After MPs suggested government was treating digital as a silver bullet for elective care improvements, DHSC has acknowledged that tackling waiting lists ‘requires organisational and cultural change, not just technology’
Ongoing transformation of NHS primary- and secondary-care pathways will help “reduce unnecessary referrals… and support a shift away from default in-person appointments”, government has claimed.
A report from the Public Accounts Committee published in November concluded that “we are not confident that the Department [of Health and Social Care] is being realistic about the immense effort needed to reduce NHS elective care waiting times, and see a significant risk that digital solutions are being treated as a ‘cure-all’”.
MPs asked the DHSC and NHS England to provide more detail on how work to cut waiting lists will be “practically affected” by tech upgrades, as well as requesting information on how the NHS “will solve the problem of legacy IT” – and whether this work currently has sufficient funding.
In its response, the department denied that technology is viewed as a silver bullet for addressing current challenges with elective care – which encompasses pre-planned, non-emergency treatments, including many forms of surgery, as well as the likes of scans and outpatient courses of treatment.
“The shift from analogue to digital underpins elective care transformation by enabling new models of care, operational change and improved use of data,” the DHSC said. “Achieving this requires organisational and cultural change, not just technology. Digital adoption will continue to support efficiency gains, including improved waiting list validation and reduced ‘did not attends’.”
One of the key changes supported by new technologies will be reforms of the current system through patients are referred by GPs for secondary-care treatment. Patients will be pointed towards health advice that may prevent the need for further care, while hospitals will increase their use of remote consultations, according to the DHSC.
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“Transformation of the e-Referral Service will expand Advice and Guidance and Single Point of Access models to reduce unnecessary referrals and speed up triage in support of elective care,” the department said. “It will also introduce ‘any-to-any’ referral capability across all care settings. Full connection of acute hospitals to the NHS App by April 2026 will support a shift away from default in-person appointments, enabling wider use of remote monitoring, patient-initiated follow-up and automated rescheduling.”
The government response to MPs’ report also flagged up benefits being derived from the use of technology in diagnosing patients, as well as gains from the nationwide healthcare data system based on Palantir technology.
“Digital diagnostics are increasing connectivity within and between networks, enabling shared requests, tests and results, improving productivity and supporting seamless pathways,” the DHSC said. “The Federated Data Platform is helping optimise theatre use and accelerate discharge of long-stay patients. The AI Diagnostic Fund, active in over half of trusts, is advancing AI-enabled imaging. Ambient AI will reduce administrative burden for clinicians, increasing available capacity.”
Legacy and cyber
But the response did acknowledge that “progress depends on replacing legacy systems, deploying interoperable electronic patient records [and] strengthening cybersecurity”.
To which end, the most recent batch of Digital Maturity Assessments (DMA) of NHS organisations found some progress made in the past year in fortifying the health service’s tech infrastructure, but also concluded that “the system is not where it needs to be”.
Issues identified in the DMAs will be addressed via the new Frontline Productivity Programme – which is intended to build on the work of the ongoing Frontline Digitisation Programme: a £2bn scheme created to ensure ubiquitous adoption of EPR systems across NHS trusts by March of this year.
“Through the DMA the department is assessing the status of each organisation against a standardised set of key capabilities and will be working to tackle the gaps identified through a range of programmes, to start delivery in April 2026,” the departmental response said. “This will include the Frontline Productivity programme which will focus on driving productivity gains through the effective implementation of systems as well as addressing legacy and cybersecurity remediation risks.”
It added: “However, ultimately system and provider leadership teams are responsible for ensuring they maintain a compliant and appropriately modern technology stack, in conjunction with the national team where shared services are used, To that end, the government is looking to use existing and new oversight mechanisms to ensure digital maturity is appropriately considered by provider leaderships and at key touchpoints with DHSC and NHSE and will set out further detail in forthcoming publications.”
The headline finding of the PAC report was that “NHS England’s programmes to reduce waiting times for elective care have not met their goals”. The MPs’ assessment noted that, as of July last year, 192,000 patients had been waiting more than one year for operations or other treatments, while “22% of patients on the diagnostic waiting list had been waiting for more than six weeks against a recovery target of 5% by March 2025 and an operational standard of 1%”.
