Our new health and social care secretary is a self declared enthusiast of all things digital. Technology correspondent Ben Heather examines his first speech and what it could mean for the NHS.
Matt Hancock revealed his three “early” priorities via a tweet the night before his first speech.
Appropriately, technology was one of them.
During the speech itself, the secretary of state spent about 10 minutes on digital technology in the NHS and why it was key to saving and improving patient outcomes (you can download the full speech through the Matt Hancock app and, if the mood takes you, watch the secretary of state learn parkour and play street cricket in Mumbai).
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In many ways, his speech comes straight out of NHS England’s handbook, but in a few areas it went further.
While he praised “pockets” of local innovation during his speech and expressed “frustration” about patchy take up of technology, he also argued for the expansion of digital provider GP at Hand despite clinical commissioning group and NHS England reservations.
Here is what the new health and social care secretary said, and what it could mean for the digital agenda.
“The entire £20bn proposed for the NHS will be contingent on modern technological transformation.”
This in an important, if fluffy, statement, and goes further than hints dropped by his predecessor.
On the face of it, it suggests that money will be ring fenced for digital technology as part of the long term plan but also that access to the new funds could be contingent on deploying the “very best” technology.
The latter would chime with noises coming out of NHS England last month, that organisations that want central funding, or even approval, for IT projects need to tick the right boxes, particularly around integration and sharing patient data within their region.
Asked by HSJ for clarity after the speech, Mr Hancock said: “The £20bn is in return for a long term plan for the NHS, which we are going to deliver. The long term plan will have the adoption of the very best technology embedded in it.”
With every tech fund since the inception of NHS England raided for other purposes to a greater or less extent, a health secretary declaring technology central to the whole plan is encouraging.
However, there will also be nervousness about what strings will come attached to any support, and how sensitive (or not) they may be to local complexities.
“In every other sector innovation reduces waste and drives cost down not up. We’ve got make happen across the health and care system too.”
There are plenty of explanations for why the NHS is not so great at this (at least at scale) including but not limited to: the IT supplier market, a lack of staff and/or executive buy in, insufficient funding, the internal market, a lack of digital skills.
The Wachter review of NHS IT also pointed out that research shows it typically takes a decade to bank the efficiency gains from an IT investment in most industries and, in the short term, it often creates more work, not less.
By that measure, money spent during the National Programme for IT should only now be bearing fruit.
Mr Hancock will probably focus on driving technology uptake in a few select areas where there is already a strong case for improved outcomes and savings. The most obvious of these are e-referrals and electronic prescribing – the latter of which can, if done properly, halve medication errors.
The secretary of state did announce (or rather reannounce) £75m for electronic prescribing during his speech. NHS England has said from October hospitals won’t get paid for referrals that are not electronic.
Other areas likely to get the carrot and/or stick treatment include staff scheduling, data quality, and electronic bed tracking.
“I’m crystal clear that suppliers who drag their feet or threaten to stand in the way won’t be suppliers for long.”
Mr Hancock’s warning aligns with several NHS leaders (Matthew Swindells and Simon Eccles most prominently), and some frustrated SMEs, that have grown increasingly bellicose about uncooperative IT suppliers.
The argument is that some incumbents have been slow to provide other suppliers with access to patient data on their systems.
This foot dragging is being partly blamed for holding up the flow of data for planning and care across the NHS and stifling new market entrants wanting to develop innovative digital services.
The public language has become stronger as several new/revised IT frameworks are being hashed out. The centre hopes the agreements will compel suppliers to mend their ways. However, Mr Hancock’s predecessor, Jeremy Hunt, had thus far refrained from adding his voice.
Having the secretary of state publicly call out suppliers will be welcomed by many in the NHS, but it’s unclear how it will actually help.
Previous national IT contracts have contained similar provisions intended to force suppliers to share data with limited success.
And given that large swathes of the NHS remain highly dependent on some of these systems, switching supplier en masse is not a realistic option.
“I am delighted to announce a half billion pound package to help jump-start [the] roll-out of innovative technology to improve patient care for patients and supporting staff.”
Broken down, this is £412m for technology spending allocated by sustainability and transformation partnerships and £75m for e-prescribing through to 2020-21,
None of this is new money. The STP fund was approved by the Treasury last month but comes from funds agreed back in 2016, and the e-prescribing money was first announced by Mr Hunt back in February.
Neither is it particularly clear how and when the money can be accessed (although a DHSC spokesperson said it would be on a “fair allocation” basis).
Any additional funding specifically earmarked for digitalisation should be welcomed by regions trying to join together a patchwork of hundreds of IT systems, but it is likely to come with tight strings attached.
“I hope that in my time as health secretary the NHS will no longer be buying any fax machines.”
So did Jeremy Hunt…