HSJ’s essential round-up of the day’s biggest stories and debate

Leading by example

The money is finally flowing, and NHS England is starting to put some substance into its latest push for digitalisation across the NHS.

So far £385m has been committed to the “global digital exemplar programme”, and some money has even been paid out to trusts, with more expected by the end of the financial year.

That’s a far cry from the £12bn National Programme for IT, the last such big digital push. But, as the failures of that programme showed, money is not the most important ingredient to ensure digital success.

Instead of a massive national programme managed through slightly less massive local service providers, a collection of high performing trusts – and then health economies – will be expected to lead this new digital charge.

These exemplars act almost like suppliers to their provider peers. Indeed they will be put on a procurement framework and paid for their digital services.

Each exemplar will be act as model for digital success, with less advanced trust buying a “blueprint” of both the “exemplar” expertise and about 80 per cent of the same IT systems.

The NPfIT saw a few IT suppliers carving up the NHS and essentially giving providers no choice about which system to deploy. The latest model will allow providers to choose but from a limited, and theoretically high quality, menu.

The plan is that in the end there will be a string of trusts across the NHS that have deployed Allscripts systems like Salford Royal, or a string of Cerner sites modelled on Wirral.

However, questions remain about how this approach will work in practice.

Will exemplar organisations have the capacity, or incentives, to help other trusts, and how much should they be paid for this service?

As the national programme showed, sticking one trusts system into another can go horribly wrong. Greater choice should help mitigate this risk, but there remain questions about whether it is realistic to import 80 per cent of one trust’s approach to digital and just fiddle around the edges to account for local conditions.

If it doesn’t work, who is responsible? The exemplar, the following trusts, the suppliers?

And finally, many of the following trusts will need serious investment before they can even think about deploying an exemplar blueprint.

If each of these following trusts needed only half the £10m of central funding that each of 16 acute exemplars have been promised, that would equate to an extra £1.1bn.

That sum would only fund part of the next wave of digitalisation in NHS, and finding extra money to fund improvement beyond the frontline is only getting harder.

STP lead steps down

One of the council chiefs leading an STP is to stand down and hand the role to a local NHS service leader.

Norfolk and Waveney STP executive lead Wendy Thomson, who is managing director of Norfolk county council, said it was “the right time to hand the role on to an NHS colleague”.

The move leaves just two STPs – Nottingham and Somerset – led by council officers alone. Surrey county council chief executive David McNulty is in a group leading the Surrey Heartlands STP.

Ms Thomson will remain a member of the STP executive board and stay as lead until her successor has been appointed.

Pay talk

“Pay has dominated the NHS workforce debate since the election – taking oxygen away from other important issues that should be examined and debated in much greater detail,” writes HSJ senior correspondent Shaun Lintern.

Is pay the most important issue for nurses and is it driving them out of the profession? The only way to know is to ask some of those who have left the front line in recent years.