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The biggest changes to the shape of the NHS in England in more than twenty years formally came into effect April 1. The changes, which were first outlined in the Government’s ‘Liberating the NHS’ white paper in 2010 (see here), have already had an impact on NHS IT. But their impact is likely to be felt even more strongly in the months and years ahead.
For the record, some of the key changes are:
- The Department of Health has been streamlined and given a new focus on public health with the creation of the Public Health England agency.
- Strategic Health Authorities (SHAs) and 151 Primary Care Trusts (PCTs) were formally abolished.
- 212 clinical commissioning groups (CCGs) and 19 commissioning support units (CSUs) started work.
- CCGs are responsible for GP IT with the exception of the GP Systems of Choice framework through which patient record systems are procured – this has been extended to the end of 2013 by which time it is due to have been replaced.
- However, many CCGs are likely to get their IT support from the CSUs, which look set to be important providers of commissioning, HR, finance, IT and analysis support for CCGs.
- The NHS Commissioning Board is now called NHS England. It’s responsible for specialist and primary care commissioning and will hold the NHS to account via the NHS Outcomes Framework under the leadership of its new Chief Executive Sir David Nicholson, the former CE of the NHS.
- NHS England’s patients and information directorate, led by Tim Kelsey, is responsible for commissioning new digital services for the NHS (including a customer service platform to replace NHS Direct and NHS Choices) and for new standards and information governance for the NHS. It’s also responsible for the re-procurement of national infrastructure including the N3 network, ‘data spine’ and NHSmail.
- The NHS Information Centre became the Health and Social Care Information Centre – it’s designed to be a ‘safe haven’ for patient identifiable data, and guard a ‘single version of the truth’ on NHS performance. It will also be responsible for monitoring national systems and services.
- NHS Connecting for Health (NHS CfH), the agency that ran the National Programme for IT in the NHS, ceased to exist. Some of its policy and advice roles pass to the DoH but the bulk of its work has been transferred to NHS England and the HSCIC.
Leaving aside the political debate over the reorganisation of the NHS, and whether or not it will have the effect the government desires, as we’ve said before it’s clear that the changes are significant and that they have considerable implications for SITS suppliers in the UK healthcare sector (see our UK Healthcare SITS Market Trends & Forecasts report if you're a PublicSectorViews subscriber).
To date, the most obvious impact has been in primary care IT, where the looming abolition of PCTs and creation of CCGs and CSUs has slowed decision making and put procurements on hold. Last year the impact was felt most keenly felt by the likes of Allocate Software, which did some business directly with PCTs (see here), although things have now improved. Going forwards, it seems CSUs will be important customers for SITS suppliers in primary care. Now that the new organisations are formally in place we expect the purse strings to loosen further, although there is still much uncertainty in the market.
In the acute sector, NHS England, which bears many similarities with the old regime, looks set to have a strong influence on the future shape of NHS IT. Its work on new IT standards and information governance rules will be particularly important, as will the guidance it’s set to issue in June on how the NHS is expected to meet Health Secretary Jeremy Hunt’s ambitious goal of being ‘paperless’ by 2018.
