• Local leaders asked to focus on regional needs in IT strategies
  • Matthew Swindells warns that digital projects that focus on lone organisations will be rejected
  • NHS England director says the “days of competition are over”

NHS England has warned local health leaders it is blocking any IT projects focused on lone organisations as part of the wider push for regional integration.

It comes amid hopes of a significant funding bump for NHS IT as part of the new five-year funding settlement, which will include a stream focused on technology.

Speaking at Health Plus Care event in London today, NHSE director Matthew Swindells said the NHS needed to “start thinking about technology in system terms not in institutional terms”.

He added: “As more money comes available my expectation is that I will see…strategies for IT that won’t have hospitals saying we won’t take the same electronic patient record as the hospital down the road because, if we did, they might make us merge.” 

The national operations and information director told HSJ afterwards that trusts’ IT business cases that focused only on internal needs were being rejected.

NHS England later clarified to HSJ that it was not asking for new regional IT strategies.

“Instead of asking for new IT strategies, NHS England will expect individual hospitals to think more about their existing STP or ICS strategy or what benefit the wider system might gain when they consider any new investments,” Mr Swindells said later.

It is not clear at what point any new or improved strategies will be put forward either by organisations or systems.

There have been two rounds of regional IT strategies in the past three years, with STP plans and “local digital roadmaps” both produced in 2016.

Mr Swindells said the roadmaps had been a “good reflection of what people needed”, but did not consider IT needs at a system level.

As with proposals around workforce and infrastructure spending, capital funding for technology as part of the long-term plan is currently being negotiated within government.

NHS England is also in ongoing talks with Treasury about further access to existing technology funds, including part of the £1.8bn “paperless” fund announced by Jeremy Hunt in 2016.

Mr Swindells said any new money from the long-term settlement would likely go towards accelerating NHS England’s existing IT strategy, which is focused on digitising secondary care, connecting IT systems within regions, better use of data, and patient digital services.

‘Days of competition are over’

NHS England director Matthew Swindells has cautioned against using new legislation to “instruct” the development of system working through STPs and integrated care systems.

It comes after the government said it was open to legal changes proposed by the health service that would sweep away the “internal market” and competitive structure under which the NHS operates,

Speaking at the Health Plus Care conference today, Mr Swindells said: “I like the fact that we don’t have a piece of legislation to mandate it. I like the fact that people have to park their egos at the door and try and focus on what needs to be done in order to make services better.

“It makes it really hard, but if we succeed it makes it likely to stick… I think we can encourage [STPs], I think we can incentivise it, but if we instruct it we break it.”

The national director of operations and information also said the “days of competition are over” for the NHS, but said people should still be offered more choice and control over their care.

He added: “We should be thinking about more ways of empowering people to able to control the care they need. This means there will always be some transactions where someone decides to have their hip replacement near where their children live rather than where they live, and we need to manage that flow.”

 This story was updated at 10am, 2 July, to reflect new updated information received from NHS England.