By Tony Collins
Sir Humphrey ‘s answer to all problems was to set up a committee or new departmental unit.
The idea was to employ more civil servants or create new job titles at higher pay grades – a point perhaps not lost on the health secretary Matt Hancock.
Hancock has announced plans to deal with the problem of NHS IT by setting up a new division. It will create new civil service jobs and give different titles to existing officials.
Is the remit of the new division – called NHSX – set out in terms vague and unaccountable enough to put a smile on Sir Humphrey’s face?
“NHSX will have an open door to allow discussion with health tech industry that is developing products to make sure that we are harnessing the best innovation to improve the NHS,” Hancock told the HSJ.
“Part of its function will be to ensure that we build the best ecosystem for health tech development in the world.”
He said the model now agreed would make NHSX a joint-venture between NHS England/Improvement and the Department of Health and Social Care. It would have its own chief executive.
NHSX will have broad responsibility for overseeing hundreds of millions of pounds in central funding for digital technology, handle central IT contracts and set national policy for digital technology.
Senior responsible officers for digital projects, most of whom are currently employed by NHS England, would be moved into NHSX. HSJ was told this would include NHS chief information officer Will Smart, chief clinical information officer Simon Eccles, and interim chief digital officer Tara Donnelly.
NHSX will second staff from other organisations, primarily NHS England and DHSC. It will begin operating from April and take over full responsibilities by October 2019.
NHS England deputy chief executive Matthew Swindells, who currently has senior responsibility for NHS IT strategy, told HSJ,
“Bringing together the leadership around this exciting agenda in one place will help us deliver the far-reaching practical improvements from the long-term plan, improve the working lives of NHS staff and deliver better, safer care for patients.”
NHS Digital chief executive Sarah Wilkinson said NHSX will create cohesion, and concentrate work and talent in one unit.
“The program of digital transformation ahead of us is extraordinary in terms of its scale, its complexity and the extent to which it can change lives,” she said.
“It will require sophisticated strategic planning, strong leadership and very tight partnership between organisations across the system.”
The Register asked whether Hancock’s plan will be the National Programme for IT [NPfIT] mark 2.
Med-tech Innovation said the NHS IT programme failed because of poor clinical engagement and a top-down, one-size-fits-all approach. It asks,
“Have we really learned from our mistakes?”
In answer to that question, says Med-tech Iinnovation, “we might look no further than Matt Hancock’s recently assembled Healthtech Advisory Board – amongst which, practising clinicians are the most notable absentees.”
Government Computing said in 2018 that NHS IT investment of nearly £13bn was approaching levels of the (notorious) National Programme for IT in the NHS.
With millions of people on waiting lists and rapidly falling decreases in people seen in A&E within four hours, the NHS does not need another pointless IT initiative of the sort we have seen many times over 30 years.
None of these countless and costly national and regional initiatives over three decades has worked as originally intended.
The main NHS IT improvements have been those achieved by autonomous hospitals and GP practices that have implemented effective but non-standardised systems. Hence systems in the NHS don’t usually talk to each other.
Interoperability ought to be the top priority for NHS IT. It’s not.
This is partly because it’s unglamorous for new ministers and Sir Humphreys to focus on “interoperability”. You’ll never hear a minister say, “We need to get the basics right before we try and create global digital exemplars and free wi-fi in GP surgeries.”
The Whitehall fashion is usually for vanity projects: digital statues built to honour the memory of a particular minister. Hence, the attention is on “driving the adoption of innovative technologies” instead of spending relatively small sums to enable clinicians to have systems that communicate across the NHS.
As soon as new ministers have their feet under the desk, they are handed a briefing paper on making the NHS a technological world leader.
The paper will not mean anything or commit the minister to anything, but it will give the incumbent something to talk about at conferences. It may even make ministers feel they are not entirely surplus to requirements. Hancock’s plan is indeed Sir Humphrey’s dream: a new division, more civil servants, new job roles and higher pay grades.
Will NHSX make any difference to you and me? That’s missing the point. The priority for 30 years has been setting up a new division, putting in place a new leader, writing a new mission statement and preparing a series of business plans. Not forgetting an expansion of the civil service payroll.
Campaign4Change awards Matt Hancock the 2019 “Under The Thumb of Sir Humphrey” award. It’s a pointless award. As pointless as NHSX.
Thank you to @TimMorton2 for alerting me to the HSJ’s interview with Hancock.
- “This has to be a welcome move, when it is so difficult to implement IT improvements across such a complex system. I would like to see the principal of openness and transparency applied to other areas of service provision from the independent sector, in particular, the provision of new cancer services.”