Hospitals across England are under growing pressure to modernise as new reporting highlights how slowly the NHS has moved away from paper-based record keeping, even while artificial intelligence tools become more common in clinical settings. The contrast is sharpening debate over whether digital systems are advancing fast enough to support safer, more efficient care.
Recent coverage in The BMJ reported that four fifths of NHS trusts are still using pen and paper for record keeping, 25 years after the first digitisation push. That finding has added new urgency to long-running questions about the health service’s infrastructure, particularly as leaders look to AI and other technologies to help relieve operational strain.
Digital progress remains uneven across the health service
The persistence of manual processes suggests that many organisations are still operating with systems that make it harder to share information quickly, track patient pathways consistently and reduce administrative burden. In practice, that can affect everything from bedside documentation to coordination between departments.
At the same time, the broader digital agenda is moving forward. BMJ reporting from August also highlighted NHS AI policy and a major investment package focused on expanding the use of technology across the health service, showing that policymakers are trying to accelerate a transition that has been years in the making.
Why the gap matters for clinicians and patients
For clinicians, paper-heavy systems can slow down routine work and make it harder to access complete patient information when it is needed most. For patients, fragmented records can raise the risk of delays or duplicated assessments, especially in busy hospitals managing high demand.
The issue is not simply about convenience. As AI systems, electronic records and data-driven tools become more embedded in care delivery, the quality of the underlying digital infrastructure is likely to shape whether those innovations can deliver measurable benefits. Without reliable electronic systems, the promise of new technology may be limited by old workflows.
Pressure grows for a more credible modernisation drive
The latest reporting also comes against a backdrop of wider concerns about NHS performance, staffing and delayed discharges. In that context, digital reform is increasingly being framed not as a future luxury but as a practical necessity. Leaders and clinicians alike are likely to face continued pressure to show how new technology will translate into better care on the ground.
For now, the headline remains clear: the NHS is investing heavily in digital ambition, but many trusts are still far from fully electronic operations. Closing that gap may prove central to whether the health service can make technology a genuine solution rather than another layer of complexity.
Photo source: AI-generated or edited image
