Daily Insight: More than just managed decline?

A better decade?

The global economic meltdown in the late 2000s was much more important for the NHS than anything that happened between 2010 and 2019 — leading to public sector austerity, which undermined many of the health service’s gains during the New Labour years.

The aftermath will go on undermining the NHS for some time, especially as the cuts to other areas of social provision on which the health service depends may now be mitigated, but not yet ended or corrected.

However, for the first time in nearly 10 years, NHS leaders can look forward over a three-year period and reasonably expect to do more — albeit only a little — than manage decline; and can also hope that a more logical and effective way of working may become a widespread reality.

HSJ editor Alastair McLellan begins the year by looking at four reasons to have hope — if only a little — for the coming months and years.

Devon divided

Anyone wanting a reminder of how badly the NHS needs new technology should look no further than south Devon, where the local hospital trust suffered a critical IT failure last September.

It’s no surprise, then, that Torbay and South Devon Foundation Trust is eager to improve its IT infrastructure, and one of the ways it hopes to do this is to use an electronic patient record.

The trust is keeping a close eye on how its neighbour — Royal Devon and Exeter FT — gets on with the daunting task of implementing its own EPR (provided by Epic), with a view to following suit with the same company.

With this backdrop in mind, Daily Insight is surprised at the reluctance of two of Devon’s four acute providers to formally commit to implementing a shared EPR — as requested by NHS Improvement in 2019.

TSDFT and University Hospitals Plymouth, which also lacks an EPR, have both signed “letters of intent”, but neither RD&E and Northern Devon Healthcare Trust have put pen to paper.

Northern Devon Healthcare Trust’s resistance is slightly understandable as the trust only went live with its own EPR in 2017, having picked Intersystems as its supplier.

The complexity of implementing such a commitment across four trusts is immense, but formally expressing support for such a move seems a logical step in line with national policy.

Maybe there is concern about the procurement implications, or maybe RD&E and Northern Devon Healthcare Trust — which share a chief executive and chair — simply aren’t ready to nail their colours to the mast yet.

Either way, it is not a great look for a health economy whose leaders were last autumn said to be “retrenching” back into their own organisations instead of tackling the key challenges collectively.