£300 million needed for London NHS digital investment – STPs

London will need at least £300 million in central funding to support its local digital roadmaps, according to the capital’s five sustainability and transformation plans.

STPs covering the city have now been published.

The plans have been drawn up by local healthcare organisations and councils to address the NHS’ immediate financial challenges and to make local changes to help the system save £30 billion by 2020-21.

The 44 plans had to be submitted to NHS England, NHS Improvement and the Care Quality Commission by 21 October. NHS England had indicated that it wanted to keep tight control over their publication, but some councils have broken ranks and published them on their websites.

A King’s Fund report this week that found the STPs had been developed “at speed” and “without the meaningful involvement of frontline staff or the patients they serve”.

Most of the plans now look set to be published in the next few weeks. The five STPs that cover London closely align with pre-2006 strategic health authority areas, and cover North Central, North West, South West, South East and North East London.

The London STPs identify pressures including high levels of health inequality, poor control of long term conditions and lifestyle related problems, and patchy access to NHS services. A backlog of maintenance and clinical quality issues at smaller hospitals were also widely identified problems.

The plans look to address these problems while closing a funding gap of £4.3 billion across the city. This included £876 million in North Central London, £1.13 million in North West London, £828 million in South West London, £934 million in South East London, and £578 million in North East London.

The STPs make it clear that most of this gap will be closed by efficiencies, changes to procurement, and pathology and shared services in line with the Carter report. This could directly affect IT departments, with some of the plans suggesting consolidated IT services, and common IT platforms.

However, they also reference the local digital roadmaps that clinical commissioning groups were asked to draw up before the STP process started.

Taken together, the plans suggest that STP areas in London want to invest heavily in analytics, shared care records, channel shift, and new digital monitoring and advice services.

North Central London STP says it will be looking for £159 million to fund its local digital roadmap over the next four years, and an additional £21 million in 2020-21.

South West London STP says its LDR – which excludes the acute sector and the IT costs of consolidating hospital services – will cost £80 million.

North West London STP says its roadmap will require £60 million. South East London STP says it will need £35 million. North East London does not give a specific figure for IT investment.

In all cases, the STPs indicate they will be looking to secure this money from the Estates and Technology Transformation Fund, which is directed at improving access to GP services, or the Sustainability and Transformation Fund, which has been severely cut to plug deficits in the acute sector.

Some £4.2 billion is allocated to be spent on NHS IT over the next five years, with around £1.3 billion of this apparently earmarked for ‘paperless’ initiatives. However, it is unclear how or when this will be distributed.

Regardless London request for central digital funding will likely go unfulfilled, with national health leaders repeatedly urging STP to lower their funding expectations.

North Central London’s requirements for IT funding were queried by Will Smart, the NHS chief information officer, at this month’s EHI Live 2016 show in Birmingham. During a presentation, he said he did not have “many £153 million [sic] pots of funding to give out” and STPs should revise their expectations.

However, the North Central STP says that the funding was central to digital transformation.

“It would be wrong to assume that such investment is not required and will not deliver value.”