Daily Insight: Merger, he wrote

After months of speculation it was announced yesterday that tech units NHSX and NHS Digital would be merged with NHS England in a major overhaul of the tech landscape.

The news isn’t completely surprising given that Laura Wade-Gery was commissioned by Matt Hancock last year to review turbulent tech leadership across the NHS.

What’s probably more surprising to some is that NHSX was launched in the first place. The unit was set up by Matt Hancock two years ago to try to streamline digital innovation in the health service.

However, the move was met with confusion – as adding another unit to an already overly complicated landscape seemed counter-productive.

In a note to staff, NHSX CEO Matthew Gould said that the NHS Digital and NHSX brands would be “retired”. When legislation allows it, NHSD will move into NHS England and NHSX will “evolve” into the strategy function of NHSE’s transformation directorate.

In his letter, Mr Gould said the strategy function would be to “emphatically” continue to include “the digital transformation of social care”. He added that Sajid Javid had told him the change reflected the “huge progress” NHSX has driven, and “how we have fulfilled our mandate”.

However, while the mergers are the right thing for the NHS, “all organisational change is difficult, and sometimes painful”, Mr Gould concluded.

Accelerators stuck in reverse

We’ve not heard a great deal about NHS England’s £160m elective accelerator programme which doled out £160m to 12 local health systems to help ramp up activity and develop new care models since they were announced with some fanfare in May. 

And perhaps HSJ’s analysis of the performance data published on Monday explains why: not one of the 12 systems managed to outperform their pre-covid levels, let alone reach 120 per cent of those levels as some had pledged to do.

The research is particularly timely given ministers are set to publish their elective recovery action plan any day now.

The performance levels were of course understandable, given the unprecedented pressure the system is under and the fact that driving up activity when the workforce, which already had high vacancies, is suffering higher record sickness rates, is an uphill challenge, and a steep hill at that.

But the performance of these systems, which were backed to outperform the average levels, really lays bare the long road ahead, particularly this winter in cutting into the backlog.

Performance within the programme ranged from 97 per cent of pre-covid levels in Nottingham and Nottinghamshire, to 86 per cent in Lancashire and South Cumbria.

However, a special mention is due for Humber, Coast and Vale, which was not in the programme, for being the only system to deliver more than its pre-pandemic activity.

Lessons must be learned from what they have been doing right.

Cinderella needs a strategy, not a fairytale

Disability has been described as the “Cinderella” of the NHS, but leaders have called for it to be positioned at the forefront of national strategy.

Figures have found non-disabled job applicants are 1.2 times more likely to be appointed from a shortlisting compared to disabled applicants, while disabled staff are 1.54 times more likely to enter a formal performance management process than their non-disabled colleagues.

While there have been efforts to reduce the discrimination faced by staff, particularly through the workforce disability equality standard, some say it needs to “go up a couple gears”.

Kate Smyth and Peter Reading, who co-chair a network of disabled NHS directors, believe a long-term national strategy on disability is required to further reduce the persistent issues faced by the NHS’ disabled staff.

Indeed, the frequency of them are borne out in the WDES figures. For example, trend of non-disabled applicants being more likely to be appointed from shortlistings is one that has “not changed radically” since the previous year.

Ms Smyth and Mr Reading urged NHS England to draw inspiration from government’s disability strategy, as a long-term workforce race strategy is set to be launched soon.

How much longer can these problems persist?