Baringa has published The NHS local technology spend report, the first independent, data-driven assessment of how the NHS spends on technology at a local level. I wrote the foreword.
The report draws on supplier-level invoice data from more than half of England’s NHS trusts to answer a question no one had yet answered with data: what is actually being spent locally on technology, and where it goes. The picture is sobering. Of an estimated £1.3bn in local technology spend at its FY24/25 peak, 65 pence in every pound keeps ageing systems running. The ’left shift’ enablers that would move care closer to home and change clinical outcomes, such as remote monitoring, population health and AI-assisted triage, account for less than 10 pence.
In the foreword I argue that how the money is spent matters more than how much, and that prioritisation matters more than funding. At a national level the aggregate investment may be roughly right. The way it currently reaches trusts is not. The confusion of roles between national and local technology programmes is one of the key underlying problems, and there is a significant opportunity for intentional consolidation.
It lands at a significant moment for the NHS: the 10 Year Health Plan, reform of the centre, and a clear ambition for AI, data and a single patient record, backed by a multi-year funding commitment. Getting the pattern of technology spend right, and quickly, is central to whether that ambition can be met.