Leadership as well as enthusiasm is needed to digitise the NHS


Jeremy Hunt’s big announcement this week was about creating a paperless NHS.  We have heard about this a number of times before, most recently as part of the NHS Commissioning Board’s Planning Framework.  What was different this time is that the Secretary of State put a date on it: there will be no more paper by 2018.

Quite what paperlessness means remains to be seen and, given the shelf life of secretaries of state, it seems unlikely that Mr Hunt will be in post when the time comes to account for success or failure.  In many ways, announcing that something would happen by a certain date is old style health politics and we have been here before with health IT. 

In announcing the milestones along the way to 2018 there were, however, some interesting signs about how the balance of power between the NHS and the Secretary of State has shifted since the Health and Social Care Act 2012.  Mr Hunt said: “Today I can confirm that the NHS Commissioning Board have agreed that hospitals should be able to share digital data from April 2014, and to adopt paperless referrals from April 2015.”   So the substance of the announcement was, in effect, that the NHS Commissioning Board had agreed to do something.  Contrast this with the number of times we have heard ministers say “Today I have instructed the NHS to…”  It is a subtle, but important, change.

Mr Hunt was at pains to stress that this was very different from the NHS IT Programme.  Even a hint of central impetus or direction was shied away from.  It is clear that he is passionate and knowledgeable about technology.  For a former culture secretary, this is home turf and it shows.  Despite the high risk nature of public sector technology projects, the lack of new money to fund change and the absence of detail about how this will all happen, he feels on safe ground.  We shall see.

One of the criticisms which is rightly levelled at previous attempts to improve IT within the NHS is that they haven’t been clinically-led or driven.  I asked the Secretary of State about how this time would be different.  In response he pointed to the enthusiasm of clinicians for technology.  This is undoubtedly true.  However, enthusiasm for consuming technology in your personal live is somewhat different from a willingness to lead and shape it in your professional life. 

Initiatives such as the Chief Clinical Information Officers campaign suggest that the health IT profession is waking up to the importance of clinical leadership if this is all to work.  However, clinical leadership will also need support from within the NHS.  If the NHS values it, then it will have to plan for it and reward it.  If Jeremy Hunt wants a digital NHS to be part of his legacy, enthusiasm alone is unlikely to be enough.