The big stories on policy and money in 2016

There was plenty of talk of money for Health IT, but the NHS organisations received more new targets than fresh cash to digitalise in 2016. Reporter Laura Stevens looks at five of the big money and policy moments of the year.

1. Hunt flashes the cash for NHS IT

The big money news that came at the top of the year was health secretary Jeremy Hunt's announcement that £4.2 billion would be invested in NHS IT, with £1.8 billion reserved for the ‘paperless’ campaign. While Hunt has consistently campaigned for more technology in the NHS, the amount of cash committed came as a surprise.

Out of the funding pot, about £1 billion was earmarked for cyber security; £750 million for technology for out-of-hospital care; and £400 million for the NHS to become digital including a new website, NHS.uk and free wi-fi across the NHS. This last policy had already been announced in September 2015, and would be re-announced yet again by the year’s end at the Health and Social Care Expo in Manchester.
 

2. £100 million for the global digital exemplars

A surprise multi-million fund was dropped in August, with the announcement that selected digitally advanced trusts could compete for a share of a £100 million pot. However, it appears all that glitters is not gold, as each trust would have to match its awarded cash and only acute trusts were invited to the party, leaving mental health and community out in the cold.

At the Health and Social Care Expo in Manchester, a month later, further details were revealed. Responding to the long awaited Robert Wachter review of NHS IT, Hunt said there would be two waves of ‘global’ and ‘national’ digital exemplar trusts, forming an ‘Ivy League’ of digital excellence. However, the half of NHS trusts that are languishing outside of these two top leagues would not receive funding until after 2020 because to being too digitally incapable.

While Digital Health News understood that the second wave of exemplars would be announced in November, it appears that these trusts will be left on tender-hooks into the New Year as 2016 slips away with no announcements.  
 

3. Introduction of the Innovation and Technology Tariff

Sneaking in before the Brexit result that overtook all other news in June was NHS England chief executive Simon Stevens’ announcement of a med tech tariff. At the NHS Confederation’s annual conference, Stevens said that the tariff would allow the introduction of innovations into the health service, a notoriously tricky market to break into.

The innovations that were chosen out of the 119 applications included apps to improve the self-management of chronic diseases, medical interventions and systems to reduce infections. Getting disruptive technology into the NHS is something Stevens has consistently pushed. When he returned from the US to his new NHS job he urged the NHS not to be “gun shy” of technology.
 

4. A financial “reset” for NHS finances

At the same conference, Stevens also announced that, post-referendum, there would be a “reset” of NHS finances. When the crackdown came, five trusts were put into a new ‘intervention’ special measures regime, with a further 13 to follow, and nine clinical commissioning groups were also put into special measures.  

The reset document indicated that NHS England and NHS Improvement are losing confidence in the ability of local commissioners and providers to resolve their performance and financial issues, with NHS Improvement visiting trusts in special measures to agree a recovery plan within the month. The document ended with an ominous warning:

“The future success of the NHS depends on providers and CCGs using this year to ‘reset’ their performance. NHS Improvement and NHS England will not hesitate both to support people in doing so and to step in where needed to ensure this is secured.”

5. An earlier than usual ‘must do’ list from NHS England

NHS England usually saves its Shared Planning Guidance for a festive treat, but this year the ‘must do’ list was published in September. It indicated that money will be allocated to the sustainability and transformation plans and the local digital roadmaps, with the STPs acting as a “route map” for the Five Year Forward View.

But the STPs have faced plenty of criticism this year, with parts of the media criticising the so-called secret plans for reducing beds and closing hospitals.  NHS England’s attempt to wrestle control of public communications around the STP process didn’t go as planned, with many councils releasing the documents in defiance of the commissioning body, often with a few sharp words about respecting local democracy. What eventually emerged were ambitious plans with big price tags, and few clear plans for how they will be funded. Digital roadmaps face similar funding issues, and many remaining unpublished as 2016 ends.

Read our full 2016 year in review here.