Government concedes it will miss 2024 e-prescribing target

The government will not be able to meet its commitment to introduce digital prescribing across the NHS by 2024, in part due to the huge variation of digital maturity of NHS Trusts.

The news comes as the government has published its response to a report by the Health and Social Care Committee’s Expert Panel, which was published in July 2023 and found that Whitehall’s goal of eliminating paper prescribing was “overly ambitious” and progress was “inadequate”.

The target of paperless prescribing was first set in 2019 as part of the NHS Long-Term Plan, which has an overall aim of creating an NHS built around the needs of the patient, using technologies to improve access to services and focusing on prevention and early detection of diseases.

However, the government has realised that its 2024 target to get rid of paper prescribing is currently impossible, as there is a large variation of digital maturity in general across the NHS, specifically when it comes to electronic prescription and medicine administration (ePMA) systems – while most Trusts have a system in place, they are of varying degrees of maturity.

“The priority for NHS England has been on ‘levelling up’ digital maturity, ensuring all NHS trusts are using the EPR,” the report on the government’s response said. 

“The most recent results of the NHS England Digital Maturity Assessment (DMA) shows that at least 80% of providers have some form of ePMA already – varying degrees of maturity but all on the journey to meet the 2024 commitment. It is expected the remaining 20% of organisations will have implemented ePMA by 2026, in line with the trajectory for EPR systems, which is being led through the NHSE Frontline Digitisation Programme.” 

However, the expert panel pointed out that in evidence submitted by the Department for Health and Social Care (DHSC), only 3% of Trusts have achieved the commitment of paperless prescribing.

The expert panel has also rated progress on digitisation of the NHS in England as “inadequate”, finding that many Trusts struggle to even ensure a basic level of digital maturity overall, mainly due to funding issues, as well as a lack of trained staff members. 

“The evidence we received for this evaluation similarly indicated that poor digital maturity within Trusts and community pharmacies hampered the progress in meeting commitments,” it said. 

Despite the government pushing back its digital prescribing target to 2026, the panel is still sceptical towards its success. 

“The evidence available to us indicate that it is not likely to be met by this deadline either. The differing levels of digital capabilities, and infrastructure, within trusts will likely continue to be an obstacle to progress on this commitment,” it said. 

It added that the digital infrastructure needed to support the digital prescribing target is not in place, mainly due to a lack of investment and inequity in funding between Trusts. 

The current funding available to trusts for ePMA pharmacy infrastructure only covers a third of Trusts in England, meaning the majority of Trusts – particularly those with low digital maturity – will struggle to implement the technology needed. Much of the digital funding has been directed towards “exemplar” Trusts – those which already have a decent level of digital maturity.