• Details for accessing £412m STP tech fund set out
  • NHS England says difficult conversations will be needed locally around who misses out
  • STPs ordered to show greater leadership in managing tech funding and improvements locally
  • Projects for IT systems that “diverge” from neighbouring organisation will be rejected

Over half of the £412m technology fund announced by new health secretary Matt Hancock in his first speech last month will not be available to the service until 2020-21.

Regional leaders have also been told to prepare for “challenging conversations and difficult decisions”, as they decide which local organisations will get a slice of the funding.

The “provider digitisation fund” is part of the £1.3bn tech fund announced by health secretary Jeremy Hunt in 2016. In July, Mr Hancock confirmed the funding had finally been approved by the Treasury and revealed the size of the allocation.

An NHS England “prospectus” was sent to the leaders of sustainability and transformation partnerships and integrated care systems earlier this month explaining how the money would be distributed. The document, obtained by HSJ, renamed the scheme the “health system led investment” and showed that health and care regions submitting proposals to access the money will face a number of restrictions from the centre.

The prospectus said that £104m of the find will be distributed this financial year, followed by £92.4m in 2019-20, and £216.1m in 2020-21. One NHS source closely involved in the process said there were concerns that the backloading would put the funding at risk, with the NHS’s history of raiding tech fund to support other parts of the system.

In theory, STP or ICS will receive money on a “fair share” capitated basis, with each region submitting a proposal for how that money would be spent locally. However, the prospectus said that within regions this money should go where the need for digital improvement is greatest rather than on a fair share basis.

“Local prioritisation is likely to require some challenging conversations and difficult decisions”, it stated.

The prospectus also hints that a survey, which has yet to be made public, shows progress on digitising the NHS over the past two years has been patchy.

”The results show that local investment over the last two years has delivered some increase to overall levels of digitisation, but that there are still significant gaps which this funding can help address.”

As first reported by HSJ in June, regions that want access to funding are expected to move towards using the same core clinical IT systems across the region rather than acquiring new and different systems.

The August prospectus said: “There should be a focus on standardising IT solutions across health systems to simplify data sharing, ease staff movement between providers and reduce the total cost of ownership. Investment in solutions that would result in the divergence of services, systems or infrastructure across the local health and care system should be avoided.”

It added: “Specifically, EPR  [electronic patient record] divergence in a local healthcare system will not be supported.”

While funding for specific projects would be held by individual trusts, STPs will also be expected to take a “lead role” in tech spending across their region, including getting rid of ageing systems, such as Windows XP, and fax machines.

The prospectus stated: “The Funding Agreements developed as part of this process will include a requirement to declare the number of fax machines currently in use; that these will be replaced by March 2020; and that all organisations will positively confirm to Dr Simon Eccles, NHS CCIO, when this is completed.”

Any proposed investment would also be expected to be able to demonstrate a financial return on investment, something which is notoriously difficult to deliver in the short term for technology projects. 

All projects should be focused on national priorities, including:

  • Advancing the digital maturity of secondary care providers
  • Enabling information to be shared across local healthcare systems, laying the foundations for integrated care
  • Allowing STP/ICSs to harness digital technology to help realise their transformation goals
  • Embedding STP/ICS-level leadership of the digital agenda at a local level.

Bids are expected to be submitted within six weeks and money handed out this year cannot be rolled out to next year. 

As with the global digital exemplar programme, funding will be expected to be matched locally.

NHS England has been approached for comment.