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

Been and gone

It’s just five months since NHSX came into being, but already more than half of a team tasked with the digital transformation of the country’s health system has left.

Over the space of a month, five members of the digital transformation team — including director Sam Shah — have departed, which NHSX says is due to their contracts ending.

It is now unclear what will happen with the dozens of projects the team was working on, including the digital transformation of urgent and emergency care, and whether the roles will be filled again.

NHSX says the remaining four members of the team will pick up any ongoing work “where appropriate” and staffing needs are being reviewed “with the aim of driving value for money and reducing reliance on external contractors”.

The team’s dwindling numbers contrast with comments made by NHSX’s head of digital transformation, Ben Showers, in a blog post written in July, just after the unit was launched.

Mr Showers encouraged potential candidates to apply to work in the team, which he stated “will be growing rapidly and extending support to the digital transformation of the NHS”.

Since Matt Hancock first announced plans for NHSX at the beginning of the year, there has been a lack of clarity over exactly what projects the unit is working on.

And the recent departures from a team charged with the overhaul of digital in the health system has raised further questions over the unit’s sustainability.

Return of the Mack

Integration may be the name of the game at the moment but, according to ex-NHS Improvement chief Jim Mackey, NHS staff care more about a sense of belonging than what it means to work in a ‘system’.

“People are worried services will get closed or rationalised, or moved to work from there to somewhere over there,” Sir Jim, current chief executive of Northumbria Healthcare Trust, told delegates at a Westminster Health Forum event last week.

More controversially, perhaps, he said leaders and organisations themselves — not only more junior staff — should be circumspect about doing everything as a system, when it could sometimes be counterproductive.

He also warned NHS leaders they need to remind themselves what their legal responsibility is and said regional plans could be seen as an “accountability avoidance measure” to “avoid the fact we’ve got a service under stress”.

As suggested by one HSJ reader: if each organisation was well-led, perhaps the system as a whole would be better off?