The biggest changes to the NHS in two decades come into effect today, and are likely to have a major impact on the future shape of NHS IT.
The shake-up of the health service first outlined in the ‘Liberating the NHS’ white paper in 2010 took effect at midnight, sweeping away most of the health service’s policy and commissioning bodies, and the remains of the National Programme for IT in the NHS.
As of midnight, the Department of Health has been slimmed down, and given a new focus on public health through its new agency, Public Health England.
Meanwhile, the NHS Commissioning Board, now called NHS England, has formally started work, under the direction of its chief executive, Sir David Nicholson, and with new headquarters in Leeds and Maple Street, London.
The board will be responsible for specialist and primary care commissioning, as well as the huge NHS Outcomes Framework that will hold the NHS to account for performance to the health secretary.
On the IT front, its patients and information directorate, headed by Tim Kelsey, will be responsible for commissioning and sponsoring new digital services for the NHS, including a customer service platform to replace NHS Direct and NHS Choices and provide an online outlet for the troubled NHS 111.
As importantly, it will be responsible for commissioning new standards and information governance for the NHS that will have a significant impact on the development of healthcare IT in the future.
For example, in June it will issue potentially critical guidance to trusts on how to prepare for health secretary Jeremy Hunt’s pledge to make the NHS “paperless” by 2018.
Midnight also saw the formal abolition of strategic health authorities and primary care trusts, which were formed into clusters ahead of the changes.
And at the same time, the 212 clinical commissioning groups that were the most publicly high profile of the changes outlined in the white paper finally started work.
On the IT front, the groups are responsible for GP IT – although not a new GP Systems of Choice framework.
However, many will get IT, information and analysis support from 19 commissioning support units, which have emerged over the past two years as potentially important suppliers of commissioning, HR, finance, analysis and IT for CCGs.
The CSUs are being hosted by NHS England, except, in a slightly confusing twist, for the handful of data management integration centres that will do ‘at scale’ warehousing and feed the outcomes framework.
These are being hosted by the former-NHS Information Centre, which became the Health and Social Care Information Centre at midnight, to underline its role as the ‘safe haven’ for patient identifiable data, and the repository of the ‘single version of the truth’ that the government has promised on NHS performance.
Providers have been left largely untouched by the changes, although the white paper underlined the government’s commitment to make all trusts foundation trusts and to ginger up the internal market by making more services open to ‘any qualified provider.’
More detail about the evolution of the changes and their impact on NHS IT is outlined in the Insight feature, All Change, please.