Executive Summary: Are you the NHS's next rock star?

Techno, techno, techno

Bob Wachter, the US digital health expert leading a government backed review of the NHS’s digital capabilities picked, perhaps unwittingly, a pertinent moment to give HSJ his first in-depth interview.

During a wide ranging interview on his review, which reports in the summer, Professor Wachter gave a firm steer that he may call for a substantial shakeup of the role of chief clinical information officers.

Their US counterparts enjoy  “rock star” status and significant influence in their hospitals, he said, while in England they are given little resource and influence and this is a “striking deficiency” of the NHS system.

His review group was “grappling” with several “overarching challenges” including clinical engagement; financial and regulatory incentives; and the balance between central and local leadership.

No sooner had he finished his discussion with HSJ last week, than word was spreading that Jeremy Hunt was to make a significant technology announcement on Sunday.

The health secretary’s announcement, that the government is to spend £4bn over this parliament on technology, involved no new money for health from the Treasury, and no substantial explanation on what all the constituent parts of the £4bn were.

The announcement did, however, indicate funding allocated to technology projects from within the NHS’s existing spending envelope is to increase. Mr Hunt said that £1.8bn was now being earmarked to “create a paper free NHS”.

Details such as how it compares to previously announced funding, and the source of the money, remain unclear but this is the largest figure so far linked to the paperless ambition.

It appears to be an increase on the commitment in the spending review to spend £1bn by 2020-21 on the digital drive.

Lord Carter’s efficiency review, published last week, also had an interesting digital proposal with an American flavour. The Labour peer recommended NHS system leaders put a US style “meaningful use” clause into provider contracts to require hospitals to meet key digital standards by October 2018.

The concept is to encourage hospitals to demonstrate that they are using their technology to its full capability, not just simply deploying systems without getting staff fulling acquainted with their potential.

Professor Wachter’s review – which is ultimately about trying to provide the safest healthcare in the most cost effective way – will also likely address similar issues.

The early indications are that the review is likely to provide some thought provoking recommendations, especially if you’re a clinical leader.

Everything in its right place?

Last week the CQC published its first “place based” care quality report, for north Lincolnshire.

The report is part of a new approach to health and care regulation which the watchdog hopes to pioneer over the next five years. The argument goes that with new care models emerging that span different sectors, and with most patients coming into contact with more than one provider, it makes sense to assess quality across an area rather than just within institutions.

As the report notes, place based assessment could become a useful way of holding to account and regulating “accountable care organisations” – providers which are responsible for the health outcomes of a defined population.

However, the success of the initiative will ultimately rest on how insightful local health organisations judge the assessments to be, and how effectively they can be used to drive change within local systems. The north Lincolnshire report, which ranges from banal (providers are “broadly in line with the national picture”) to incisive (a lack of clarity could jeopardise the region’s joint strategic plan) is a good place for the CQC to start.