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

Not-so-great expectations

In stark contrast to his digitally-enthused boss, Matt Hancock, NHSX chief executive Matthew Gould has used his first salvos in the job to lower expectations on NHS IT investment.

Mr Gould, who officially started in the role as effective NHS tech tsar on Monday, told HSJ last Thursday that getting a sceptical Treasury to part with more money for NHS IT would be a big job.

Earlier that day, he told an audience at a tech conference in London he was nervous about overpromising NHS IT improvement.

When HSJ asked about the latest target to digitise NHS trusts by 2024, which was set less than six months ago in the long-term plan, Mr Gould said it was “doable” but a “stretch”.

While some quick wins would come from tech staff and board training and sweating assets, there was, Mr Gould said, an “irreducible cost” to replacing the IT systems at the scores of trusts still relying on ageing infrastructure and with warehouses of paper records.

This more sober attitude reflects the reality that there is simply not enough money in the system to fully digitise providers and, when central money is promised, it often arrives late and in a reduced state (for more, read The Download from last month).

However, Mr Gould believes he can do better at persuading the Treasury than the many who have tried (with mixed success) before him.

This is because NHSX is a new and unique beast. It corrals tech staff and powers from the Department of Health and Social Care, NHS England and NHS Improvement under Mr Gould. These combined “levers of power”, as he repeatedly called them, will allow NHSX (and specifically Mr Gould) to make the NHS’ tech case to the Treasury with one voice.

On day one, it is too early to judge whether this will work.

The project to merge three Essex acute trusts and create a new £850m beast now has a name: the “Mid and South Essex University Hospitals Group”.

The branding will likely stay whatever its future statutory form – but when will the formal merger happen?

The three trusts originally planned to merge this April but the move was recently pushed back to April 2020. The delay was partly caused by their clinical reorganisation, which has sparked some controversy and was referred to the health and social care secretary by local councils.

Mr Hancock – whose efforts appear to have shifted from his leadership bid to being wannabe PM Boris Johnson’s spokesman on Planet Earth – recently passed it onto the independent reconfiguration panel for their consideration.

The trusts are continuing to do what they can to forge ahead with the merger despite the uncertainty around the clinical reorganisation. But contingencies are sensibly being put in place should there be further delays.