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

Slow networking

The NHS has already spent more than four years trying to move off the old national IT network, N3, onto a cheaper new replacement.

But the £700m project is now six months behind expectations, putting the target to move every organisation over by August 2020 in doubt. 

The contract for N3 (provided by British Telecom) - to essentially provide internet and networking access for the NHS and much of social care - is the sort of thing health and social care secretary Matt Hancock has repeatedly riled against.

It is a long contract with a single supplier, which has been so difficult to exit that it has been extended twice, for a cumulative six years.

Last year, NHS Digital, which manages the contract, paid BT about £37m, more than any other single supplier.

The replacement system, known as the Health and Social Care Network, predates Mr Hancock’s appointment but aligns with his push for more supplier competition and shorter, more flexible contracts.

There are 17 accredited HSCN suppliers, including BT, from which NHS and social care organisations can pick. These organisations are connected through a central exchange, creating a sort of network of networks.

NHS Digital has reported that organisations which have switched have saved between 50 and 70 per cent, which suggests the NHS has been paying too much for years.

Unfortunately, the majority of organisations have yet to make the switch, with NHS Digital citing the handover between BT and new suppliers as contributing to the delays.

Mass medication

A Midlands trust is reviewing the treatment of 1,400 patients in its children and adolescent mental health services, following concerns about “inappropriate” treatment methods.

Midlands Partnership Foundation Trust says patients with autism have been treated with “medication only approaches” under the previous provider in Shropshire. It is so far unclear how many of the cases involved substandard treatment.

A common problem for learning disabilities and autism is they are often mistaken for mental health illnesses, and then “treated” with psychotropic medication as a result. One way to tackle the issue, some suggest, is by improving the education and understanding of learning disabilities and autism within the NHS.

You wonder whether the issues in Shropshire would have been picked up at all had a new provider not taken the service over. And could there be other areas across the country with a hidden list of patients being treated with inappropriate methods?

Some readers have suggested the issue is widespread, with one even suggesting it was so common the Care Quality Commission should launch a thematic review.