The long-running debate over digital transformation in the NHS resurfaced this week after The BMJ highlighted how many hospital trusts in England are still relying on paper-based record keeping, even after years of push toward full digitisation. The issue has once again put patient safety, staff workload and system efficiency under the spotlight.
In a recent BMJ Future Health newsletter, the publication said only about a fifth of hospital trusts in England reported using fully electronic clinical record keeping. The newsletter also pointed to the continuing use of pen and paper for record keeping across NHS trusts, framing the situation as evidence that progress on digitisation remains uneven.
Digitisation efforts still face familiar barriers
The latest reporting suggests that the NHS is still dealing with a gap between policy ambition and practical implementation. While electronic systems are widely seen as essential for modern care, the BMJ coverage indicates that many organisations have not yet fully moved away from paper records.
That matters because record systems sit at the centre of clinical decision-making, handovers and continuity of care. When systems are fragmented or incomplete, clinicians can lose time searching for information, and teams may face avoidable administrative pressure. The BMJ material does not provide a full national audit, but it does show that the issue remains current and unresolved.
Why the issue matters for frontline care
Digital records are often promoted as a way to improve access to patient information and reduce duplication. The BMJ’s reporting instead suggests that paper continues to coexist with digital infrastructure in many parts of the service, leaving staff to manage hybrid workflows. That can complicate documentation and slow down care delivery, particularly in busy hospitals.
The publication’s latest coverage arrives amid broader scrutiny of NHS performance and operational resilience, with recent BMJ commentary repeatedly returning to questions about workforce strain, service pressure and the pace of reform. In that context, the persistence of paper records has become more than a technical issue; it is being treated as part of a wider challenge around how the health service works day to day.
For now, the message from the latest reporting is clear: the NHS digital transition is still incomplete, and the system’s dependence on paper remains a live issue for patients and staff alike.
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