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

The chair nobody wanted

The new chair of NHS England, it was announced today, will be the Tory peer Lord David Prior. The name will be familiar to followers of the NHS’s upper echelons (having previously been a health minister and chair of the Care Quality Commission), as well as to keen readers of The Sun.

Lord Prior is what you’d call a reformer and is not one to keep his occasionally controversial views to himself – the Labour party has kindly distributed a handy list of some of them, suggesting the peer might get a rough ride from opposition members of the Commons health committee in his imminent pre-appointment hearing.

Yet, Lord Prior is not easily characterised and is no classic Tory headbanger.

He’s been an enthusiast for international hospital chains taking over our beloved district generals; and suggested an inquiry into future healthcare may be necessary, given no one knows how to pay for the NHS. Yet, he said early on that competition and markets had little role in the sector.

Perhaps his most obvious flaw is understatement, having described the medical profession as “a bit dysfunctional” and Brexit as “a terrible mistake”.

One serious question as he comes into the job is will he want to get stuck in to making strategy and policy, and delivering the message – something Simon Stevens as chief executive has largely had to himself in NHS England’s Skipton House HQ.

Another challenge is that – in the nicest possible way – he is the chair nobody actually wanted. Government, officials and NHS leaders would much rather see NHS England and NHS Improvement joined at the top, but lawyers said it was not possible under current legislation to install NHS Improvement’s Baroness Dido Harding as NHS England chair too.

Many people would like to see that legislation changed as quickly as possible. Do these people include Lord Prior? He’ll surely let us know pretty soon.


AI and the NHS

As more and more NHS trusts partner up with tech companies to use patient data, the Department of Health and Social Care has released a new “code of conduct” for managing the relationship, particularly when artificial intelligence is involved.

Health minister Lord James O’Shaughnessy revealed this code at Health and Care Innovation Expo in Manchester on Wednesday, calling it an “important step towards creating a safe and trusted environment in which innovation can flourish”.

The code, which is voluntary, covers everything from telling NHS organisations to get fair compensation for commercial access to data to ordering NHS Digital to create a new national registry of how artificial intelligence is used in the NHS.

It is light on details and poses as many questions as answers, but further guidance, particularly around commercial relationships, is expected in the months to come.

The code also acknowledges, not for the first time, that getting good (or any) tech into the NHS is hard and made harder by a confusing approval regime, handled across multiple agencies.

Part of the solution, according to the code, is a “more rigorous and sophisticated” approval scheme for NHS technology, which is both easier for suppliers and NHS commissioners alike.

That is a laudable ambition and follows concerns raised with HSJ earlier this year about the fragmented nature of the current system.

However, there remains little detail on whether this will entail replacing current systems, such as NHS Digital’s app library assessment or Medicines and Healthcare products Regulatory Agency’s medical software registration, or simply add to them.