Daily Insight: Rhetoric vs reality

The NHS’s inability to optimise private sector capacity has long been a frustration for all sides.

The prime minister convened his elective recovery taskforce last year with a brief to crack some heads together and tackle this knotty problem.

HSJ understands the taskforce’s recommendations are due this summer, possibly around July. But no one seems terribly optimistic that its recommendations will be able to shift the dial. As with so many things in life, it comes down to cold, hard money.  

As NHS Confederation’s Rory Deighton told HSJ yesterday there was a “disconnect between government policy on the use of the independent sector, the prime minister’s pledge that ‘NHS waiting lists will fall’ and the financial reality”.

He added: “If the government [was] serious about using the independent sector to reduce elective lists, then it must recognise that it is funding clarity and certainty that is required.”

When the taskforce does set out its recommendations, expect “patient choice” to feature prominently.

But more than one NHS figure close to the review has told HSJ that if there is to be genuine patient choice, there needs to be genuine money to fund it all.

You can’t see the joins

NHS England has been trying to achieve the “convergence” of electronic patient records across integrated care systems, but this is tricky to achieve in larger health systems.

Cheshire and Merseyside has 17 trusts with 10 different EPRs, making it one of the least digitally joined up.

Trying to create a single EPR across the whole ICS is a non-starter, as several trusts have only just implemented new systems, from different suppliers.

CEO Graham Urwin told HSJ: “Our strategic position is one where we won’t introduce any new EPR vendors into the C&M digital economy and will converge around fewer supplier solutions where patient flow and other organisational strategies align…”

This means there are two big procurements on the horizon, one of which is for Liverpool University Hospitals Foundation Trust, which has submitted an outline business case for a new EPR to NHSE.

The LUH procurement will be complicated by the need to ensure compatibility with the specialist trusts in Liverpool, which run on various other EPRs, including Meditech and Altera.

Meanwhile, three neighbouring providers – St Helens and Knowsley Teaching Hospitals Trust, Southport and Ormskirk Hospital Trust, and Warrington and Halton Hospitals Foundation Trust – are preparing to launch a separate joint EPR procurement.