NHSX to “reduce the asymmetry” between big suppliers and buyers

Profile picture for user ddpreez By Derek du Preez February 27, 2020
CEO of NHSX, Matthew Gould, has also said that the central digital unit for the NHS will be hiring a Director of AI.

Image of NHSX logo

The CEO of NHSX - a recently established central digital unit to support transformation across the National Health Service (NHS) - has outlined plans in a new blog to better support buyers in their dealings with what he labels as the ‘big suppliers’. 

Matthew Gould has said that he will be providing more commercial support to the frontline, reducing the “asymmetry” between suppliers and buyers. A small team is being set up, alongside NHS Digital, to work out what should be negotiated nationally, as well as to support local negotiations. 

A Centre of Expertise will also be created to specifically advise on any arrangements involving data. 

NHSX was announced in February last year by Health Secretary Matt Hancock, who has made it his aim to overhaul technology use across the National Health Service. Gould, previously Director General for Digital and Media at the Department for Digital, Culture, Media and Sport, was announced as CEO in April.

Hancock has also released a technology strategy for the NHS, which focuses on open standards, interoperability, user-led design and a cloud-first approach.

The Health Secretary has said that vendors that don’t comply with the new playbook for NHS tech will be phased out in the coming years and has pitched a NHS-as-a-Platform model. Since then NHSX has begun exercising its spend control powers and reduced NHS transformation programmes from 30 to 10. 

Insights into plans

Gould uses this week’s blog to outline what NHSX has been doing in the months since its official launch, stating: 

On 1 July last year, we launched NHSX to rapturous applause.  Or, to be exact, to a mixture of hope, scepticism, indifference and bemusement. An initial flurry of public activity has been followed by six months of a lower public profile, leading some to wonder what we’ve been up to in the meantime.  So let me try to explain.  

We have been working on three main tasks - laying the foundations for a new approach; building capability; and doing all the things that we were doing before we created NHSX.   

First, laying the foundations for a new approach. We want to do some important things differently, but this takes time to get right and implement.

Gould’s plans for NHSX are still very much in progress, but some other examples include: 

  • Shifting funding given to the frontline for digitisation from the Global Digital Exemplar to a new digital aspirant programme. 

  • Moving to a “less burdensome way of doing governance” for projects, reducing burden on “lengthy form-filling”.

  • Moving from building an NHS app with huge functionality to a ‘thin’ app that can be a platform for others to build upon, through the use of APIs. 

  • NHSX wants to “unblock the bottleneck” in the NHS App library, developing a new standard for health apps. 

  • Simplifying guidance on information governance, so that there is a “single, simplified, coherent” set of guidance for staff to follow.

  • Coming up for a plan to regulate AI and working through what the NHS AI Lab should be.

  • Developing a new approach to scaling applications that have proven to improve productivity. 

  • Working with Health Education England, NHSX will work on building the skills, confidence and leadership in digital transformation. 

However, Gould notes that NHSX does have some constraints, most notably what he describes as “bandwidth”. As such, it is on a recruitment drive to support its various priorities. He says that the organisation has already appointed its first CTO, as well as a new Chief Nursing Information Officer. It will also be announcing a new CIO and Chief Commercial Officer, and is on the hunt for a Director of AI, as well other leads for NHSX’s various “missions”. 

But, Gould states that he doesn’t want NHSX to become oversized and bloated (perhaps learning from the mistakes of GDS?). He says: 

I still want to avoid turning NHSX into a leviathan.   We needed to build expertise in a series of new areas to fulfil the role we’ve set ourselves, but we won’t grow bigger than we need to.   

And we are taking the time we need to find the right people, with the right skills and attitudes, to form a brilliant and diverse team, crucially including people with real experience at the NHS frontline, and deep tech and commercial skills. 

My take

NHSX has come a long way in the time it has been active. Gould appears to be taken a considered approach to activities ‘on the ground’, whilst also recognising that the organisation needs strong leadership in its key areas of focus. However, as we’ve stated time and time again, the NHS is an incredibly complex organisation that doesn’t do too well with intense control from the centre. It’s incredibly fragmented and tends to respond better to change with more carrot and less stick (although some of the latter will be necessary). Frameworks, guidance, support, as well as making tools that are obviously superior available, will be key. The tough decisions to make, however, are: what do you mandate from the top and what do you let happen naturally at a grassroots level?