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

Doomed to repeat?

Well, here we go again.

Local health systems will be told to draw up new five year plans, once their beefed up funding allocations have been confirmed.

These will replace the previous five year plans that were drawn up by Sustainability and Transformation Partnerships in 2016, which quickly unravelled once everyone (including the government, eventually) realised there simply wasn’t enough money to deliver them.

There is more money this time, which means the efficiency challenge is broadly half that of the previous plans. But the extra investment will need to be spent extremely wisely.

As Nigel Edwards, chief executive of the Nuffield Trust, warned at an evening event yesterday, the NHS often seems “doomed to repeat” the failures of the past.

He said: “One thing that always struck me about those implementing the next reforms is their absolute certainty that they know the answer. And we never seem to evaluate those reforms.”

Wolves at the door

The chief executive of a relatively high performing trust has let rip on his struggling neighbour.

David Loughton, of Royal Wolverhampton Trust, accused Shrewsbury and Telford Hospital Trust of “poor planning” in relation to its proposed closure of Telford’s emergency department overnight.

Mr Loughton, who described himself as “pretty angry”, claimed Shrewsbury missed opportunities to address the workforce issues in it’s accident and emergency two years ago, and is worried about the impact it will now have on his own organisation.

Head in the cloud

Health and social care secretary Matt Hancock elaborated further on his enthusiasm for all things digital on Wednesday, by publishing a “tech vision” for the NHS.

The document included a few details that fleshed out an emerging NHS IT strategy based around strictly enforced national standards and (relative) local flexibility.

For the first time, Mr Hancock said NHS digital services and data should shift from servers within trusts to “the cloud” (ie online).

If implemented universally, this would be a big (and costly) shift of NHS IT from locally owned hardware to massive data centres owned by the likes of Amazon, Microsoft or IBM.

Much of the vision was focused on changing the relationship between the NHS and IT suppliers, with the inference being that the former has been locked into big expensive contracts for too long, stifling innovation.

According to the vision, the standards, which include requirements around the free and secure flow of information, will be weaved into NHS regulation, with the intent to shut out suppliers that do not meet this bar.

How this will work in practice, particularly for IT suppliers already deeply entrenched in the NHS, remains to be seen.