent improved efficiency.”

Rishi Sunak had even more elaborate digital dreams, saying the NHS needs to “radically innovate” to survive, promising a digital future of “robots assisting surgery” and “drones transporting prescription medicines to patients.”

For the opposition, Wes Streeting said in June: “Our health service is being held back by creaking, outdated technology. It’s time for an upgrade.”

“If the NHS fails to secure the advantage of AI and digital for its patients, the private sector will,” Streeting warned, adding that the service needed “deep and fundamental change to make the NHS fit for the future.”

But the actual record says digital is a far from easy solution. Last month the Infrastructure and Projects Authority (IPA) published its evaluations of the Department for Health’s big projects: the most troubled ones are digitisation programmes.

The IPA is a Cabinet Office watchdog, overseeing major government projects. Its annual report includes “traffic light” judgements of departmental schemes.

It marked the NHS Frontline Digitisation project “red.” That means “successful delivery of the project appears to be unachievable.”

Frontline Digitisation is a £2 billion project to “accelerate the uptake of the foundational technology that is needed to underpin digital transformation.”

One of the prominent parts of this basic architecture is electronic patient records. The IPA says that one major reason Frontline Digitisation is failing is that “a number of NHS trusts are reporting they are unlikely to be able to fully implement an electronic patient record by March 2025.”

In June Barclay told the NHS Confederation: “The reason I care about tech is simple: it improves outcomes and helps you do your jobs.”

Speaking to the NHS managers, he said: “Let me say this: when budgets are tight, tech is often the first thing to go. That is not my approach. I am protecting the tech budget — and those key investments that will help us in the long term.”

But it turns out that’s not true. The IPA report shows that the government cut £600 million from the Frontline Digitisation project. This digitisation programme budget was “being reduced to support other NHS England priorities.”

Despite promises, Barclay is taking cash out of IT to shore up a generally struggling, underfunded NHS.

This is not the only NHS digitisation programme in trouble, according to the IPA.

It also marked the GP IT Futures project as “red.” The GP IT Futures scheme is a plan to increase the market in software doctors can use for patient records, appointments and the like.

But the IPA says it is “unachievable.” After three years of funding, there no major significant suppliers of GP tech have entered the market.

Other NHS IT schemes are also in trouble. The IPA mark the Digitising Social Care plan as “amber.”

This is better than “red,” but is still worrying. It means “successful delivery appears feasible but significant issues already exist, requiring management attention.”

Digitising Social Care is a plan for all social care recipients and providers to have electronic records, parallel to the NHS. The current target is for 80 per cent of both providers and recipients to have an electronic record.

In 2021, 40 per cent of providers have such a record, but after another two years, this has only risen to the imprecise figure of “more than 50 per cent” having digital records. Progress is too slow. The government do not expect the scheme to be completed until 2031, at a cost of around £2.7bn, although care providers will have to bear most of the cost.

The Electronic Staff Record plan to have a new unified digital record for all NHS staff to replace the existing, Oracle-based record is also judged by the IPA to be flashing at “amber.”

The Department of Health wants to replace the existing system by 2028: that system will actually expire in 2033. But already there is “slippage in the programme schedule.”

There are some fundamental reasons for these IT problems. The government sees them as a sort of magic bullet that will fix the NHS, when in fact, careful nurturing of existing staff and recruitment of new health workers is much more important.

It also sees IT as a way to “save money” rather than improve efficiency. With just “saving money” in mind, the government is not clear enough about the need to invest in IT before it can expect any efficiency gains — a lot of money and time has to be spent on digital solutions before they will properly work, but the government slashed the budget on one of the key schemes.

The government also doesn’t see that IT means the NHS has to have its own capacity in well-trained, loyal and efficient IT engineers and management.

Trying to buy a packet “off the shelf” or from external contractors won’t work.

Streeting’s case that the Tories are mismanaging NHS IT is correct. But that doesn’t mean Labour will necessarily do better.

Streeting has the same politics of the last New Labour government, which had the worst possible record on NHS digitisation: Labour’s plan for electronic patient records and digitised NHS communication, Connecting for Health, was a hugely expensive failure.

Tony Blair’s government handed big, unwieldy, top-down contracts to external firms without properly supporting the NHS’s own IT staffing, skills and capacity, and the result was a massive rip-off. This reflected their general faith in private contracts over public-sector investment — a faith Streeting also seems to hold.

Follow Solomon Hughes on Twitter at @SolHughesWriter.