Is the new Mandate for NHS England the green light for digital transformation?

On June 19 2023 the Secretary of State for Health and Social Care, Steve Barclay, published the Government’s Mandate for NHS England which sets out its objectives for the future. In the document Mr Barclay suggests that the NHS can move forward through innovation by adopting digital health technologies. Here we take a look at what the mandate says, and how the NHS will achieve its aims.

What is the NHS Mandate?

Each year the Government of the time publishes its Mandate for NHS England. In it are its objectives for the organisation, as well as its budget. The document is a record of the NHS’s accountability to the Government and will be used to measure its effectiveness over the coming year. 

This Year’s Mandate

The first of Mr Barclay’s objectives is to cut NHS waiting times, which grew due to the COVID-19 pandemic and subsequent lockdowns. To support this aim the Government has promised up to £14.1 billion be made available for health and social care in the next 2 years, in addition to what it calls ‘record funding’ to improve elective care, urgent and emergency admissions, as well as primary care performance. 

To achieve these goals the Government suggests two key ways to enable the NHS to recover and deliver:

1. Supporting innovation and adopting ‘the right’ digital technologies

2. Ensuring the workforce can continue to deliver the care they provide 

Digital Aims

The Mandate notes that digitally mature Trusts are around 10% more efficient than those which are less digitally mature and this digital maturity plays a crucial role in reducing the length of time a patient stays in hospital. Increased length of stays has proven to be distressing for the individual concerned as well as costing the NHS at least £1.7 billion in 2022/23, so it’s no wonder the Government has placed such a high priority on reducing the numbers. 

Mr Barclay also states that one of the Mandate’s key priorities is to support health and care systems to ‘level-up’ their digital maturity and to ensure that a core level of infrastructure, digitisation and skills is in place by March 2025.

In the matter of Artificial Intelligence (AI), which is much in the news these days, the Secretary of State notes the use of this technology to help clinicians diagnose cancer. A recent report broke the news that AI has cut waiting times for cancer patients at Addenbrooke’s Hospital, enabling treatment to take place two-and-a-half times faster than previously. 

Mr Barclay has issued a challenge to the NHS to adopt ‘safe, ethical and effective’ AI tools to improve outcomes for other patients and to make the most of the opportunities this technology offers. 

He goes on to say that the NHS App will be transformed in order to lead to better care and a better experience for patients. In May of this year the Government announced its plans to give patients greater choice by offering them different healthcare providers via the NHS App so they have a choice of where to go – according to the Government this has been shown to cut up to 3 months off their waiting time. 

Three Priorities

The Mandate has three clear priorities:

1. Cut waiting lists and recover performance: Mr Barclay suggests that GP access should be improved by switching to digital telephony, procuring new digital tools and providing training for staff who need it. By the end of this year it wants all practices to have new digital tools available to them

2. Support the workforce through training, retention and modernising the way staff work: the Mandate emphasises the need for sustainable work practices which meet the changing needs of patients

3. Deliver recovery through the use of data and technology: The adoption of innovation and technology is described as crucial within the NHS in order to ‘drive a new era of digital transformation’. It hopes that this will enable the health and care system to thrive into the future. It suggests AI might be used to offer better treatment, develop new screening techniques and devise new equipment that allows treatment from home. 

Using digital to transform

In order to support the digital transformation that the Mandate requires it suggests that the upskilling of staff in the implementation and utilisation of digital tools is of paramount importance. This delivery, it says, should also include:

• Ensuring the innovative, safe and effective delivery of live services following the transfer of functions from NHS Digital. This involves trusts and foundation trusts, as well as adult social care providers holding digital records by March 2024
  It also requires barcode scanning of high-risk medical devices to a Medical Device Outcome Register to improve patient safety

• Developing a federated data platform, optimising health and social care data more effectively, and maintaining robust cyber security resilience as outlined in the National Cyber Strategy

• Transforming the NHS App so it can be used by at least 75% of the population to book and manage appointments, order repeat prescriptions, and access patient records

• Increase the uptake of AI tools to support NHS staff in achieving best practice

This year’s NHS Mandate is shorter than in previous years. This is because, according to Mr Barclay, the health system asked for fewer targets. The importance of digital technologies is, therefore, highlighted by the rest of the document’s brevity. Nevertheless, it is ambitious in its digital aims and objectives, focusing on the benefits that a digitally mature health service can bring to the population of England. In the matter of finance for these plans, however, the budget is still limited by ‘financial balance’ and ‘robust’ management to ensure that budgets are being managed effectively. However, it appears that there is no separate or additional budget for the implementation of the digital process which the Government places so much emphasis on and which it says is vital to the future of the health of the population of this country.