Analysis: STP digital plans need a major reboot

The largely vague and un-costed digital components of the STPs need a substantial upgrade, or the NHS will continue to lag behind comparable health systems on technology for years to come, writes HSJ technology correspondent James Illman

Sustainability and transformation plans have fallen well short of their overall goal, so it is not surprising that the digital elements in the plans are also largely undercooked.

Indeed, the consensus among senior figures working in digital health is that, while there are notable exceptions, very few areas have spelt out a compelling narrative for how they will deliver a digitally mature STP.

The approach taken in the bulk of the STPs is a cobbling together of previous initiatives and cookie cutter style statements about integrated patient records, e-prescribing and patient access to records, designed to tick the local digital roadmap guidance check list, rather than tangible delivery plans.

A muddled starting point didn’t help: Areas were first told to produce local digital roadmaps and set a headline target for a paperless at the point of care NHS by 2020; this was confusingly translated into the STP process and official acceptance that ‘paperless’ was the wrong focus and 2020 was the wrong target. This added to a lack of joined up thinking.

Some observers are concerned that some of the stronger parts of LDRs have not been carried over into the STPs – efforts are being made to correct this.

Funding running short

Even the more advanced plans which do set out cost forecasts raise tricky questions about the huge gap between available and required funding.

The handful of STPs which produced forecasts both revenue and capital requirements for their digital plans included north central London (total cost of £180m), Hampshire and Isle of Wight (£70.8m) and Frimley Health (£71m).

This small and obviously unrepresentative sample suggests an average of around £100m – and a hypothetical total of around £4.4bn for all 44 areas. Some STPs indicated funding for at least some of their plans was already earmarked (Frimley, for example, only requires £33m of new money), while capital receipts and other efforts to raise funding locally were also cited.

But most plans are dependent on securing central funding from the £900m estates and technology transformation fund or the £1.3bn to help fund the Paperless 2020 programme. These funds will be heavily oversubscribed, so significant questions remain about what can be achieved with funding running short.

Full story in The HSJ 3 January 2017