A large and toxic cloud has hung over NHS IT since the failure of the £12bn National Programme that saw billions wasted on systems that barely worked. Since then, we’ve seen the collapse of Care.data, the botched attempt to share patient records through a central database, and a plan for a “paperless NHS” that first aimed to deliver by 2018, was put back to 2020, and is unlikely to be achieved before 2023.
The opportunity for technology to reform and improve the UK’s health and social care system is obvious to anyone who’s ever used a smartphone. There are undoubtedly pockets of excellence in the NHS, but the gap between the best and the worst is enormous. IT leaders have never managed to get over the argument that says: do you want to spend more money on doctors and nurses, or on computers? In the austerity hit NHS, there’s only ever one answer.
Even in the better NHS trusts, there’s a hugely complex legacy to unravel. At Leeds Teaching Hospitals – a great example of a forward-thinking health organisation – there are 460 different IT systems in use. Multiply that across the whole health system and the transformation to digital becomes an ever-bigger challenge.
One day, hopefully sooner than later, somebody has to get NHS technology right. Enter Matt Hancock.
The new secretary of state for health and social care comes with technology squarely in his comfort zone. Through ministerial appointments at the Cabinet Office and the Department for Digital, Culture, Media and Sport (DCMS), it’s been the strongest thread in his political career. There was disappointment in the tech sector when Hancock was promoted from DCMS to health because he was seen as a passionate advocate for digital at the highest levels of government, and he understood the issues better than any of his predecessors (although admittedly, that’s not always been an especially high bar).
He’s wasted no time in putting technology overhaul at the heart of his plans to reform the NHS and social care systems. In July, he promised to make £487m available for NHS technology projects and to replace paper-based systems. In September, he announced a £200m fund for digital centres of excellence and plans to pilot the NHS app across England.
His Labour shadow, Jonathan Ashworth, observed: “This isn’t a serious plan for technology and innovation in the NHS – it’s a pipe dream”.
Now Hancock has launched his “technology vision” for the NHS – a digital future based on open standards, interoperability and APIs, but which retains local autonomy of IT decision-making. It’s a perfectly sensible, ambitious plan, which appears to have learned the lessons of the National Programme. But to paraphrase an old saying, if that’s where you want to go, you wouldn’t start from here.
To be fair, Hancock told Computer Weekly that he doesn’t underestimate the challenge – but he’s looking for a real change in attitude and approach to technology at a local level. His predecessor, Jeremy Hunt, became the longest-service health secretary in history – not far short of six years. Hancock may need to be in place even longer to see through the digital transformation he wants – but this time, the NHS needs finally to get IT right.