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Gauging where we are with a paper-free NHS – Paul Rice

As NHS England today launches the results of the digital maturity self-assessment for secondary care providers, the Head of Technology Strategy in the Digital Technology team explains the opportunities and challenges ahead:

There is a well-worn joke about a tourist in Ireland asking a local for directions who is rather puzzled by the response: “Well sir, if I was you, I wouldn’t start from here.”

As an Irishman, I am confident that I can repeat that joke with impunity, but what relevance you might ask does this tale have to the scale of digitisation, and the use of information technology in the NHS?

It is not black humour. It is not a reflection on the mixed fortunes of the National Programme for Information Technology. Rather, it’s a plug for the first comprehensive national self-assessment of the digital maturity of NHS Providers, summary detail of which is published today on MyNHS.

The benefits to the NHS of effectively exploiting information technology, insight and intelligence are myriad and clear. Better use of data and digital technology has the power to support people to live healthier lives and use care services less. It is capable of transforming the cost and quality of services when they are needed. It can unlock insights for population health management at scale and support the development of future medicines and treatment.

What has not been comprehensively available until now is a measure of the NHS by NHS providers at their current level of digitisation.

More importantly, what the results of the Digital Maturity Assessment will reflect is that, while it’s necessary to have all the technology and “kit” available, it is far from sufficient to ensure benefits are being optimised. As the recent Nuffield Trust report “Delivering the Benefits of Digital Healthcare” recognised, “information systems are one part of a much wider set of instruments for creating change.”

How ready an organisation is to challenge existing workflows and practices, through the use of digital technology led by clinicians and informed by the needs and expectations of service users, is vital to reimagining potential destinations.

The work was developed collaboratively between NHS England, UCL Partners and the NHS. As local organisations pull together to develop their digital roadmaps, their plan from getting from A to a paper free future, this Digital Maturity result provides a robust and candid reflection of the scale of the challenge. It allows the key strengths and gaps in providers’ ability to be highlighted so that insight and lessons learnt can be drawn from those making greater progress for the benefit of everyone.

Importantly, those who judge themselves to be in the best fettle are applying themselves to all three dimensions simultaneously – they have senior clinical and board level sponsorship, alignment between their strategic ambitions and the enabling information technology all operating on fit for purpose infrastructure.

The path ahead is inherently disruptive. Exploiting new technology effectively requires new workflows, makes variation in practice transparent and provides an opportunity to transfer more authority and responsibility to the patient.

Our plans for the future deepen and widen the assessment to encompass more care settings – reflecting the increasing importance of place-based planning, leadership and delivery.

I grew up in a landscape of rolling drumlins, vertiginous cliff edges and apparently endless sandy strands. For local communities the route to paper-free may well share these characteristics: A reasonable map. Sturdy boots. Companions. A sense of purpose. Best foot forward.


Paul RicePaul Rice is the Head of Technology Strategy in the Digital Health team in NHS England. He leads the team that is instrumental in delivering a digitally enabled and “paperless” NHS.

For the past two years he has overseen delivery of four major capital funds worth in excess of £300million that help the NHS build the capability to introduce integrated digital care records and enable nurses to transform practice, enabled by technology, to “release time to care”.

Paul was a major contributor to the National Information Board’s roadmap document, Personalised Health and Care 2020 – published last November – the first articulation by the health and care system of its commitment to release the benefits of digital technology, data and intelligence.

He is currently leading one of the key delivery work streams.

Paul was formerly the Director of the Long Term Conditions programme in Yorkshire and Humber with a particular focus on Telehealth. He has been a Primary Care Trust Director, a transformation director in the NHS Modernisation Agency and a policy lead in the Department of Health.

He has published and spoken widely on the challenges and opportunities to deliver high quality, efficient and effective service models utilising assistive technology/telehealth/information technology.

Paul holds a first degree in Law and Accounting and a Doctorate in Medical Law and Bioethics.

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