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

Not cut, deferred

Once again, a sizeable chunk of funding to help NHS providers improve their digital technology has not made it to the frontline as planned.

NHS England has confirmed its latest tech fund – the £412m “health system led investment fund” – spent about a third less than planned in its first year.

The national commissioning body has stressed this is not funding cut, but funding deferred until next year. It also argued the reason the money didn’t make it out the door was because local NHS organisations didn’t get organised in time.

That is probably true in several instances and certainly in one area – Dorset Integrated Care System confirmed local disagreement had prevented it from accessing the fund last year. NHS England has not said which regions missed out on the money, so it’s not possible to ask those areas why they believe the funds have been deferred.

But it is hard to ignore a recent history in which every major NHS England tech fund has been cut to a greater or lesser degree. These cuts were not, for the most part, made because of local disorganisation but because the centre diverted the money to pay for more urgent concerns. Tech funding deferred was also not, in most cases, carried over. More typically, cuts were followed by more cuts.

By some accounts, distributing the health system led investment funding had already been delayed by nearly a year by the time the new health and social care secretary Matt Hancock announced it in his maiden speech in July last year. Now, for some, it will be delayed for a further year again.

One commenter on HSJ’s story said they had been told the money was being held back to “ease NHSE/ DHSC finances”. That explanation would be more in keeping with the pattern in past central tech funds; announced and then subsequently lost in transit to the NHS frontline.

Defending HEE

In his first interview as chair of Health Education England, Sir David Behan has spoken candidly about the need for less fragmentation and more collaboration between the arm’s-length bodies when it comes to workforce planning.

The former Care Quality Commission chief said he was surprised by the fragmentation of workforce development, adding it is simply too important an issue to let this continue.

Sir David recognised some trusts’ leaders hold animosity towards HEE – but he stressed this is not a broken organisation, in contrast to the CQC, which he said was in a perilous state when he first joined.

He called for HEE to be clear on its purpose – and indicated that if it can’t do this it will fail.

Sir David also revealed the continued professional development cuts were not as straightforward as they seem. He described a “trade-off” between paying for training and paying for nurses, in which training lost.

Maybe, just maybe, with a new advocate in the midst, HEE won’t have to make this trade-off again.