Why data coherence will define whether NHS digital transformation succeeds
The NHS is now, at large, a digital organisation: electronic patient records are in place in some form across every trust, and the 2025 Spending Review committed up to £10 billion to NHS technology and digital transformation by 2028/29. Digital adoption however has not produced a coherent information environment – with particular challenges associated with extracting, and managing years of legacy data from many superseded or outdated systems.
Patient data remains scattered across systems and organisations, with most significant impact at the point of care where continuity and access matters most. Clinicians still transcribe between systems, re-enter information and make decisions without the full picture in front of them. NHS digital transformation is no longer whether pathways and services are digitised, but whether data can follow the patient, retain its clinical meaning, and be available at the point a decision is made.
Chaired by Alex Kafetz, Non-Executive Director at the Care Quality Commission, this Public Policy Projects and CHIME roundtable – supported by RLDatix – brought together CCIOs, CNIOs, CDOs and medical directors from NHS trusts and ICBs with interoperability specialists, academics and industry representatives. Delegates discussed the challenges around legacy data management, strategic clarity, functaiontl capability, and system expectations.
It became clear that data quality suffers when frontline staff put information into systems and get nothing back. Legacy records are retained but not activated, leaving a patient’s history technically preserved and practically inactionable. Data too often remains tied to the legacy applications in which it was created and has ‘lived’ for years, making it difficult for organisations to change systems without losing access to what was there before.
Decisions taken during EPR transformation – particularly around migration versus archiving – were identified as the point at which much of this is settled.
The report sets out eight insights for NHS leaders on moving from digital adoption to data coherence, spanning data quality and workforce engagement, legacy data strategy, trust and transparency, patient agency, and the case for separating data from systems as a condition of procurement. Download the full report to read the findings in full.
