Daily Insight: Regulate to innovate

The national programme for IT, Paperless by 2018, global digital exemplars, digital aspirants – these are just some of many attempts to digitise the health service in the past.

To that list we can now add the imaginatively named Plan for Digital Health and Social Care, which is essentially the government’s roadmap to how it aims to digitally transform the health service.

Launching the plan, health and social care secretary Sajid Javid reiterated his view that the NHS must move from being “Blockbuster in the Netflix era” to a modernised healthcare system that maximises the opportunities presented by technology and innovation.

The plan contains some new digitisation targets, including a new requirement for integrated care systems to have population health management platforms in place by 2023.

But potentially the most significant line for chief executives of integrated care boards and providers was the suggestion that digital improvement may soon be added to the conditions which trusts and ICSs have to legally meet as part of their operating licence.

In other words, the government wants to change regulation to push digital transformation further up local priority lists.

A consultation with system leaders is planned, but – whatever they say – a brave new world lies ahead.

The biggest table in the world

ICSs are determined to ensure there is sufficient representation at the “table” – but how much is too much?

Penny Dash, chair designate of North West London’s ICB, believes she has the “biggest table in the world”.

However, she believes NHS England are right to question whether ICBs such as hers can be run effectively at its size.

She told a Public Policy Projects event this week her table had “about 30 seats” but there were “many, many, many people frustrated” that they did not have one around it.

Dr Dash said: “NHSE, I think rightly, are really starting to question [whether you] can you be an effective unitary board, really taking appropriate responsibilities for spending, five or six billion pounds of public money in order to improve the health of the population and everything else, with a board of that size.

“I think they are right to challenge that, so this is going to be really difficult.

“What I do think we absolutely need to do is make it really, really clear where all those voices fit in.”

The former McKinsey partner believes her role is to provide clarity but does not have the “magic solution”.