{"id":10049,"date":"2025-07-30T15:46:49","date_gmt":"2025-07-30T14:46:49","guid":{"rendered":"https:\/\/www.gpsj.co.uk\/?p=10049"},"modified":"2025-07-30T15:47:18","modified_gmt":"2025-07-30T14:47:18","slug":"great-plan-now-we-need-to-get-real-about-digital-delivery","status":"publish","type":"post","link":"https:\/\/www.gpsj.co.uk\/?p=10049","title":{"rendered":"Great plan: now we need to get real about digital delivery \u00a0"},"content":{"rendered":"\n

The government\u2019s big plan for the 10 Year Health Plan for the NHS laid out a big role for delivery. However, the\u00a0Highland\u00a0Marketing advisory board felt the missing implementation plan will have some big issues to address, from addressing the state of NHS IT today, to finding the time and money to deliver on its vision.<\/strong><\/p>\n\n\n\n

The government has published its 10 Year Health Plan, Fit for the Future. Picking up from Lord Darzi\u2019s investigation into the state of the NHS in England, it says the service is \u201cat a historic crossroads\u201d and must \u201creform or die.\u201d<\/p>\n\n\n\n

Its vision for reform is a new model of care that will be achieved through the now-familiar three shifts (from hospital to community, treatment to prevention, and analogue to digital) and delivered by a shake-up of NHS structures, finance, and regulation.<\/p>\n\n\n\n

The plan also sets out some big plans for digital, including a single patient record, a massively expanded NHS App, some new, national platforms, and five big \u201cbets\u201d on data, genomics, AI, wearables, and robotics. Overall, the Highland Marketing advisory board was pleasantly surprised by the direction of travel.<\/p>\n\n\n\n

\u201cI looked at this from a number of perspectives. Is it a nice story? Does it read well?\u201d said GP and CCIO Jason Broch. \u201cAnd the answer is \u2018yes\u2019. It\u2019s a good story because a lot of it is stuff that we have been saying for years and years. And it reads well because there is buy-in for All across the NHS.\u201d<\/p>\n\n\n\n

On the other hand, members agreed that the 10 Year Health Plan is not a plan. \u201cYou cannot call something a plan if it has no implementation section,\u201d said entrepreneur Ravi Kumar. This is a vision. But I like the focus on prevention and early intervention.<\/p>\n\n\n\n

\u201cIf it happens, and if we get the neighbourhood model, things will be very different. Digital innovation with the patient in control: that is a great idea. As a vision, it is a great document.\u201d<\/p>\n\n\n\n

Six key issues for health tech:<\/strong><\/p>\n\n\n\n

Sir James Mackey, the transition chief executive of NHS England, has said a delivery plan or plans will be developed this summer. The advisory board felt these will need to address some tensions the plan skips over.<\/p>\n\n\n\n

These include where power will sit in the new structures, as integrated care boards are slimmed down, and \u201creinvented\u201d foundation trusts come on stream. How the tension between the short-term imperative to reduce waiting lists and the long-term ambition to address health inequalities at \u201cplace\u201d level will be handled.<\/p>\n\n\n\n

How money will flow around the system, while reinventing payment by results and year of care funding are worked out. But when it comes to technology, the advisory board felt there were six, key issues ahead:<\/p>\n\n\n\n

NHS IT is not a greenfield site: <\/strong>Analogue to digital is one of the plan\u2019s big themes, but in practice the NHS has been trying to go digital for 30 years. Stop-start investment in big programmes has left the health service with patchy infrastructure, an incomplete roll-out of electronic patient records, and a lot of software that is not as well integrated with them as it could be.<\/p>\n\n\n\n

The advisory board argued the plan doesn\u2019t recognise this, but a significant chunk of the \u00a310 billion that the spending review says will be available for NHS IT and transformation over the next three years could be spent on sorting it out.<\/p>\n\n\n

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Cindy Fedell, a former NHS chief information officer who now works in Canada, said: \u201cThere\u2019s lots of poor infrastructure, lots of fractured stuff, to address if we\u2019re going to get proper use out of it; and that\u2019s before we start talking about everything that the plan says they want to do.\u201d<\/p>\n\n\n\n

Wicked problems can\u2019t be wished away: <\/strong>Because it doesn\u2019t engage with the current IT landscape, the 10 Year Health Plan is curiously silent on some key issues. \u2018Cyber security\u2019, for example, doesn\u2019t rate a mention. Nor does \u2018interoperability\u2019 or \u2018information governance\u2019 or even \u2018data quality\u2019.<\/p>\n\n\n\n

The plan\u2019s authors may think these issues will be solved by the single patient record, a pet project of the Tony Blair Institute for Global Governance, which the plan says will \u201cbring together all of a patient\u2019s medical records in one place\u201d and \u201coperate as a patient passport\u201d to \u201cseamless\u201d care.<\/p>\n\n\n\n

To bring this about, the plan says there will be legislation to require providers to share information. However, the NHS has a poor record on getting clinical and patient buy-in for grand data plans and is still facing a backlash over its decision to award the Federated Data Platform contract to a consortium including Palantir.<\/p>\n\n\n\n

Andy Kinnear, who worked for a commissioning support unit that introduced one of the first shared care records, said: \u201cA lot of the rules that are in place are there to protect us and our civil liberties by blocking inappropriate access to sensitive data. It\u2019s all going to get very fraught, once people start engaging with this.\u201d<\/p>\n\n\n\n

Too much centralisation could kill innovation: <\/strong>It\u2019s not just the single patient record that suggests the government wants the centre to have a much bigger role in NHS IT. The plan also talks about an expanded NHS App and national platforms, starting with virtual wards and remote monitoring. <\/p>\n\n\n\n

David Hancock, a consultant who has worked for both EPR and shared care record vendors, said: \u201cFrom an industry perspective, this concerns me. If there are systems out there doing these things, what will happen to them? Will they be expected to link to the NHS App, or will this supersede them? And how will new people get into the market? This could kill innovation.\u201d  <\/p>\n\n\n\n

Mind the app: <\/strong>The plan devotes a whole section to the NHS App, which it says, \u201cwill be how we create a truly empowering, digitally enabled NHS.\u201d It promises a My GP tool for advice and access to appointments, a My Choices feature to help patients pick providers, My Specialist and My Consult platform to help them find specialists and consult with them remotely.<\/p>\n\n\n\n

It says there will be a My Companion for general health advice and My Medicines, My Vaccines, My Health, My Children and My Carer areas to pool meds, vaccines, test and wearables data, and specialist advice in one place. Yet, Highland Marketing advisory board chair Jeremy Nettle pointed out, the NHS App today is extremely limited and all one-way.<\/p>\n\n\n\n

\u201cIt pushes information at you, but you cannot push back,\u201d he pointed out. \u201cI can get a text from my GP, but I can\u2019t message them back. That\u2019s not helpful. And lots of other services don\u2019t even use the app. My local hospital still sends letters.\u201d The plan has little to say about how the app will get from A to B; or how this will be paid for.<\/p>\n\n\n\n

Productivity is achievable but won\u2019t fund IT: <\/strong>The digital commitments in the 10-year Health Plan will take far more money than the Treasury has put up. At various points, the plan appears to suggest that some of the missing money will come from cash savings or productivity improvements.<\/p>\n\n\n\n

For example, it says outpatient appointments cost \u00a314 billion a year, a lot of which could be saved if pre-op and follow-up assessments were carried out online. The problem is productivity projects require pump-priming for everything from devices to pathway redesign and training.<\/p>\n\n\n\n

\u201cThe NHS has tried repeatedly to do transformation from within its operating budget, and it doesn\u2019t work,\u201d said Andy Kinnear. \u201cThe money you want to release is not there at the start; you get it out down the line.<\/p>\n\n\n\n

\u201cIt\u2019s not news that there are lots of follow-up outpatient appointments that probably don\u2019t need to happen, but the money\u2019s not been there to stop them happening. It feels like the ambition and the budget are out of alignment.\u201d<\/p>\n\n\n\n

Same for consumer tech: <\/strong>The plan also talks about making the NHS as easy to access as online shopping or banking, which have been funded, in part, by transferring work from staff to users.<\/p>\n\n\n\n

\u201cThe consumerist aspect of the plan is interesting, because it has driven big changes in other areas,\u201d said Andy Kinnear. \u201cWe work our own tills. We print our own boarding passes. And we\u2019re happy to do it.\u201d<\/p>\n\n\n\n

Equally, it took 50 years for banks to go from the first cashpoints to today\u2019s interoperable apps; and banks are starting to bump up against public opposition to branch closures. The NHS may be able to move faster, but it\u2019s likely to find itself in a bind.<\/p>\n\n\n\n

Either, it will find it even harder to shut clinics and surgeries used by elderly and disadvantaged patients, pushing up costs because of joint-running. Or, it will find itself increasing health inequalities by disadvantaging patients who no longer have physical services but cannot use digital ones (another topic on which the 10 Year Health Plan is basically silent).<\/p>\n\n\n\n

Where\u2019s the money? Where\u2019s the time?<\/strong><\/p>\n\n\n\n

Overall, the advisory board felt that time and money are the big issues a 10 Year Health Plan delivery plan or, better, a digital roadmap, will have to address.<\/p>\n\n\n\n

\u201cThere is an over-emphasis on what technology can do in the short term,\u201d said Ravi Kumar. \u201cAnd I would have liked to see a finger in the air calculation of what a digital first service will cost in the long-term. I think it could be ten or 20 times more than has been mentioned: we might be looking at something like \u00a3200 billion.<\/p>\n\n\n\n

\u201cAt the moment, if I go into hospital, I\u2019ll struggle to get wi-fi on my phone. If we want patient engagement, we need to sort out that kind of issue before we begin – and we won\u2019t be able to do it on the cheap.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"\n

The government\u2019s big plan for the 10 Year Health Plan for the NHS laid out a big role for delivery. However, the Highland Marketing advisory board felt the missing implementation plan will have some big issues to address, from addressing the state of NHS IT today, to finding the time and money to deliver <\/p>\n

Continue reading Great plan: now we need to get real about digital delivery \u00a0<\/a><\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[9],"tags":[3652,3773,4570,25,417,26,264,1827,1877,2167,605,122,3249,310,416,422,1748],"class_list":["post-10049","post","type-post","status-publish","format-standard","hentry","category-nhs-healthcare","tag-ccs-rm6273-employee-benefits-services-framework","tag-ai-2","tag-clinical","tag-government-public-sector-journal","tag-government-journal","tag-gpsj","tag-gpsj-magazine","tag-healthcare","tag-highland-marketing","tag-highland-marketing-advisory-board","tag-hospitals","tag-nhs","tag-patients","tag-public-sector","tag-public-sector-journal","tag-public-sector-magazine","tag-secretary-of-state-for-health","odd"],"yoast_head":"\nGreat plan: now we need to get real about digital delivery \u00a0 - Government & Public Sector Journal<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.gpsj.co.uk\/?p=10049\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Great plan: now we need to get real about digital delivery \u00a0 - Government & Public Sector Journal\" \/>\n<meta property=\"og:description\" content=\"The government\u2019s big plan for the 10 Year Health Plan for the NHS laid out a big role for delivery. 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