NHS Digital Transformation of Screening

Rating: The programme’s Delivery Confidence Assessment (DCA) rating remains Amber, reflecting the challenges associated with the scale and complexity of the transformation, while confirming that its objectives remain achievable. Since HM Treasury approval of the Programme Business Case in July 2023, the programme has made significant progress in modernising national screening services. Key milestones met include the introduction of digital communications for cervical and bowel screening programmes, and progress towards digital breast screening and human papillomavirus (HPV) self-testing. IPA/NISTA gateway reviews in 2025 and 2026 confirmed that delivery remains feasible. The programme is within budget and continues to progress toward its goals of improving screening safety and participation, modernising technology, and delivering more efficient, innovative services.

Schedule: A Programme Business Case (PBC) Addendum extended spend approval to March 2026, to allow time for the full PBC refresh following the 2025 Spending Review. Delivery has progressed well, with new digital services for cervical, and bowel screening deployed, and services such as Manage Breast Screening. The programme is now transitioning to be part of the wider Transforming Patient, Public and Staff-facing Services programme from April 2026, which will retain existing organisational and governance arrangements to support continued delivery.

Cost: The original WLC estimate set in the original 2023 PBC, with one off cost spend due to end March 29. This was updated in the PBC Addendum to a one off cost spend ending in Mar 26, which reduced the WLC. This reflects the decision to replace the DToS programme with a new, larger programme that included investment for screening alongside other areas of investment.

Source: NISTA Major Projects Annual Report 2025-26 (data)

Rating: Compared to financial year 23/24-Q4, the Infrastructure Project Authority's Delivery Confidence Assessment rating at 24/25-Q4 increased from RED to AMBER. This is primarily due to the following factors‚ the programme having now commenced delivery with new digital products being developed, tested and scaled. There is work in progress to secure future funding beyond 2025/6 and agree a commercial approach for technology and other partners beyond 25/26.

Schedule: Compared to financial year 23/24-Q4, the project's end-date at 24/25-Q4 increased from 30/03/2033 to 31/03/2033. This is primarily due to the following factors‚ This a 10 year change programme to deliver digital transformation of all the national screening programmes. Following the Programme Business Case (PBC) approval in July 2023, lengthy commercial approval processes meant the mobilisation of the strategic delivery partner/supplier did not start until early 2024 and was only fully mobilised in June 2024.

Cost: Compared to financial year 23/24-Q4, the project's departmentally agreed Whole Life Cost at 24/25-Q4 (measured in £m) decreased from 113 to 106. This is primarily due to the following factors‚ The programme Baseline Whole Life Cost is currently 108.69 (£m). The forecast cost is £250.69.The forecast expenditure is aligned with the spending review, February 2025, to include costs up until 2028/29. This a bid only, however this won't be known until the funding allocation for the next spending review period is confirmed. The funding up until 25/26 is confirmed.

Source: NISTA Annual Report 2024-25 (data)

Rating: The Senior Responsible Owner's Delivery Confidence Assessment rating at 23/24-Q4 is Red. This is primarily due to the following factors. The programme continues to report Red although significant progress has been made, transitioning the programme into its delivery phase. The initial Statement of Work with the screening delivery partner was approved and has begun. From the end of January 2024, teams have been onboarding and teams are now fully mobilised._x000D_ _x000D_ _x000D_ Over the coming months the following actions are planned to further improve the RAG rating:_x000D_ -Confirmation of 2024/25 budget for the programme_x000D_ -Development of the Release 0 detailed delivery plan completed and pilot locations agreed_x000D_ -Design and build of CaaS Integration Service to transition the cohorting service for Breast Screening and Diabetic Eye Screening_x000D_ -Plan and scope outlined to utilise Breast Screening Select to support DToS Releases_x000D_ -Continue to monitor the progress of SoW approvals and push for prompt sign off at each stage

Schedule: The project's end-date at 23/24-Q4 is 2033-03-30. This is primarily due to the following factors. The project's end-date at 23/24-Q4 is schedule to finish on 30-MAR-2033. This is the date of the programme lifetime, the programme is a 10 year planned programme to deliver digital transformation to other screening services, not just the Breast and Diabetic eye that is mentioned in the current reporting. As per the options discussed in the current PBC there is remaining services that will benefit from Digital Transformation, AAA, Bowel, Lung, Grail, AN + NB, Cervical) and prioritisation of these will take place in further options appraisals in the following PBC's that will be presented to HMT

Cost: The project's departmental-agree Whole Life Cost at 23/24-Q4 is 113m. This is primarily due to the following factors. Baseline whole life costs remain in line with the latest approved business case

Source: IPA Annual Report 2023-24 (data)