IT governance in the NHS: aligning technology with patient care and organisational goals 

What are the core principles of IT governance in the NHS?

IT governance ensures that technology serves the NHS’s overarching mission: providing safe, effective, and patient-centred care.

Strategic alignment: digital and IT initiatives must be directly linked to NHS Trusts’ objectives

• Value delivery: IT investments should demonstrate measurable benefits in terms of patient care, workforce efficiency, and financial sustainability
• Risk management: effective IT governance must mitigate risks related to cyber security, data protection, clinical safety, and regulatory compliance
• Resource management: optimising IT spending and workforce resources ensures that NHS digital investments deliver the highest value for money
• Performance measurement: NHS IT systems should be continually assessed to drive improvements

Why is governance so important, and what happens due to a lack of governance?

Governance is not only vital to ensure security and proper IT management, but also due to the government standards NHS organisations must adhere to.

• Data Protection and Security Toolkit (DSPT)
• Cyber Assessment Framework (CAF)
• Clinical Risk Management Standards (DCB0129 and DCB0160)
• NHS Digital Service Manual
• Procurement and Supplier Management Policies
• Change Management and Technical Design Authority (TDA) Governance

These governance measures are designed to protect data, improve resilience, promote interoperability, and more. Failure to adhere to IT governance policies can have significant consequences. Examples like the WannaCry Cyberattack (2017), Irish HSE (2021), and London Hospitals (2022-24) cyber attacks were caused by outdated systems and insufficient cyber security, and lead to significant disruptions.

My advice…

Based on my experience in the NHS and working with organisations like yours, I’ve learnt some valuable lessons surrounding successful IT governance…

• Governance should enable, not hinder. IT governance must be seen as a facilitator of digital transformation rather than a barrier
• Engage clinical leaders. I’ve found that the most successful IT projects involve clinical and operational stakeholders from the outset
• Learn from past failures and use case studies of governance failures (e.g., the WannaCry attack) to inform future strategy
• Continuously improve. Your IT governance is not a one-time task; it must evolve with technology and organisational needs

By taking a proactive and structured approach to IT governance, the NHS can navigate digital challenges and harness technology to provide safer, more effective, and more efficient healthcare services.

I’ve seen organisations upskill their IT to the point where they’re seeing successful EPR implementations, highly effective threat mitigation, and reduced IT waste. IT governance has a high success rate, so what are you waiting for?”