NHSX - what have we been up to?

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. Some examples:

• We’re shifting the funding we give the frontline for digitisation from the GDE programme (which has worked well, and established a series of exemplars showing what digital can do) to a new digital aspirant programme;
• At the same time, we’re moving to a less burdensome way of doing governance for our projects, still giving sufficient assurance but not using up huge amounts of scarce bandwidth on lengthy form-filling (I want to write more about this in a future blog, as I think it’s important);
• We’re moving from trying to build an NHS app with huge functionality to having a ‘thin’ app that can be a platform for innovation by others, who can use our APIs to develop their own apps or safely innovate within ours;
• We’ve developed a different approach to unblock the bottleneck in the NHS App library, in which we develop a new, proportionate standard for health apps in consultation with the sector, and accredit organisations to certify compliance;
• We are going to make a big push to simplify guidance on IG, so that there is a single, simplified, coherent set of guidance for staff to follow;
• We have been working through what the NHS AI Lab should be, which includes developing the AI in Health and Care Award recently announced by the Secretary of State, and coming up with a plan for how we regulate AI;
• We will take a new approach to scaling applications which have proved they can improve productivity, and are working out how we can help stretched providers deploy them;
• With HEE, we will scale up sharply the misnamed ‘soft stuff’ - building the skills, confidence and leadership in digital transformation, and underpinning it with professions for clinical and non-clinical staff working in tech so they get the support, accreditation, training and status they deserve;
• We want to provide much more commercial support to the frontline, to reduce the asymmetry between big suppliers and the providers buying from them.   We have been working with NHSD and other partners to set up a small team that can work out what should be negotiated nationally, and support the frontline for the things they are negotiating locally.  And we will have a Centre of Expertise specifically to advise on any arrangements involving data.

The list isn’t exhaustive, but I hope it makes clear that we have quietly been working on some important projects that will help the NHS.   

The biggest constraint on all this is our own bandwidth.  So we’ve been recruiting to fill a series of new posts that will give us the expertise and capacity we need.   We’ve appointed our first permanent CTO, and we have just announced our new CNIO. We will soon be announcing our new CIO and Chief Commercial Officer.  And there are a range of other jobs - for example, we’ll be appointing a Director of AI, and we’re in the middle of appointing leads for each of the five NHSX missions.  

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.  

Third, we’ve been getting on with all the programmes that we already had in flight, together with some new ones (like building the IT back-end for Screening, and scoping out a new system for Booking, Referring and Managing Advice).  In the past six months we have made real progress. Here are a few highlights:

• Making progress on standards. Working closely with NHS Digital, we’ve consulted on and are testing standards for medications, and in the next year will move those to full implementation across all care settings. We’ve got a draft specification for a common pathology catalogue for blood sciences, and have drafted a position on pathology messaging for consultation. The rollout of SNOMED has been finalised for general practice, with initial engagement with mental health services underway. And we’ve been working on improving identity management across the NHS by integrating ESR and NHSMail as well as enabling a pilot for use of digital staff passports.
• Introducing new national services like the record locator and the event management service to support location of records and notifications of events like changes to demographics.  Initial piloting of a new API management layer which will facilitate better access to national services starting with the PDS. Again, this has been a joint effort between NHSX and NHSD.
• We established a thriving events programme for digital health innovators with events held in Leeds & London, including hosting ‘Innovation Surgeries’, creating a one-stop-shop for advice. 
• NHS App has achieved national coverage, with 1.9 million logins and over 107,000 appointments made. But we’ve also set out a new direction for the App - keeping it thin, and looking at how we support the providers of other apps. This was the subject of my very first blog. We’ve also enabled 7 services to connect to NHS login so far, with 11 more coming, and 49 approved to start work. (Both of these are also great examples of NHSX and NHSD working closely together.)
• The AI Award in Health and Care was launched, providing £140m over three years to accelerate the testing and evaluation of the most promising AI technologies, as part of the wider AI Lab.We launched the AI:Getting it Right report, outlining NHSX’s approach to developing, deploying, and disseminating AI into health and care; and we held a roundtable on the future of regulating AI in health and care, which you can read more about here. 
• We deployed digital professionals to work with Children and Young Person’s Mental Health providers to prototype and improve the services they offer, and met the Long Term Plan commitment to offer 100,000 women a digital maternity plan, supporting the sharing of maternity data to support clinical and patient needs.
• Finally, and by no means least or last, we produced over 80 blueprints through the GDE programme, which worked with 51 organisations, helping successor organisations to digitise quickly and effectively. 

We will very soon be setting out our plans in more detail, in a Tech Plan that will show how tech will underpin and help deliver the NHS Long Term Plan. In keeping with how we want to operate, we won’t launch a fully formed magnum opus on the world, but put out a series of draft elements over time, looking for comments. We will start with the vision and overall plan. I hope you will join the conversation.]