POLL: Should there be a mandatory minimum tech spend in the NHS?
- 7 February 2020
This week it was reported that NHSX is looking into the prospect of introducing a mandatory minimum technology spend for NHS trusts and Digital Health News wants your opinion.
New NHS planning guidance states the organisation, along with NHS England and NHS Improvement, will be exploring what the level of funding should be in order to achieve full use of digital technology in the NHS by 2024.
The document also states NHSX will set out its approach for mandating technology, security and data standards in early 2020/21 with all systems and organisations expected to comply with the standards.
In light of this, Digital Health News is asking readers to vote in our latest poll which asks whether mandatory minimum spend on technology should be introduced across the NHS or not.
You can cast your vote below. Polling closes at 10am on 17 February and we will post the results shortly afterwards.
14 Comments
This has to be about outcomes and capabilities and not about specific percentage of turnover figures. Some Trusts are more advanced than others which would suggest that the less mature need to invest more (acknowledging that if you’ve already invested then you probably have a higher support cost). What we need are a core set of ‘Digital Capabilities’ that Trusts must achieve within a certain period, as noted in the LTP but very loosely defined. As others have said, just setting a spending target will result in lots of cash wasted on irrelevant toys.
Without a mandate some organisations are very unlikely to invest sufficiently in Digital to enable true transformation however it is not as simple as that as others have said.
Some considerations I can think of:
1. What is in or out of scope? Do we mean people or kit or both? Do we include BI, IT, IG, clinical informaticians, medical devices, records management etc?
2. Money without appropriate leadership, strategy and plans will result in money poorly spent.
3. How does this align to STP/ICS spending on Digital?
4. Money doesn’t = culture change, we need culture change to support digital transformation more than we need tech imho
Just a few thoughts.
tech is a people business, no different to clinical, the nhs needs to invest in technical people just as much as it does clinical people … this is one aspect of the cultural change that needs to take place in (y)our NHS … the NHS has developed strong clinical leaders, people who are much stronger than many of the non clinical leaders …
Not everything that can be counted counts, and not everything that counts can be counted.
A specific funding level won’t introduce behaviours to transform, and you can’t be truly transformative without digital.
Jane however, is bang on the money.
We all know minimum investment wouldn’t work without clear standards setting what should and could be achieved. To deliver this we have to start with the Leadership teams and better benefits realisation. We need to support every NHS organisational board fo understand the power of digital working. NHSP has a programme ready to go which would be hugely beneficial. Secondly as a community we need to be better as showing the benefits to patient safety and operational efficiency. This will make people want to invest not have to invest.
I hope this doesn’t sound too pedantic but we want leadership teams and better benefits management more than realisation. A small investment up front on analysing what’s needed and why, before making an investment, is far more productive than our habit of trying to realise stuff long after the decision has been made.
As for patient safety, here’s a suggestion. Every time a patient record tells a clinician something about their patient that they otherwise wouldn’t know, and they act on that knowledge, that’s a patient safety incident avoided. If this argument stands up to scrutiny, then we can discuss with clinical colleagues what percentage of records apply. Then we’ll have a sense of scale for the safety benefits that IT enables.
With a target we could at least move the dialogue from how much to what to spend.
Thanks David
I wonder if its both. Showing the change you made before helps teams be more certain about future investment. So building on previous success rather than throwing good money after bad.
I love the idea of a patient safety benefit scale, we need some simple tools that show how safety, efficiency and agility are linked to having the right data in the hands of the clinical teams. Whether this is in the moment or big data lakes it works for both.
I cannot see the voting app – presumably my Trust is blocking it but if there were an option for “Please No!” I would be voting for it. The thread of replies prompted by Jane is the one to follow. I understand the comment about some Trusts not investing without this being mandated but what would they be investing in – if they are that remote from understanding the benefits? (Mentioned in another post.)
It is intelligent, informed and evidence-led spending that is required. A lot more complex to mandate but well worth the effort. (I still remember when “No Delays” transmogrified into “18 Weeks” – complete with its big gaps, prioritisation issues and perverse incentives.)
A commitment to allocate funding would only be supported if it came from increased NHS finding.
Typo- “funding”
A mandatory minimum spend is not helpful – it’s too blunt an instrument.
Better for the centre to make a recommendation, then mandate that Trusts publish their tech investment level in a standard way for scrutiny and comparison.
Previous recommendations on investment back in the 2000s were not followed resulting in the gulf in IT development between the NHS and the world the rest of business lives in!! We have not even caught up now! Maybe a blunt instrument is needed. Unfortunately many Trusts do not see the importance of IT in improving working conditions for beleaguered staff, improving experience for patients and hitting the targets.
I share Michael Bewell’s view and have seen this evident in the Trust I work in. We are playing catch-up in our IT Development because of short-sightedness at board level. Failure to see the need for ongoing investment year on year as being the cost of doing business. Also there is so often a failure to train staff in new technologies and to provide the basics for them – i.e. computers that don’t take 20 minutes to start working. The digital future is here but sadly it is not evenly distributed.
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