Exclusive: Hancock's 'NHSX' power grab for NHS England work

Senior sources familiar with discussions told HSJ that, if it proceeds, the new unit would represent a major shake-up of how the multibillion-pound digital transformation programme was managed and delivered.

The proposal has sparked concern among senior figures at NHS England about the impact of separating digital work from other core-NHS operational oversight, HSJ has been told.

If it does proceed, NHSX would host the lead managers for about 40 national digital transformation projects, most of whom are currently employed by NHS England, HSJ has been told. This would include NHS chief clinical information officer Simon Eccles, chief information officer Will Smart and the chief digital officer.

While talks are at an early stage, HSJ has been told the health and social care secretary wants NHSX to be based in the Department of Health and Social Care, under a director general.

Another proposal being considered is to retain the unit within NHS England but make it more accountable to Mr Hancock and DHSC.

NHSX is also likely to affect NHS Digital, the arm’s length body that collects NHS data and runs some national IT infrastructure, such as NHSmail, the NHS Spine, and the health and social care network.

When approached by HSJ, a DHSC spokesman said it was “keen to create a platform for innovation in the NHS and [to] demonstrate to innovators that this is the best country in the world to develop and deploy health tech to solve some of healthcare’s biggest challenges”.

“We are therefore looking at ways of combining expertise across the government, NHS and industry to make this happen,” he said.

He would not comment further on NHSX.

An NHS England spokesperson said: “We are completely supportive of the approach being developed with DHSC to align national NHS work on technology and information, and agree with the approach which the secretary of state will soon be setting out.”

Mr Hancock has made improving digital technology in the NHS a major focus since he was appointed in July last year. He has repeatedly criticised the poor state of NHS IT and supported digital health companies, such as Babylon Health, seeking to disrupt the status quo.

However, HSJ has been told Mr Hancock has been frustrated by the limits of his influence over the NHS digital strategy.

DHSC, NHS England and NHS Digital all have big roles in developing NHS IT but the lines and responsibilities between each organisation are not always clear.

NHS England is currently leading on the IT strategy for the NHS, sometimes called the digital transformation programme, covering £4.2bn in technology spending from 2016 to 2020-21. This strategy is based on a combination of plans including Personalised Health and Care 2020, the Five Year Forward View, the Wachter Review and, now, the NHS long-term plan.

NHS Digital is responsible for delivering parts of this strategy at NHS England’s direction but is also an arms-length body accountable directly to DHSC and Parliament, rather than NHS England. NHS Digital receives most of its funding from DHSC, not NHS England.

In addition, there is a national information board and the digital delivery board, both chaired by the NHS chief clinical information officer, that have overall strategic oversight of NHS IT and NHS Digital specifically.

The chief clinical information officer, currently Dr Eccles, is employed by NHS England but is also the senior representative for DHSC overseeing NHS Digital.

A new major change under the NHSX banner would be the latest in a long line of moves to reorganise national NHS technology responsibilities.