Questions asked about £1bn NHS IT fund

The government’s plan to invest £1 billion in new technology for the NHS in England over the next five years has received a cautious welcome from trade body Tech UK.

Speaking to Digital Health News, Natalie Bateman, head of health, social care and local government at Tech UK, said the commitment in yesterday’s spending review was a positive step but that it doesn’t match the £3.3 million to £5.6 billion investment that the DH is thought to have requested from the Treasury.

“That’s quite a significant difference in terms of the allocation of money, so that naturally poses the question of what is that money going to cover and what it isn’t going cover,” she said.

Chancellor George Osborne did not mention the commitment to NHS IT in his spending review speech to the Commons yesterday; despite its lengthy focus on "fully funding" the Five Year Forward View plan so close a £30 billion gap between funding and demand by 2020-21.

However, a policy paper for the spending review, posted on the Treasury website, disclosed the figure.

The policy paper doesn’t go into detail about what the money will cover, although it does say it will be used to “deliver better connected services for patients and ensure that doctors and nurses have the information they need at their fingertips."

Key goals mentioned in the policy paper include 80% of clinicians in primary, urgent and emergency care having digital access to key patient information by September 2018 and every health and care professional concerned with an individual’s care to have access to relevant information by 2020 through integrated care records.

Bateman voiced a note of concern over this agenda, commenting that having an integrated record is just “one element” of meeting health secretary Jeremy Hunt’s agenda of a paperless NHS by 2020.

She added that this mean questions remain about the other areas of technology where investment will be needed.

Neither the Department of Health nor NHS England could confirm to Digital Health News how the £1 billion will be broken down.

However, NHS England’s director of digital technology, Beverley Bryant, has previously suggested that the organisation could launch another ‘technology fund’ similar to previous funds over the past couple of years. 

The 'Safer Hospitals, Safer Wards: Technology Fund' and 'Integrated Digital Care Technology Fund' allowed NHS organisations to pitch for money to support digital projects, such as electronic patient records and electronic prescribing, on a matched-funding basis.

Bryant has also suggested that money could be linked to a new model of trust digital maturity and an element of payment for 'meaningful use'.

Bateman said a new tech fund was something she had considered when looking at the spending review and that such an approach “offers a lot of benefits in terms of ensuring direct investment locally in terms of technology and data."

She added that funding was only one element, however, and that any investment needed to come with “strong guidance and support."

As expected, Chancellor George Osborne used the spending review to commit an extra £4 billion to the NHS next year, to front-load the Conservative's election promise to deliver an additional £8 billion a year to the health service by 2020-21.

This is in addition to £2 billion the Chancellor committed to the NHS during last year’s autumn statement, but it still leaves the NHS committed to finding an additional £22 billion of efficiency savings by the end of the Parliament.

This will be made more difficult by other government policies, such as cuts to social care, the Treasury's announcement yesterday of a major programme of reform to create an integrated health and social care service, and the Conservative's election commitment to a seven day NHS.

Other tech-related investments mentioned in the policy paper for this year’s spending review include £10 million to expand the Healthcare Innovation Test Bed programme, which was launched in March this year as a way for healthcare innovators from across the world to trial new technologies and digital services, such as wearable devices, at working NHS sites.

The review also commits a total of £5 billion to invest in health research and development. This includes £250 million for the 100,000 Genomes Project, which aims to sequence the genomes of 100,000 people in the UK with cancer or a rare, genetic disease.

John Appleby, chief economist at healthcare think-tank The King's Fund gave a cautious welcome to the overall investment saying the need to deal with provider deficits and pensions costs left “little breathing space” to invest in new services.

“The new funding will stabilise services in the short term, but smaller increases later on in the parliament and the requirement to implement seven day services will leave budgets stretched to the limit.”

He added that a “large chunk” of the additional funding for the NHS had been found by making cuts to other DH budgets, including public health, although details are not yet clear.

The Royal College of Physicians and the Royal College of Surgeons issued a joint statement welcoming the investment, but also arguing that the public needed to be "realistic" about what it could deliver.

"The NHS deficit is worsening by the day, and we need to be realistic about how much of this money will be spent shoring up services this winter," their presidents Professor Jane Dacre and Miss Clare Marx said. "We await further detail."