The must-read stories and debate in health policy and leadership

Ticking the box

There are growing signs that the NHS could be in for a sizeable technology funding boost as part of the long term financial settlement.

Speaking at an event, NHS England director Matthew Swindells gave an outline of where that money, if it arrives, could go and what strings might be attached.

The existing priorities around digitising secondary care (the unfinished business of the National Project for IT), improving data use, building patient digital services, and connecting IT systems will remain.

But there will be a growing emphasis on the last of these priorities so that information about a patient follows them regionally across providers.

Mr Swindells said NHS England is already rejecting trusts’ bids for funding or approval of IT projects that fail this test by focusing too much on their own organisation’s needs.

Mr Swindells has also said that regions that want to access any new tech money (and whatever money is left from the last tech fund), will need an IT strategy that ticks this integration box.

Whether this means a whole new round of document writing, or just tweaking the digital elements of existing “sustainability and transformation plans”, is unclear.

But what does seem clear is that there will be little patience, or money, for NHS providers determined to do their own thing when it comes to technology.

Capital ambitions

The health secretary’s top property adviser’s warning that the NHS must not waste extra funding on maintaining “decrepit old buildings” comes with huge decisions to be made around the health service’s capital ambitions.

NHS estates tsar Sir Robert Naylor told an audience at the Health Plus Care show in London yesterday that it was crucial the NHS avoid repeating the spending mistakes of the New Labour years.

“What we need to ensure is that we don’t make the same mistakes that we made during the Blair government and simply pour that money into increasing salaries of staff or into new nice things to do or have,” he said.

“Blair’s government wanted money for reform and that’s got to be the mantra for this government as well but we’ve got to use this money in a much more efficient and effective way.”

The prime minister’s £20bn five year funding announcement this month has given system leaders a modicum of certainty about what they have to play with in terms of revenue. But, while there has been much talk of a 10 year capital plan, there is yet to be any substance.

The decrepit, old buildings Sir Robert talks of are commonplace across the NHS, as years of neglect and questionable capital to revenue transfers by the Department of Health and Social Care have caught up on the NHS’s crumbling estate.

The government’s long term capital plan must be radical and genuinely transformative to address this. It cannot simply be a patch up job of a tired, dilapidated estate not fit for purpose for practicing 21st century medicine.