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Health secretary’s plan to overhaul NHS IT raises funding questions

The health secretary, Matt Hancock, has unveiled his vision to build what he says will be “the most advanced health and care system in the world”.

In proposals published today (17 October), Hancock outlines plans to introduce new minimum technical standards to ensure NHS systems are interoperable and can be continuously upgraded.

Systems which do not meet the standards will be phased out, while government will “look to end” contracts with health and care IT providers which fail to understand the NHS’s new architectural principles, the Department for Health and Social Care said in a statement.

To coincide with the launch of Hancock’s tech vision, NHS Digital has also published a new framework for IT standards. They include plans to encourage hospital trusts to use patients’ unique numbers wherever possible so their medical histories can be accessed by clinicians around the country. Detailed specifications of data standards are the first to be drawn up and will be published “over the coming weeks”.

In addition to the technical standards, the government has published architectural principles to guide the adoption of new IT. They include: making all digital services available in the browser; being internet and public cloud first, building a data layer with registers and APIs; adopting “the best” cyber security standards; and separating the layers of the patient record stack into hosting, data and digital services.

“A modern technical architecture for the health and care service has huge potential to deliver better services and to unlock our innovations,” said Hancock. “We want this approach to empower the country’s best innovators — inside and outside the NHS — and we want to hear from staff, experts and suppliers to ensure our standards will deliver the most advanced health and care service in the world.”

But there is currently no funding allocated to making the latest plans a reality. A spokesperson for the Department of Health and Social Care told NS Tech: “Digital transformation and technology services in the health and care system are currently funded through a combination of revenue and capital funding from central and NHS budgets.”

“The tech vision, and the NHS Long Term Plan, envisage that this model will continue, with funding drawn from the Spending Review and NHS resources,” the spokesperson added.

Alan Woodward, visiting professor of cyber security at Surrey University, welcomed the standards, but said the main limiting factor for NHS trusts and clinical care groups looking to overhaul IT was a lack of funding. “I think the key to all of this is, firstly, is there more money? And, secondly, convincing those who are spending what limited budgets there are to actually spend it on IT and not something else.

“I just suspect the journey will take rather longer than [Hancock] expects because there are so many competing pressures [on NHS executives].”

The health secretary unveiled £450m of funding for new technology across the health service in August. Woodward said the numbers might seem large, but suggested the funding would not go far across the entirety of the health service. “Think about it per head and what it could actually do,” he added. Earlier this year, the NHS spent £157m on upgrading to Windows 10 alone.

The Department for Health and Social Care did not immediately respond after NS Tech asked if the £450m of funding was new money or drawn down from previously announced funds.

The Health Service Journal reported earlier this week that a full IT overhaul could cost the NHS as much as £13bn.