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

Hancock intervenes, CQC retreats

One of the first indications of how Matt Hancock would approach his new job as health and social care secretary came when he intervened with a relatively obscure IT contract. 

The Department of Health and Social Care had been rumbling along on developing a replacement for the central IT contract for more than a year before Mr Hancock’s arrival.

Atos had been providing desktop IT to DHSC, NHS England/Improvement, the Care Quality Commission and the Health Research Authority for years and discussions for a replacement were all at an advanced stage.

However, Mr Hancock, as he has since made clear, does not approve of big, long IT contracts. In August, he ordered a halt to work on a replacement contract and a review that would explicitly consider switching to Google, as opposed to Microsoft, software.

Following the intervention, several organisations involved raised concerns about delays to the project. 

As recently revealed by HSJ, in November the CQC decided to opt out of whatever resulted from Mr Hancock’s review, saying what was proposed no longer met the organisation’s needs and it would be doing its own thing. 

The CQC said the decision was not connected in anyway to Mr Hancock’s intervention but the timing, after more than a year working on the joint project, is curious.

Meanwhile, the review has led to significant changes to the replacement contract. Rather than one mega IT contract, there will be many small ones. And, yes, central bodies will now be able to try Google.

Twisting your ALBs

How long is an arm? If you are an arm’s length body in the NHS, you might be forgiven for feeling the answer is “not long enough”.

The Department of Health and Social Care’s communications director has “reminded” ALBs that pretty much anything said to the outside world which touches on Brexit needs to go through an approval process. That’s not only press releases but also tweets, emails to suppliers and even phone calls with the public.

It’s not just DHSC officials overseeing these communications either – in some cases, ministers and the Department for Exiting the EU are involved as well.

The impetus for the DHSC’s latest reminder of this was a tweet, which was not run past DHSC, from NHS Blood and Transplant Authority about blood donor sessions in Dover being moved during the period around Brexit. A reasonable response to the forecasts of traffic chaos, you might think, but this operational decision was later overruled by the DHSC. Red faces all round.

This grand scale micromanagement points towards an intense nervousness in Whitehall and among ministers about how the risks of Brexit are conveyed to the public. While there is nothing to suggest clinical commissioning groups and trusts are being asked to go through a similar approval process, many of them have been pretty quiet on the detail of their plans to deal with Brexit consequences.

That’s true even in Kent, which is expected to bear the brunt of the impact on traffic if there are delays at ports. Kent Community Health Foundation Trust was unusual in revealing some staff could be asked to sleep at their workplaces or work out of their nearest site.

With less than 50 days to go until Brexit, sleep may be hard to come by for some of those planning for a no-deal scenario.