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Written Statements

Volume 614: debated on Wednesday 7 September 2016

Written Statement

Wednesday 7 September 2016


Wachter Review

Today an independent review has been published which makes recommendations about how to support the effective implementation of IT systems in the health system in England.

In October 2015 I asked Professor Robert Wachter, a US clinician and authority on the issues and challenges of implementing IT and digital systems in healthcare, to undertake a review of implementation of IT in the NHS, with a particular focus on the introduction of electronic health records in the acute sector. It was to draw on recent experience in both England and the US and make recommendations on how to introduce such systems more effectively in the NHS. The review started in February this year and was supported by an advisory board drawn from digital healthcare experts in the US and UK, as well as a representative from Denmark.

The independent review has now been completed and the full report is attached and available at

Healthcare, like other areas of life, needs to make effective use of technology to deliver services as efficiently and cost effectively as possible, while meeting the needs of patients and their expectations of a modern public service. If we are to deliver on our ambition to deliver the safest, most efficient healthcare possible for NHS patients we must make the most of these technologies, moving away from paper-based records to a system that provides every health care professional with the information they need, at the point of care, so that they can make safe, effective treatment decisions, and that provides patients with easy access to all the information they need to be active partners in managing their health and wellbeing.

Digital technology is increasingly in use in many parts of the NHS but there are still some organisations that have yet to embrace its use, and many more that have found the task of implementing systems very challenging. The result is that despite already making investments in digital technology, local NHS organisations are often not getting the expected benefits for patients, health care professionals or the system.

Professor Wachter’s review identified a number of critical factors for success and has made 10 recommendations that focus on:

The importance of clinical engagement and leadership to successful implementation.

The need to improve workforce capability in the use of technology in the delivery of care, in particular the need for more clinician-informaticists (clinicians with informatics expertise) to lead implementation of clinical IT systems, including for a National Chief Clinical Information Officer (CCIO).

A phased approach to funding and implementation that reflects the level of readiness and existing digital maturity of NHS Trusts with initial support for those Trusts which have already made good progress in digitising and are ready to go further, or which are demonstrably ready to make good progress.

Interoperability as a core characteristic of the system from the outset to support clinical care, innovation and research.

I am grateful to Professor Wachter and his advisory group for their work on this important area for the future development of a NHS that is sustainable and meets our expectations of a modern service.

Today I am also presenting plans to start to implement those recommendations with the announcement of:

The first Global Exemplars. These Trusts are judged to be the most advanced in the use of digital technology in England, and which we expect to move to become world leaders at an accelerated pace:

Each Global Exemplar will be supported via international partnerships and will be expected to share their learning and experience across the NHS to show how care can be enhanced across the whole health system using digital technologies. Each of these Trusts will be able to bid for up to £10 million of funding.

The creation of a group of National Exemplars. These Trusts, although not yet as advanced as our Global Exemplars, are ready to make good progress in implementing digital technology and each can bid for up to £5 million of funding.

A competition to find a UK university partner to set up a Digital Academy to provide improved workforce capability in use of technology in the delivery of care.

The first Global Exemplars will be:

City Hospitals Sunderland NHS Foundation Trust

Luton & Dunstable University Hospital NHS Trust

Oxford University Hospitals NHS Foundation Trust

Royal Free London NHS Foundation Trust

Royal Liverpool and Broadgreen University Hospitals NHS Trust

Salford Royal Hospitals NHS Trust

Taunton and Somerset NHS Foundation Trust

University Hospitals Birmingham NHS Foundation Trust

University Hospitals Bristol NHS Foundation Trust

University Hospitals Southampton NHS Foundation Trust

West Suffolk NHS Foundation Trust

Wirral University Teaching Hospital NHS Foundation Trust

NHS England has also already announced, in July, the appointment of Professor Keith McNeill as NHS Chief Clinical Information Officer. Professor McNeill will have a key role in providing national leadership for this important agenda that will increase the speed and scope of the NHS’s adoption of digital technologies to support the transformation needed to deliver NHS services fit for the future. He will act on behalf of the whole health and care system to provide strategic leadership, also chairing the National Information Board, and acting as commissioning ‘client’ for the relevant programmes being delivered by NHS Digital (previously known as the Health and Social Care Information Centre).

It can also be viewed online at: