Treasury funding for Digital Exemplars starts to make its way to NHS Trusts


The Global Digital Exemplar programme will see leading Trusts provide IT services to Trusts that are less digitally advanced.

healthcare technologyThe Treasury has approved £385 million of funding for the NHS’s Global Digital Exemplar(GDE) programme, which will see technology leading Trusts placed on a procurement framework and, in partnership with their technology providers, sell digital tools and blueprints to other Trusts that need guidance.

The aim of the GDE is to avoid another National Programme for IT debacle, which saw a fixed number of IT suppliers trying to implement standardised technology across the NHS, without taking into account local needs. The programme ultimately failed and cost the taxpayer billions of pounds.

Instead, GDE will give those Trusts buying from a selection of technologies used by other ‘exemplar’ Trusts. According to an interview published in the Health Service Journal with NHS England’s director of operations and information, Matthew Swindells, the exemplar Trusts will be able to sell blueprints for success to other Trusts, which may procure up to 80% of the same technology as whichever GDE they from.

The funding forms part of Health Secretary Jeremy Hunt’s commitment to create a ‘Paperless NHS’ by 2020, for which he promised £1.3 billion. The original target set by Hunt was 2018, but this has since been pushed back due to changing expectations.

Hunt also recently said that he is “relieved” that most people seem to have forgotten about the original promise of 2018, but added that the NHS will be in jeopardy if it doesn’t act on the opportunity to implement modern digital systems.

Speaking to the NHS Sustainability Committee, Hunt said:

I have made big, bold statements about it. I perhaps rather bravely said I wanted the NHS to be paperless by 2018 in my first few months as Health Secretary, and I am quite relieved that most people seem to have forgotten that I made that promise.

I think we are making good progress. There is definitely lots to do. We are weak at the moment on hospital IT systems.

The GDE programme

According to the Health Service Journal, £195 million of the funding has been allocated to 16 acute and seven mental health GDEs, with the remaining £190 million being allocated to ‘fast-followers’, which are the initial Trusts that have been matched to the exemplars.

The money has been slow to come through from the Treasury, with Trusts only receiving some funds in June, having been promised it in November last year.

NHS England defines a GDE as follows:

A Global Digital Exemplar will be an internationally recognised NHS care provider delivering exceptional care, efficiently, through the use of world-class digital technology and information. Exemplars will share their learning and experiences to enable other trusts to follow in their footsteps as quickly and effectively as possible.

By joining up and digitalising health systems we can provide clinicians with more timely access to accurate information, support service change to help improve health for all and provide patients with better access to their records and support service change which will improve health for all. Through Global Digital Exemplars, we have an opportunity to develop leaders of this digital transformation who will eclipse the best in the rest of the world.

The GDEs will be paid by the other Trusts for their ‘blueprints’ and technology services. The idea is that the followers will be more willing to change if they are given a choice about what technologies they need and are getting guidance from other ‘leading’ Trusts, rather than a technology supplier simply just telling them what to do.

However, despite this progress being made, The House of Lords Select Committee on the Long-Term Sustainability of the NHS recently warned that there is a “worrying lack of credible strategy” to encourage uptake of technology and innovation across the NHS, citing poor leadership and incentives.

When the report was released, Lord Patel, Crossbench Peer and eminent obstetrician, said:

The Department of Health at both the political and official level is failing to think beyond the next few years. There is a shocking lack of long-term strategic planning in the NHS. This short sightedness stems from the political importance of the NHS and the temptation for politicians to reach for short-term fixes not long-term solutions.

To solve this we need a new body that is independent of government and is able to identify clearly the healthcare needs of a changing and ageing population and the staffing and funding the NHS will require to meet those needs. This new Office for Health and Care Sustainability should be a trusted, independent voice as the Office for Budget Responsibility has become on economic forecasting and on public finance matters. It will need to look ahead and plan for 15-20 years into the future.

Digital Academy

The funding news follows a separate announcement earlier this week that three of the world’s top universities will provide virtual masterclasses in leadership and digital as part of a new programme to provide NHS staff with the right skills to drive digital innovation.

The NHS Digital Academy, let by Imperial College London’s Institute of Global Health Innovation, in partnership with Harvard Medical School and the University of Edinburgh, will be open for applications in September.

The Academy is part of the NHS’ wider technology plan to simplify access to care online or otherwise, ensure hospitals are taking advantage of improvements in digital technology and increasing the skills of staff.

A virtual organisation, the Academy will provide expertise for clinicians and health managers who are delivering digital programmes in the NHS, including how to use new technology to improve patient care and experience; and to deliver efficiencies.

Rachel Dunscombe, Director of Digital for Salford Royal NHS Foundation Trust, a partner in the initiative, has been appointed the Academy’s Chief Executive.

It is currently anticipated that 300 candidates will pass through the NHS Digital Academy, each spending up to 12 months studying part-time.

Health Secretary Jeremy Hunt said:

If the NHS is going to have world-class IT systems we need a major programme to spread global best practice – and this links three of the best universities in the world to do just that.

The Academy will ensure the next generation of NHS leaders is well equipped with the most exciting innovations that deliver the best care available to patients everywhere.

My take

Progress is being made, but given the complexity of the NHS, it’s also incredibly difficult to measure levels of success. I’m pleased to see that the government isn’t mandating technology decisions from Whitehall and giving Trusts’s a level of choice around what they implement and how. But let’s hope the exemplars are up to the job of leading the way for the rest of the NHS – no small task.

Image credit - hand pushing healthcare button on touch screen © pichetw

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