Passing chatbots for dementia patients and tools for manipulating big data as he entered the annual NHS Health and Care Innovation Expo in Manchester on Thursday, the health secretary, Matt Hancock, could have been forgiven for thinking the health service is well on the way to exploiting the potential of digital technology.
But visits to see hospital and ambulance services in action as he gets to grips with his new post have left him horrified at the pervasive and lethal weaknesses in NHS technology, and he has wasted no time in giving vent to his feelings.
Hancock loves tech. He used to work for his family’s software business, was the first MP to launch his own app and was responsible for digital policy as a minister for two years in the Department for Digital, Culture, Media and Sport.
Since being appointed health secretary two months ago, he has made three big calls. He has scrapped the famous Monday morning meetings in which his predecessor Jeremy Hunt brought together system leaders and delved deep into operational detail. He has used his first appearance in front of the health and social care select committee to attack the “very, very old school” NHS management culture, and he has declared that his mission is to sort out NHS technology.
Relaxing the firm grip his predecessor attempted to have over day-to-day running is a wise move. In the aftermath of the 2013 reforms, the secretary of state could deploy the excuse that the leaders of a chaotic system needed to be brought together, but subsequent restructuring of the central bodies and the increasing integration of NHS England and NHS Improvement make that redundant. It is better for Hancock and the NHS if he applies himself to where he has expertise.
In a punchy speech (which I chaired) at Expo, Hancock accused the NHS of being the “world’s most frustrating place to work for its IT”, and claimed that bringing together NHS data with genomics and artificial intelligence could unleash a power to save lives “literally greater than anywhere else on the planet”.
To tackle the current mess he announced a six-pronged attack including: strict, mandated standards which will apply to every bit of kit so that systems can talk to each other; stopping people who don’t know what they are doing from deciding what to buy; helping partnerships such as that by DeepMind and Moorfields on revolutionary artificial intelligence analysis of 3-D eye scans to thrive; ramping up technical skills across the entire health and care system; and changing NHS culture to make it tech focused at every level.
He gives the impression that he will have no compunction about battering managers or suppliers who don’t fall into line.
The difficulties of spreading new treatments and ways of working across the NHS frustrate patients, politicians, staff and managers. The progress of the Vanguard programme under the Five Year Forward View is just the latest example of the slow pace of change, which has led to failed experiments over the years with everything from central diktats to market forces.
Hancock’s answer is good – and disruptive – technology. The way Babylon’s online consultation app has taken a wrecking ball to the GP funding and out of area registration systems shows how technology can trigger major changes in months that would take many years through traditional routes.
Hancock has made big commitments on which he now has to deliver. They will involve overhauling everything from clinical training and lifelong development to the skills of managers and boards. It will mean paying good money to bring in tech and data talent and ensuring the culture is creative enough to keep them. And it will mean many more collaborations with tech companies, and making sure the NHS gets a good deal for taxpayers and patients.
Focusing on technology is, of course, not a panacea. It will not obviate the need for more emergency medicine consultants, thousands more nurses and better social care. But if Hancock really can help drive change, it will be time well spent.
• Richard Vize is a public policy commentator and analyst
