NHSX annual report 2020 to 2021

Published 15 October 2021

The role of NHSX in digitally-enabled care

In its second year of operation, NHSX continues to set the strategic, policy, and delivery objectives for digital transformation throughout the NHS and adult social care sectors. Using the levers available through NHS England and NHS Improvement, as well as the Department for Health and Social Care, it supports NHS and care organisations to digitise their services, connect the health and social care systems through technology, and transform the way patient care is delivered at home, in the community and in hospital.

NHSX has played a critical role in the response to the pandemic. It led the creation of the NHS Data Store, which allowed the NHS to route ventilators and billions of items of PPE to where they were needed and enabled world class research into COVID-19. We undertook significant work on the technology and data underpinnings of the vaccination programme in conjunction with NHS Digital. NHSX also worked with NHS Digital to develop systems and capabilities now widely used throughout the NHS and NHS Test and Trace, including text messaging systems to contact those self-isolating at home and test kit home delivery services.

Within the wider system we have led concrete transformation. NHSX took action to ensure the NHS could continue to deliver remotely. We enabled the provision of 40,000 laptops to the system and ensured 99% of GP practices had the capability to provide online and video consultations, working alongside NHS Digital.

Wider transformation has been enabled, most notably through the simplification of information governance guidance which gave clinicians and decision makers better access to information during the response to the first wave of the pandemic, improving patient care.

Commercial capabilities have also been deployed. We worked with NHS Digital to strike a deal with Microsoft which saved the NHS hundreds of millions of pounds and provided Microsoft 365 digital tools to 1.2 million staff across the health service.

In 2021 to 2022 NHSX will increase the momentum of transformation and publish a series of policy initiatives, including The Digital Transformation Plan for Health and Care and the national data strategy - Data saves lives: reshaping health and adult social care.

Other key achievements

AI in Health and Care Award

NHSX’s NHS AI Lab is supporting the testing, evaluation and scale of promising AI-driven technologies through the £140 million AI in Health and Care Award. Winners include automating early lung cancer detection and developing deep learning software that could improve the NHS Breast Cancer Screening Programme.

The lab also launched the COVID-19 Chest Imaging Database, with the British Society of Thoracic Imaging and Royal Surrey NHS Foundation Trusts. This rapidly grew to be one of the largest collections for medical imaging in the UK. The database supports better understanding of the COVID-19 virus and helps develop technology that enables the best care for patients hospitalised with a severe infection.

11,000 iPads delivered to care homes

11,000 iPads were delivered to care homes to equip staff and improve care for residents. Discounts for broadband services were negotiated for care homes as part of our work to digitise the adult social care sector and connect it to the NHS.

GP Connect

To help health and care professionals access the best medical information available at the point of care, we worked with NHS Digital to enable the GP Connect service. This national service provides safe and secure access to GP records in multiple care settings.

We also published additional information contained within 55 million Summary Care Records, including the addition of COVID-19 specific information. This enables that information to be made accessible to authorised professionals in order to deliver better care.

Digital Aspirants

We have provided almost 60 trusts with funding and support for their digital transformation journey through the Digital Aspirant programme. This is building core digital capabilities that will make services resilient for the future, as well as significantly increasing allocations to mental health trusts.

Digital playbooks

Outpatient pathways are being redesigned across ophthalmology, dermatology, respiratory, cardiology and musculoskeletal health. Teledermatology is being resourced to allow GPs to easily access advice from hospital specialists, enabling quicker patient referrals for treatment and diagnosis. NHSX is scaling the use of digital remote monitoring across the country and a series of digital playbooks have been launched to showcase best practice across the health and care system.

Artificial intelligence (AI) leadership resources

A Buyer's Guide to AI in Health and Care and AI: How to get it right were published. The resources inform and support safe data-driven innovation and procurement of technologies using AI in the NHS.

Digital nursing network

Our digital nursing network is focused on increasing the digital capabilities of the nursing workforce to drive forward digital transformation. The network of 1,100 nurses is growing and work is underway to develop and embed a professional architecture to champion this change.

How we have invested in digital transformation

NHSX Spend 2020/21 Revenue £m Capital £m Total £m
Admin 22 0 22
Run/Maintain 282 118 400
Transformational 209 358 567
Covid 77 17 93
Total 590 492 1,082

In 2020 to 2021 NHSX was allocated £1,097 million of funding made up of £590 million of revenue and £492 million of capital. Of the £1,097 million allocation NHSX underspent by £15 million or 1.4%. The main areas of investment are:

Capital and revenue funding

Our primary focus is on the capital and revenue to fund transformational programmes aligned to the NHS Long Term Plan commitments and the Secretary of State’s tech vision. Key programmes include:

Frontline Digitisation

£350 million of capital and revenue to support NHS healthcare providers in achieving a standard level of digitisation.

Shared Care Records

£50 million of capital and revenue to support the development of a shared care record for local health systems.

COVID response

£90 million of revenue to support the digital healthcare response to COVID-19, with spend predominantly incurred through the initial response.

Primary Care

£130 million of revenue to support the digital transformation of GPIT infrastructure.

Sponsorship of NHS Digital

Sponsorship of NHS Digital to enable the arms length body to discharge its responsibilities through running and maintaining the digital services and assets which it has launched on behalf of the NHS in previous years. NHSX also works with NHS Digital to enhance these, as well as building new services. Investment in this work is £400 million. Key services include:

NHS.UK website

The NHS.UK website is often the first resource used by the public for sign posting within the healthcare system.


The NHS App is an interface where the user can access their patient records, order repeat prescriptions and book appointments.

NHS Spine

The NHS Spine is the central system which supports the IT infrastructure for health and social care in England, joining together over 23,000 healthcare IT systems in 20,500 organisations.


Hosting and managing the NHS mail platform, NHSmail is our secure email service approved by the Department of Health and Social Care for sharing confidential patient and sensitive information.

Creating and running costs of NHSX

The creation and running costs of NHSX which now leads the strategic transformation of technology in the NHS. The value of this is £22 million.