Can Centres of Global Digital Excellence Help the NHS?

Global Digital Excellence

Back in August 2016, NHS England announced a £100 million funding pot to set up centres of global digital excellence within the NHS. The original plan was to allow trusts to bid for up to £10 million each for investment in digital infrastructure and specialist training. 26 trusts were already deemed to have been ‘already advanced in their use of technology in hospitals’.

In the words of the official announcement;

Once established, the centres will lead the way for the entire system to move faster in getting better information technology on the ground, delivering benefits for patients and sharing learning and resources with other local organisations through networks.

An ambitious plan indeed. Fast forward one month, and 12 NHS Trust’s had been selected. Known as “digital exemplars” (another great NHS buzzword in the making there) they were to be given £10 million each to ‘inspire a digital revolution across the health service’.

Global digital excellence within the NHS – Selected Trusts (announced Sept. 2016)

North

  • Salford Royal Hospitals NHS Trust
  • Wirral University Teaching Hospital NHS Foundation Trust
  • City Hospitals Sunderland NHS Foundation Trust
  • Royal Liverpool and Broadgreen University Hospitals NHS Trust

Midlands and East

  • West Suffolk NHS Foundation Trust
  • University Hospitals Birmingham NHS Foundation Trust
  • Luton & Dunstable University Hospital NHS Trust

London

  • Royal Free London NHS Foundation Trust

South

  • Oxford University Hospitals NHS Foundation Trust
  • Taunton and Somerset NHS Foundation Trust
  • University Hospitals Bristol NHS Foundation Trust
  • University Hospitals Southampton NHS Foundation Trust

New additions for February 2017

  • Cambridge University Hospitals NHS Foundation Trust
  • Imperial College Healthcare NHS Trust and Chelsea and Westminster Hospital NHS Foundation Trust (a joint partnership).

Six mental health trusts are to be added in the coming weeks taking the total to 16 sites.

NHS England chief information officer, Will Smart, confirmed only four acute trusts were immediately being funded as global digital exemplars (as of February 2017).

How are trusts selected?

According to the official NHS England selection criteria;

High Digital Maturity self-assessment scores for ‘readiness’ and ‘capability’.

So any trust can ‘self-assess’ and pass themselves off with a good score on ‘readiness’ and ‘capability’ without any independent verification. Let’s take the recent addition of Cambridge University Hospitals NHS Foundation Trust, a fantastic hospital in my opinion (as an ex-employee), but a failing one in the past few years. Placed in special measures under two years ago and tainted with the costly and shambolic roll out of the ‘EPIC’ IT system in 2014. Certainly not a global digital excellence centre in the making.

Involvement in innovative digital healthcare initiatives

Notice the word ‘involvement’, not a track record of ‘success’, just ‘involvement’. Something I am sure 95% of trusts could claim I suspect.

Representation of a range of different solution types

Anybody that works in within the NHS would testify to passing this one. There in lies the problem with IT in most NHS trusts, a plethora of ‘legacy’ IT systems that hold back any innovation or progression. I suspect all NHS trusts would pass this one.

NHS Improvement confirmation that organisations will be hindered in their ambitions due to other issues

Firstly, let’s define what NHS Improvement is:

NHS Improvement is responsible for overseeing foundation trusts and NHS trusts, as well as independent providers that provide NHS-funded care. We offer the support these providers need to give patients consistently safe, high quality, compassionate care within local health systems that are financially sustainable. By holding providers to account and, where necessary, intervening, we help the NHS to meet its short-term challenges and secure its future.

So assuming NHS Improvement have to ‘confirm that organisations will be hindered in their ambitions due to other issues’, they will have assessed each submission and supplied supporting evidence for the application. Where is this evidence? What are the ‘other issues’ that hinder a trusts ambitions?

Budget

The original budget was £100 million, it is evident that this will be exceeded, or possibly extended, and is not clear. So here are my calculations:

  • Initial Twelve sites
    • 12 x £10m = £120m – Over budget by £20m already
  • Two more sites added
    • 14 x £10m – £140 – Over budget by £40m now
  • Six mental health trusts to be added
    • 20 x £10m – £200 – Budget doubled

Return on Investment

How will ‘success’ be measured? Something that is not clear. I have failed to get an answer from NHS England, despite numerous emails, on how these global digital excellence centres will be measured.

Conclusion

Once you cut through the buzzwords and strap lines, you can see that this project has real potential to improve IT systems and ultimately patient care within the NHS. In response to “Can centres of global digital excellence help the NHS?” Yes, they can. Sadly and unfortunately though, the NHS has an appalling record when it comes to large IT projects, such as NPfIT and Care.Data. Unfortunately this feels very similar, albeit on a smaller scale and due to this, it will be a success in a limited number of locations and fail in a larger number.  It will then be shelved quietly in a few years.

While I am sure this programme has been put together with the best intentions, it appears the execution leaves a lot to be desired once again. Let me know your thoughts.

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