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Cowper's Cut 190: Interesting updates - digital in-housing, Big Pharma Day and Owen Paterson issues

Cowper's Cut 190: Interesting updates - digital in-housing, Big Pharma Day and Owen Paterson issues
"Will no-one rid me of this turbulent backlog?"

The Wade-Gery review has concluded that the NHS's digital outhouses - NHS Digital (the trading name of the Health And Social Care Information Centre) and NHS X (pronounced 'NHS Kiss') - should be brought back in-house into NHS England/Improvement.

This was due to be part of Health But Social Care Secretary Sajid 'The Saj' Javid's speech to tomorrow's NHS Providers conference. However, Number 10 Downing Street have taken the announcement off him. The PM will announce it next week.

A little context: in those dear, dead days beyond recall of the NHS Commissioning Board, the original plan was for NHS CB/England to be the digital commissioner, and for NHS Digital to lead provision.

Then NHS Kiss made its way into the scene under Matt 'Alan' Hancock's tech-hearting tenure as SOS. As "a joint unit of NHS England and the Department of Health and Social Care", NHS Kiss was meant to "have the strategy, powers and technical expertise to:

  • negotiate national contracts
  • design the technical architecture to link up the whole system across health and care
  • set national policy to deliver the necessary change

NHS Kiss set the overall strategy for digital transformation and commissions NHS Digital to deliver core central products like existing APIs, the Spine, and the National Record Locator Service".

Yeah, I know: clear as mud.

The argument now will be whether the loss of the tension between independent-ish NHSD / NHS Kiss and NHS E/I is A Bad Thing. Some tech suppliers think that the split between architects and builders has value.

Certainly, this centralises more power into NHS E/I. Power, moreover, that is likely to be wielded over ICSs quite firmly. And power that, should the Health Bill be passed in its current form, can much more easily be directed by the Secretary Of State.

And it does so under the aegis of Dr Tim Ferris, as NHS E/I director of transformation.

This is interesting, because digital is now meant to be a dedicated board-level function in the NHS. Those are the rules, apparently.

So will Dr Ferris now become NHS E/I director of digital, and a new director of transformation be appointed?

We shall see.

Naturally, there has been unhappiness about these changes within the NHS D/NHS Kiss nexus. There has, apparently, even been some blogging, that has led to 'sharp reminders about social media policy'.

Big Pharma Day
As if Number 10 didn't have enough to do, they have interceded on NHS Pope Amanda Pritchard's busy diary (with the 'Saj bollocking' slots very much red-lined) to take a whole day out of commission in December. This day is for the PM and Her Holiness The Pope to attend a 'Big Pharma Day' with leaders of some of the largest pharamceutical companies.

Which is nice. Perhaps it's even a good thing, if we can start getting upstream in introducing better research and development, and more timely innovation and clinical pathway redesign. (Those are not small 'if's.)

But it might also read interestingly to the political classes, as controversy about the Government's pandemic procurement and VIP  fast-tracking continues.

It could even play into concerns that very senior figures in NHS E/I (even those shortly leaving) have been putting their thumbs pretty firmly on the scales when it comes to certain companies.

Yes, some of these people do have 'big University' connections. How did you guess?

And yes, the new chair of E/I is required to be 'pharma-friendly', as well as a 'critical friend', as Dave West of HSJ spotted in the change to the person spec.

Owen Paterson: gone, but not forgotten
Finally, I was reminded of a very bad, spuriously NHS-attacking document produced by Randox lobbyist Owen Paterson's dodgy and now-shut thinktank UK2020.

It was in 2016. An uncritical write-up in The Times is here, and Paterson's promo piece for Conservative Home is here. Dr Margaret McCartney took it apart with some style in this review.