The NHS has made real progress in its digital transformation. Across the service, trusts have invested heavily in systems and infrastructure in the name of more connected, effective patient care.
Almost all NHS trusts in the UK have now adopted an electronic patient record (EPR); NHS England has just announced the rollout of Microsoft Copilot to half a million clinicians and support staff. Yet for many frontline teams, the day-to-day experience of work still feels slower and more fragmented than it should.
This is the productivity gap now facing NHS digital transformation: the difference between having technology in place and that technology delivering usable time back to staff.
The productivity gap is much more than a single system failure or a lack of investment. It sits in the small, routine frictions that shape the working day — the time you lose accessing your laptop, moving between systems, identifying the right information, completing a duplicated process or simply reaching a patient through the right channel.
Individually, these delays can feel minor. Repeated across thousands of staff, shifts and sites, they become a profound operational challenge.
The NHS productivity gap is now measurable
Drawing on over 200 Freedom of Information responses from NHS trusts, Apogee’s Time Back, Care Forward report found that everyday digital and operational friction adds up to around eight minutes of lost time per staff member, per day.
Scaled to reflect the size of the NHS workforce, that equates to 2.1 billion minutes — or 35.2 million hours — of staff time each year. This roughly equates to around 20,000 appointments, which is similar to the savings that NHSE suggests a single EPR would make.
In financial terms, it represents more than £1 billion in lost productivity. In practical terms, it is an incredible amount of time that now cannot be diverted to things like improving patient flow, supporting colleagues, reducing pressure on services and delivering care.
If trusts are going to combat the inefficiency that undermines patient care, it has to deal with this challenge. There are some key areas to start with.
False starts
The first place that time is lost is before work even begins.
For most NHS staff, the working day starts with access: logging into devices, opening clinical systems, connecting to the right applications and finding the information needed to begin. When that process is slow or unreliable, productivity is lost at the very point care should begin.
Our FOI data found that staff wait, on average, more than 80 seconds to reach a usable desktop environment, with some organisations reporting delays of six minutes or more. These may sound like small delays, but repeated across shifts, wards and departments, they quickly become a significant drain on capacity.
This is something we’ve actually seen at Apogee ourselves. Our work with Salisbury NHS Foundation Trust required managing a fleet of over 1,000 laptops — of which we eventually cut more than half. The time spent wrestling with these devices could have been more effectively deployed for patient care.
Paper still clogs digital workflows
The second point of friction is how information moves through the trust.
Despite the widespread adoption of electronic patient records, NHS workflows still depend on a complex mix of digital and physical processes. Documents can be created in one system, printed for use elsewhere, scanned back into another, then stored across multiple locations and often handled more than once. Every handoff introduces the possibility of delay, duplication or error.
FOI responses again show the scale of this hybrid reality, with responding trusts printing more than an astonishing 1.1 billion pages in a single year and recording tens of thousands of print and scanning faults. We can see this reality in trusts like University Hospitals Birmingham NHS Foundation Trust, which is about to migrate almost a quarter of a billion patient record images into its EPR system before the end of the year.
For clinicians and operational teams, all of these things mean time spent waiting for, recreating or chasing information that should already be available. That is time that should be spent acting on that data, rather than waiting for it.
The cost of miscommunication
Even if you can start work on time and find the information you need to do your job, there’s a third area of jeopardy for NHS staff: communication with patients.
Appointments, reminders, referrals and follow-ups all depend on information reaching people at the right time, in a format they can act on. When that connection breaks down, the impact is felt across the service. Appointments are missed; clinical capacity goes unused; schedules become harder to manage; and staff spend more time recovering activity that should have happened first time.
Our research found that trusts issued 37.9 million appointment communications by post or hybrid mail in a single year, while reporting around five million missed or unattended appointments over the same period. The issue is not simply whether messages are sent, but whether communication reliably converts into care.
Trusts cannot fix what they cannot see
Underpinning all three issues is a visibility gap. Many trusts do not have a consistent view of how work actually happens across devices, systems, documents and communications. Our FOI responses found that 67% of trusts could not confirm how long it takes a typical user to access their system. Nearly half (44%) could not confirm how many pages were scanned into their electronic patient record systems.
That makes it harder to know where time is being lost, which processes are creating the most friction, or whether changes are delivering measurable improvements. When operational friction is not measured, it becomes much easier for lost time to be accepted as part of the working day.
Digitally mature trusts approach this problem differently. They treat time as a managed operational resource, rather than an unavoidable casualty of complex healthcare delivery.
That means looking beyond whether a system has been deployed and asking how effectively it supports the flow of work in practice. For instance, can staff access what they need quickly? Does information move cleanly between teams and settings? Are documents captured once and made available where they are needed? Do patient communications help appointments translate into attended care?
These questions connect areas that are often managed separately, despite frontline staff experiencing them as part of the same working day. A holistic approach to this problem can be transformational.
Giving time back to care
This is why the next phase of NHS transformation cannot be defined by the introduction of new tools alone. The bigger opportunity is to make existing systems work more cohesively around the people using them.
That means reducing unnecessary steps, improving interoperability, simplifying how information is captured and retrieved, and strengthening the communication channels that connect patients to care. In practice, digital maturity is not measured by the number of platforms in place, but by whether those platforms reduce friction across the working day.
For trusts under pressure to improve productivity, that shift matters. If digital systems make everyday work slower, harder to navigate or more fragmented, their value will always be limited. But when they are designed and managed around the reality of frontline work, they can return time to the people who need it most.
Every minute saved from avoidable friction is a minute that can be reinvested in patients, colleagues and care. That is where the next phase of NHS digital transformation must focus: not just on digitising the service, but on giving time back to move care forward.
By Gary Day, Sales Director for Public Sector, Apogee
About the author
Gary has over 30 years of sales management experience within the Managed Print and IT solutions space. Experienced in working within both Corporate and Public Sector client channels, Gary’s most recent roles have been at a senior level, concentrating on transformation and new business growth. Gary has a particularly deep understanding of the Public Sector, and continues to demonstrate this through the development of our relationships within both Government and independent framework contracts. Integrity and a strong commitment to deliver value to our customers are key attributes that Gary carries into the workplace.
