It is five years since the UK's National Health Service (NHS) - one of the largest health providers in the world - missed its planned deadline to go paperless.

The idea was that it would rid itself of reams of paper for more efficient electronic health records. As if to mark the event, a study emerged this week which showed that in England, the NHS spent £1.19 billion ($1.44 billion) on storing paper-based medical records over a five-year period.

How about another anniversary? It is 20 years since the NHS began contracting for its ill-fated National Programme for IT, a centrally £10 billion ($12.14 billion) effort designed in part to create electronic health records for all, among other things.

UK national newspaper The Times accessed real-estate records for NHS England, the health department quango which manages the NHS, as if to show how abysmal the efforts have been since. It found hospitals spent more than £234 million ($284 million) on the storage of paper medical records in the year to April 2022. This included about £175 million ($212 million) for on-site storage and more than £59 million ($72 million) for off-site storage. It calculated the total spend since 2017 was £1.19 billion ($1.44 billion).

It might be argued it is a fraction of a percent in the context of NHS England's annual budget of £160.4 billion ($195 billion), but it is still a lot of money.

The health service does not have a good track record when it comes to sticking to its paperless timetable. The 2018 target was set 10 years ago by Jeremy Hunt - then health secretary, now head of government finances, or chancellor of the exchequer.

It was only a couple of years before the staggeringly complex healthcare organization - really a loosely coupled economy of very disparate organizations - realized that 2018 was a ridiculous ambition. In 2015, NHS England's national director for patients and information Tim Kelsey named 2020 as an altogether more realistic target date.

Picking apart what happened next is challenging, but in 2020, government auditors reported £4.7 billion ($5.7 billion) had been allocated to the digital transformation strategy between 2016-17 and 2020-21, with the target of trusts reaching a "a core level of digitization by 2024."

The Times reports that 12 percent of hospitals in England are still paper-based.

In response to their story, a spokesperson for NHS England said it was providing £1.9 billion ($2.3 billion) to ensure trusts can provide a core level of services digitally so patients can access them in the way they choose. "Digital, data and technology underpin so much of our lives; how we socialise, shop and work. But in the NHS, we are yet to harness this enormous potential in the way that other industries have."

But they didn't give a date for when this is supposed to be in place. Various figures are out there, though. One health tech research and media company estimated that 2027 would be the earliest possible date to go paperless.

However much the cost of storing paper, and whatever the digitization timetable, there is one important thing NHS IT pros should remember about paperless health system deadlines: none of them are set in stone. ®

https://www.theregister.com//2023/10/05/pick_your_year_its_time/