Today’s must read stories and talking points

Cyber insecurity

Since the end of the National Programme for IT, the NHS has developed a reputation for not spending quite as much as it planned on technology.

On Tuesday, HSJ reported that the last major tech fund that was announced, in February 2016, was not flowing out to the system as expected.

In 2016-17, central NHS technology (which largely means IT systems) spending was £256m less than planned, equivalent to about a third of planned expenditure.

The signs point to another underspend this financial year and the Department of Health and Social Care has said tech money not spent as planned is fair game for diversion to alleviate “pressures” on other parts of the system – and there are plenty of those.

However, tech projects are not just competing against huge provider deficits and heaving accident and emergency departments for money.

They are competing against a growing realisation that the NHS has not been spending nearly enough on cybersecurity.

In the wake of the WannaCry ransomware attack in May 2017, an NHS England review has recommended that the NHS needs £1bn to get up to speed on cybersecurity.

The review is not yet published and NHS England has played down the headline figure, claiming it was the product of an “early draft” and did not account for existing spending across hundreds of NHS organisations.

However, even if the eventual net figure is substantially lower, tech spending elsewhere will have to be cut, probably by hundreds of millions, to make room.

NHS England and the DH are still trying to lever more capital for cybersecurity out of the Treasury but HSJ understands that even in a best case scenario, belt tightening around existing tech projects will be necessary.

This should mean some additional capital funding for local cybersecurity projects – but that money will come with obligations to meet new data security standards.

Even with funding, a large portion of the cost of meeting these standards will have to be absorbed by local organisations.

Meanwhile, NHS England and DH are carefully scrutinising existing technology projects designed to support transformation of healthcare and cutting spending where they can.

Missing the target

Cancer patients in three counties are at greater risk of death than elsewhere in the country because of slow referrals and late diagnosis, HSJ’s analysis of official data reveals.

Clinical commissioning groups in Essex, Kent and Lincolnshire are disproportionately represented in the worst performers against the national 62 day target – and in many cases their performance has got worse over the past two and a half years.

The standard is for 85 per cent of patients to start treatment within two months of an urgent cancer referral. However, the worst performing areas were more than 20 percentage points below that figure in quarter two of this year.

CCGs covering populations in the South East account for 12 of the 20 worst performers nationally over the past 10 quarters.

Over the 10 quarter period for which data is available – beginning in quarter one of 2015-16 – Thurrock CCG and Basildon and Brentwood CCG had the lowest average performance at 62 and 67 per cent respectively. Thurrock also had the worst performance in the country in quarter two of 2017-18 at 61 per cent.