Why digital literacy is the hidden clinical competency the NHS cannot ignore

By James Freed, deputy director for The NHS Digital Academy, NHS England

Digital is no longer an add-on to healthcare, it is inseparable from it, and is a key pillar of the NHS 10 Year Plan.

Electronic patient records, remote consultations, rostering, pathology and radiology systems, and an expanding family of AI-enabled tools now frame how clinicians deliver care and how patients experience it.

Yet too many clinicians still practice without the confidence or competence to use the very systems that underpin safe, effective care.

When the NHS Digital Academy ran a learning needs analysis across the NHS, three quarters of staff identified at least one digital skills deficit.

Around half of clinicians told us that, at the point they start work after finishing their training, they don’t feel ready to use the technologies their roles now require.

That’s not a marginal training gap, it’s a key clinical risk.

What digital literacy really means

At the NHS Digital Academy, we use a straightforward definition.

Digital literacy is the set of capabilities that fit a person for living, learning, working, participating and thriving in a digital society.

For clinicians, that means being both confident and competent with the tools that now mediate everything from documenting care to coordinating teams.

It’s layered.

At the foundation is basic familiarity such as using a computer, mouse, keyboard, tablet or phone, and yes, that still matters.

Roughly five percent of the workforce have issues at this level, often because they’ve managed to work around digital systems for years until a modern EPR made it unavoidable.

Above the basics sit the essential skills for work.

These include navigating the internet safely, using productivity tools, and managing routine tasks such as rosters and payslips online.

Then come product-specific skills aligned the everyday systems that clinicians must use to deliver care.

There’s also the broader layer of emerging technologies.

Most clinicians do not need to become data scientists, but they do need to recognise capability, limitation and risk, especially with the rapid development of AI.

Digital literacy extends into awareness of data skills and user-centred design too, because without those, service improvement and multidisciplinary teamwork will always fall short.

More than ‘nice to have’, it’s a patient safety issue

A surgeon wouldn’t wield a scalpel without training, and the same should apply to an EPR or an AI-enabled decision support tool.

Without training, good people leave, systems falter, and patients are put at risk. Staff shortages are already acute, we cannot afford to let digital stress become another driver of staff attrition.

Every clinician, regardless of their specialty or seniority, needs baseline competencies to engage with training and to keep learning.

As systems multiply and evolve, the most valuable skill will be the ability to learn how to learn.

This means being able to identify gaps, troubleshoot, and use available support, whether colleagues, documentation, or AI, to solve problems in real time.

The inequalities we risk widening

Digital transformation also has an equity dimension, and as with any technology, adoption curves favour those with better education or resources.

Digital exclusion is real and according to the Essential Digital Skills for Work report, NHS staff are, on average, less digitally literate than the wider UK workforce.

If we ignore that, we risk hard-baking inequity into service design and delivery.

The solution is leadership that designs inclusively, pairs digital with non-digital options where needed, and funds training as seriously as it funds tech procurement.

Digital inequality must not be allowed to mirror or exacerbate health inequality.

What works in building digital skills?

NHS evidence and research shows that staff know their own limits and prefer learning that is contextual, practical and peer-led.

That is why digital champions models are proving so effective.

Trusts such as Sussex Community NHS Foundation Trust, Black Country Integrated Care Board, the Midlands Partnership University NHS Foundation Trust and University Hospitals Plymouth NHS Trust have built programmes where motivated individuals provide hands-on support to colleagues.

These initiatives improve confidence, data quality and system adoption. Imperial College Healthcare has gone further by launching a data literacy programme, enabling clinicians and non-clinicians alike to translate data into service improvement.

Primary care offers another angle with the fact that supporting the public and showing less digital literate citizens to use the NHS App or NHS 111 directly reduces unnecessary GP visits.

Health Innovation North East and North Cumbria demonstrated a five percent increase in NHS app uptake, which might sound modest, but scaled across tens of millions of people, it has a profound effect on productivity.

When it comes to evaluating success overall, the most powerful single indicator is digital confidence.

Confidence correlates strongly with competence and is a practical measure of whether people feel able to use the tools they need safely and effectively.

It also tracks with retention and wellbeing, making it both a clinical and workforce metric.

The role of AI in both learning and practice

AI is not only a tool that clinicians must understand and use in the workplace, in turn it can transform learning itself.

Adaptive tutoring systems already exist in mainstream education and can guide individuals toward understanding, rather than spoon-feeding answers.

Within the NHS, there is active exploration of how assistants embedded in Microsoft Copilot and similar systems could help staff learn in real time.

However, enthusiasm must be tempered with caution.

Generative AI is convincing even when it is wrong, and without clear boundaries it risks teaching unsafe practices.

Used responsibly, it could be the most effective training partner clinicians have ever had. Used carelessly or incorrectly, it could be extremely dangerous.

Making digital literacy core

Digital literacy is not a qualification to earn once and forget, the pace of technological change is too fast for that.

For clinicians, continuous learning including short bursts, peer support, contextual problem-solving, and ethical experimentation with AI must become the norm.

Leaders must create the space and time, and provide the structures to make this possible, rather than assuming staff will learn in their own time.

It is a clinical competency on par with communication or team-work and the NHS cannot afford to treat it as optional when patient safety, workforce wellbeing and health equity are at stake.

We know what works and the NHS should invest in people as much as in platforms, scale digital champions, measure confidence, and design inclusively.

Digital tools are here to stay.

Our responsibility is to ensure clinicians are ready to use them safely, confidently and creatively, and to help shape what comes next.

When we embed digital literacy at the heart of clinical training and practice, we not only protect patients, we are also equipping the NHS for the future.

James Freed is Deputy Director for The NHS Digital Academy, NHS England. He will be joining a discussion panel on the topic of rethinking digital literacy for clinicians at BMJ Future Health on 6 November 2025.