Daily Insight: Digital revolution delayed, and DH officials squirm

Welcome to the future

The Health and Care Innovation Expo kicked off on Wednesday – a two day tech fest for the health service’s disruptors, change makers and blue sky thinkers.

Jeremy Hunt, Simon Stevens and US digital doctor Professor Robert Wachter were among the speakers on Wednesday, but most of the important policy announcements had been revealed before the Manchester Central had opened its doors.

Professor Wachter’s much anticipated report into IT in the NHS had some stark warnings for ministers: get rid of the “unrealistic” target for a paperless NHS by 2020 (he suggested 2023 “as a reasonable date to have robust clinical information systems in all NHS trusts”); and the funding for such a project needs to almost double, from £1.8bn to £3bn.

Mr Hunt’s reply was also heavily trailed. He called the Wachter report a “sobering but important read” and said the huge variation in hospital IT systems was not good enough for the NHS. In response, 12 trusts will receive funding of up to £10m each to fast track digital innovation and act as “global exemplars”; universities will compete to host the first ever NHS digital academy; and NHS Choices will be revamped, among other measures.

But he did reveal he wasn’t entirely sure he was going to be health secretary after Theresa May became PM this summer. Him and the rest of us.

The NHS England chief executive’s speech wasn’t previewed, but in the Q&A afterwards that Mr Stevens was more candid. He warned that upcoming five-day strikes by junior doctors would be “no good for patients” and no matter how long the notice period, “it will not be possible [for the NHS] to ensure there will be no harm to patients”.

He also said NHS England would set out its expectations for public engagement and consultation on sustainability and transformation plans next week. About time too, since STP leads have been discouraged from publishing draft proposals by NHS England officials.

The prime minister also had to defend the STP process at PMQs. “They should be locally driven and take into account concerns and interests locally, not just of CCGs but of local authorities and the public,” Theresa May said.

So there was plenty of futuristic stuff on day one for delegates to discuss at the Expo bars.

But the biggest talking point of the day was much more lo-fi: Simon Stevens’ new beard, cultivated while on holiday on a boat in the Russian Arctic (NB: You heard about it first from HSJ.)

Awkward afternoon for DH officials

A set of Department of Health officials had the awkward task on Wednesday afternoon of explaining the “incredibly convenient” admin error in the 2015-16 annual accounts.

The error, which boosted the DH revenue position by £417m, helped avoid a humiliating process in which the department would have been forced to ask Parliament for more money.

DH permanent secretary Chris Wormald, along with finance chiefs David Williams and Andrew Baigent, appeared before the Commons public accounts committee, whose members had worked themselves into a lather over the timing of the accounts, as well as the infamous admin error.

The trio all insisted the error was a genuine mistake, rather than a sneaky ploy to (sort of) balance the books, but Norfolk MP Richard Bacon was having none of it: “Are you honestly asking us to believe that it was all accidental and nobody noticed?”

Given the desperation (and significant resources) with which the DH and all NHS bodies tried to find every possible revenue saving last year, Mr Bacon probably reflected the thoughts of most observers.

Meanwhile, committee chair Meg Hillier had come prepared with a good soundbite, saying “all of this makes us think these accounts are rotten”, to which Mr Wormald replied that they were “unqualified” by auditors.

The money men from the DH will want to avoid a similar squirming session next year, but the money situation in 2016-17 doesn’t look too much brighter.