2019-20 Annual Report and Accounts Information and technology for better health and care Health and Social Care Information Centre (HSCIC) Annual Report and Accounts 2019-20 The Health and Social Care Information Centre is an executive non-departmental public body created by statute, also known as NHS Digital. Presented to Parliament pursuant to Schedule 18, paragraph 12(2)(a) of the Health and Social Care Act 2012. Ordered by the House of Commons to be printed on 16 July 2020. HC 537 © NHS Digital copyright 2020 This publication is licensed under the terms of the Open Government Licence v3.0 except where otherwise stated. To view this licence, visit nationalarchives.gov.uk/doc/ open-government-licence/version/3 Where we have identified any third-party copyright information, you will need to obtain permission from the copyright holders concerned. This publication is available at www.gov.uk/official-documents Any enquiries regarding this publication should be sent to us at [email protected] ISBN 978-1-5286-2041-3 CCS0520637790 07/20 Printed on paper containing 75% recycled fibre content minimum. Printed in the UK by the APS Group on behalf of the Controller of Her Majesty’s Stationery Office. Contact us: NHS Digital 1 Trevelyan Square Boar Lane Leeds LS1 6AE Telephone: 0300 303 5678 [email protected] www.digital.nhs.uk Contents Chairman’s foreword 6 Performance report 8 Chief Executive’s introduction 8 What we did in 2019-20 10 Performance analysis 34 Accountability report 40 Corporate governance report 41 Remuneration and staff report 48 Salaries and pensions of senior management 58 Annual governance statement 64 Statement of Accounting Officer’s responsibilities 72 Parliamentary accountability and audit report 73 The certificate and report of the Comptroller and Auditor General to the Houses of Parliament 74 2019-20 Accounts 77 Notes to the accounts 82 Board members’ biographies and register of interests 108 5 Chairman’s foreword Over the past few months, we have faced the most serious public health emergency in a century. Our hearts go out to the families who have lost loved ones and to the clinicians who have witnessed the harrowing effects of the coronavirus (COVID-19). We all feel the NHS 111 online and the NHS We’ve delivered flags on website were critical to preventing electronic records to ensure deepest gratitude to the NHS from being overwhelmed clinicians can see coronavirus in March, to providing the related information about the hundreds of information and guidance people patients. We have provided thousands of needed and to getting those remote working capabilities to affected the treatment they help non-frontline workers workers – both in required. Traffic on NHS 111 contribute effectively from the NHS and across online rose to almost 950,000 home. We worked directly with sessions a day, but service trusts as they built capacity, society – who have response times and reliability did inventing new smartcard not suffer significantly. solutions so that returning fought this disease. clinicians could get to work Our product development teams quickly and providing hardware From the beginning of the worked hard to protect the and network connections as pandemic, digital and data public and frontline workers. In new hospitals opened. technologies have played an a matter of days, we built a ‘fit important role in understanding note’ service on the NHS 111 We have helped to moderate the the virus and its impact, in online platform that allowed devastating impact of this virus by protecting members of the public people self isolating to get notes creating the information needed and in helping clinical staff. I am without contacting their GPs. to fight it. We rapidly assembled very proud of the expertise, We identified those most linked data sets to provide commitment and flexibility vulnerable to coronavirus and, national early warning to help shown by our teams as we have by the end of March, nearly a plan and manage NHS services worked to develop vital solutions million people were being and have worked quickly with at an unprecedented pace while protected by the government’s leading research groups to put insisting on the highest standards shielding programme. our comprehensive data sets at of usability, reliability, and their disposal – while ensuring information governance. In the succeeding weeks, we have that data protection standards delivered a steady stream of new are maintained. services and provided direct support to help the NHS workforce and local organisations. 6 NHS Digital Annual Report and Accounts 2019-20 Our experiences over the past The fight continues. In the months have challenged how coming months, the work to we organise our health system, protect people, support the our society, our economy and frontline and inform research our lives in ways we could not will demand the same energy, have anticipated – but they have expertise and commitment we confirmed one thing we already have shown since March. knew. Digital and data However, I would like, on behalf technologies are crucial to the of the Board, to take this future of our health and care. opportunity to thank everybody at NHS Digital and in our Three years ago, we began work partner organisations for what to transform NHS Digital into they have done, not only in the trusted technology partner response to coronavirus but in the system needed. The past building and maintaining the few months have demonstrated infrastructure and capability that beyond any doubt the vital has allowed us to fully play our importance of our digital and role during this crisis. data services to public health and effective clinical care. They have proved the reliability of our platforms and critical national infrastructure, even under extraordinary stress, and they have demonstrated the flexibility of NHS Digital’s teams as we delivered the solutions a rapidly evolving crisis demanded in days rather than weeks. Noel Gordon Chairman, NHS Digital 7 Performance report Chief Executive’s introduction The 2019-20 financial year will be etched in our memories as the year that coronavirus (COVID-19) arrived in England. For the last two months of the business year, February and March 2020, the emergency response to the pandemic consumed NHS Digital. In the circumstances, This crisis affects us and all those operations capability, and so we serve on a very personal level many of our other products and the commitment and as well as through the demands services, have proved to be critical it places on us as an organisation. and powerful enablers. dedication of our Sadly, a number of our staff has been colleagues and partners have Delivery of these robust national suffered the searing pain of products and services has been completely losing loved ones to the virus and underpinned by significant extraordinary. So many have been separated from strengthening of the core loved ones for extended periods technical capabilities within our many of them have of time. Many have been organisation, through an managing complex domestic extensive transformation worked so many situations, juggling caring for programme which has focused on hours to deliver so vulnerable friends and family, skills development and educating children at home and assessment. We have welcomed many services. living in the confinement strong new talent and we imposed by lockdown. continue to extend our training Saying thank you offering for staff at all levels in the The extent to which we have organisation. As the digitisation seems completely been called on in recent months is agenda for the health and care inadequate, but I testament to the critical role that system accelerates over the NHS Digital plays in the health coming months and years, cannot introduce and care system. One of the most turbocharged by the experiences this overview of the heartening experiences of the last during the coronavirus outbreak, few months has been seeing the we will need to continue to year without new services we have delivered in transform and adapt. recent years, as part of the NHS starting by paying Digital Transformation In addition to more advanced tribute to them. Programme, being put to such digital products and platforms, effective use. Our NHS 111 much more sophisticated use of systems, the NHS App, NHS login, data and analytics are critical to our referral and prescribing the future of the system. In platforms, our Data Services response to the pandemic, the Platform, our more rigorous Department of Health and Social framework for primary care IT Care gave additional powers to services, the National Event NHS Digital and other Management Service and organisations, allowing us to National Record Locator service, access and disseminate data with NHSmail, our core infrastructure much greater ease across the capabilities, our cyber security system. We leveraged our GP Connect platform to enable 111 8 NHS Digital Annual Report and Accounts 2019-20 Performance report providers to insert COVID-19 It is critical that we operate Our role as the national data alerts into GP records and book with extraordinary care with guardian for the system is more patients into GP practices and respect to privacy, critical than ever, as is our ability other local COVID-19 care centres. confidentiality and the to make independent We were able to include ethical handling of patient judgements about legal and ‘additional information’, including data at all times, but never ethical use of NHS data, and our COVID-19 flags, into