NHSX set to become part of new NHS England 'transformation directorate'

The UK government is looking at plans to make NHSX part of a new NHS England and Improvement (NHSE&I) "transformation directorate", less than two years since the digital unit was established.

The plans, which are currently at proposal stage, aim to ensure better collaboration and ensure digital transformation work is not siloed. NHSX CEO Matthew Gould said that the initiative is still "subject to full approval" by the Department for Health and Social Care (DHSC) and HM Treasury.

“This is a hugely positive step for our goal of digital transformation across the NHS and social care sector,” he said. “The proposal would do what we in NHSX have been advocating and demonstrating – taking digital out of its silo and putting it at the heart of the NHS and social care.

“Our work carries on. NHSX will continue to champion digital transformation as a joint unit of DHSC and NHS England, and no functions are transferring out of NHSX or back to the department.”

NHSX was set up by health secretary Matt Hancock in February 2019 as a central team to lead on digital strategy, and a joint unit between DHSC and NHSE&I. The aim was to bring together responsibility for policy, implementation and change in digital, data and technology across the health service in England.

However in November 2020, a Public Accounts Committee (PAC) report said there was still no clear implementation plan for how this will be delivered and that governance and accountability arrangements “are both overly complex and insufficiently funded”.

It added that there is a lack of clarity over the roles of NHSX and NHS Digital, as they often overlap, leading to confusion. Despite being set up in February 2019, NHSX still has no finalised governance arrangements, and because it is not a statutory body, and does not have to prepare financial statements for audit, there is little transparency over its spending.

The PAC said NHSX should “as a matter of urgency” publish an implementation plan for meeting its ambitions, which should set out actions to transform digital services and identity and prioritise areas where digitisation of services “will add the greatest value to patients and clinicians.” 

This news on this latest proposal comes following a government white paper last week, which set out plans to re-organise the NHS and make legislative changes, aiming to reduce bureaucracy and improve integration and data sharing. 

“At the heart of the changes being taken forward by the NHS and its partners, and at the heart of our legislative proposals, is the goal of joined up care for everyone in England,” the white paper said. “Beyond the legislative proposals set out in this document, there are several other changes to the health and care system – including improved data sharing, financial arrangements to support integration and improvements to public health services – that our proposals are designed to support and to align with.” 

Commenting on the new white paper, Hancock said: “The NHS and local government have long been calling for better integration and less burdensome bureaucracy, and this virus has made clear the time for change is now.

“These changes will allow us to build back better and bottle the innovation and ingenuity of our brilliant staff during the pandemic, where progress was made despite the legal framework, rather than because of it,” he said.

“The proposals build on what the NHS has called for and will become the foundations for a health and care system which is more integrated, more innovative and responsive, and more ready to respond to the challenges of tomorrow, from health inequalities to our ageing population.”