The fortnightly newsletter that unpacks system leaders’ priorities for digital technology and the impact they are having on delivering health services. This week by senior correspondent Nick Carding.

You might think now is the time for stable leadership in the NHS tech sphere, to build on the innovation delivered during the pandemic. But the opposite is unfolding.

When news broke last month of Tim Ferris’ appointment as NHS England’s new director of transformation, it marked the beginning of yet another era for technology in the NHS.

All change

For readers who missed the story, Dr Ferris will move from his current role as CEO of the Massachusetts General Physicians Organization to the full-time role of heading up NHSE’s new transformation directorate.

This matters to the NHS tech community because it is this transformation directorate which will hold ultimate power and control over national tech policy and delivery in the NHS.

It’s barely been two years since NHSX was created with a similar brief — albeit with more of a focus on policy than delivery — but the new directorate’s creation partly represents Sir Simon Stevens lassoing back control over tech from Matt Hancock.

As HSJ exclusively revealed in February, the directorate will become NHSX’s new home as national leaders aim to capitalise on the tech innovations rolled out during the pandemic.

Given that tech leaders have long banged on about tech needing to be seen as a core function of transformation — rather than one of many different ingredients — the move appears to make sense.

It also suggests that creating NHSX as a joint agency of the Department of Health and Social Care and NHS England which floated somewhere between the two bodies was more about enabling Mr Hancock to seize control of the tech agenda than having genuine transformational merit.

That said, sources report NHSE’s leadership is (unsurprisingly) now far more interested in tech and its potential than prior to the pandemic. Put crudely, the battle to put tech higher up on Sir Simon’s agenda has been won and the new directorate’s birth can be seen as proof of this.

NHSX diminished

At this point, it’s worth noting that it’s hard to see Dr Ferris’ appointment as anything other than a stifling of NHSX’s direct influence over the big names.

Instead of reporting to Sir Simon, it looks like NHSX CEO Matthew Gould will instead be reporting to Dr Ferris – who, in turn, will report to Sir Simon. But Dr Ferris will also inherit the improvement team led by Hugh McCaughey, which could lead to NHSX having to jostle for attention.

One thing is certain — NHSX will need to justify its work to Dr Ferris, and a good start would be to complete long-overdue strategies on best practice and funding digital innovations, both of which have been held up by the pandemic. While the unit has had some successes during the pandemic, such as simplifying information governance guidance and helping the roll-out of virtual wards, we are still to see strategies spelling out the overall plan, which was ultimately why NHSX was created.

Big job 

There is also change over at NHS Digital. Its CEO Sarah Wilkinson has announced her departure from the organisation in summer, with no replacement confirmed — though HSJ reported last month that NHS Test and Trace chief information officer Simon Bolton was a leading candidate.

NHS Digital appears to have had a relatively successful pandemic, having built a raft of new covid-19 solutions and strengthened existing infrastructure services such as NHS 111.

But with uncertainty lingering over how the organisation’s workload can be maintained and developed, and what role it can play in the NHSE directorate’s plans, there will be much to take on for Ms Wilkinson’s replacement.

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