UK finance minister promises NHS £3.4B IT investment to unlock £35B savings The UK's finance minister has promised the country's National Health Service (NHS) £3.4 billion ($4.33 billion) in IT investment, claiming it would unlock £35 billion ($44 billion) in efficiency savings by the end of the decade. Speaking as he presented the nation's budget yesterday, Jeremy Hunt, the chancellor of the …
Would that be the same Mr Hunt, who, as his first job as Health Minister, changed the NHS management structure so that instead of only one region being in the red, they all were. Then blamed "inefficiency" on the sudden fall from grace rather, than his own miguided imposition of extra red tape with no extra funding to cover it.
Pepperidge farm remembers... though, arguably sadly, the voters don't.
If it's a 10x RoI then why haven't they done it before, instead of waiting until just before a general election? If they'd started 5 years ago, before inflation hit, then it would have cost a lot less and would have delivered the savings sooner.
What's also not clear is whether this is £3.5B for a £1B planned project spend plus overruns or whether it's an HS2 £3.5B which will spend £2B getting nowhere before forecasting an unaffordable overrun of £5B and then be cancelled.
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Yes, they seem to have a soft spot for the numbers 3 and 5
It might be a necessary, if unpopular thing.
The only way to make the UK work - and I mean merely not shit, aspiring to be good - is increased spending on core things. Esp the complete broken local Government situation.
Not like the fucking Tories haven’t massively jacked up taxes to the highest label since 1948.
https://amp.theguardian.com/uk-news/2024/mar/07/uk-taxes-have-reached-1948-levels-but-the-contrast-between-the-budgets-is-stark
It’s a government project, so that £3.4B is likely to be the total contract cost ie. Initial Capex spend plus 5~7 years of Opex.
The savings figure is more suspect. I anticipate it will include theoretical savings, for example efficiency improvements (reducing number of unfilled appointments) enable the avoidance of additional spend rather than actually reducing current spend.
The biggest threat to survival is the bonkers NHS Trust and Integrated Health Boards ‘choice’ system. You basically have multiple functions duplicated many times across England, with each having a CEO, FD, People Team, Procurements, Estates, IT Teams all doing stuff ‘locally’ and part using national backbone systems.
The ROI isjust nuts. More like £24bn to save £2bn.
When you have this structure you can break out “poorly performing” trusts for being run by private companies, thus “saving” taxpayer money. Once that bridge is crossed, all the high profit bits of the NHS go to insurance based private healthcare and the taxpayer pays for all the low margin/cost center stuff like GPs. Service levels will plummet but Whitehall and pals will be paid well and have access to nice exclusive london hospitals which generously offer equivalent services to frontline without all the proles queueing up.Then, we can subsidize this shitshow by selling patient data to Google and insurance companies, which will be done with implicit consent granted by using the phone app - which as we know, is the only actual way to get an appointment now.
Can’t wait for in-network, out of network healthcare. Great way to separate the classes of people with money and people without
This is my projection:
£3.5Bn target over 6 years
2 years will wasted on procurement so the contracts are "given" to incumbents and Palantir with no oversight
£10Bn spent over 3 years
Bugger all delivered & what is delivered barely works
Contracts extended because too much has been invested to give up.
Palantir sucks every possible asset it can out of the NHS before say that they cannot deliver.
Have they never heard of templates? You know, standard letters and notes where the computer just has to put in the patient's name and address? This is not something that requires AI, and the risk of it generating inaccurate info is far too high to start using it right now when it comes to something as important as patient health.
Perhaps they can use AI to generate the letters, and put them on the blockchain.
Then pay for them with crypto.
Is that all joined up thinking? Or do I need to circle back?
More seriously, this article was a complete shower of...buzzwords. Of course, Labour will double down on this stuff if/when they get in.
It's all the vogue right now but AI is just Pixie Dust.
Sprinkle it on anything and "this time next year Rodney, we'll be millionaires".
Props to anyone who gets the reference.
The muppets spending billions on AI don't understand what the letters actually stand for.
AI = Artificial Idiocy.
Automating, or templating notes and letters is something the hospital I worked at has been doing for years... I think it's called "the bleeding obvious". What might help the NHS more is funding OAP care properly, funding mental health care properly and other social services so the beds can be emptied for people who will actually benefit from being there.
How long will it take for them to see that cuts save money on one are but cost more in another? Cur mental health spending saves a bit in one area but it's a lot more expensive when the police have to pick up the slack as they're not trained or equipped for the role... to take one example.
Or my Dr. daughter having to see the same mental health patients every day, as there in no availability to take them into secondary care. And then patients grumble that they can't see a Dr.
The vast majority of patients seen in a week should be under secondary care i.e. hospitals where proper diagnostics and treatment can occur and not the sticking plaster that a GP can offer. A GPs diagnostics are a stethoscope and blood pressure meter. A hospitals are multitude and varied.
This is just more "cutting waste" bullshit on steroids as the examples make clear. We've now got 40 years of IT to look back on and it's clear to most that, while productivity has increased, costs generally have not been reduced. When e-commerce was the next thing™ I remember someone from IBM sagely noting that, while it would improve processes, it probably wouldn't save costs. This was packaged up in the neat slogan "work smarter, not harder", which is one of the better ones of the last few decades.
Also, given the size of the NHS and proposed duration, this can't really count as investment. No, it'll probably just be the usual creative accounting with budgets for, I don't know, pandemic protection being run down or research projects not being renewed.
Likely there will be a case when during a rollout, the NHS staff will have to do double entries - in legacy system and in the new system. That will be even more burden. Then you will have problems with data reconciliation.
Potential for massive disaster and more strain on the NHS especially if done by usual suspects with poor delivery record.
"costs £3.4 billion but it helps unlock £35 billion"
It's a large-scale, government funded project, so will obviously end up costing 10x the original budget, so that leaves you with a modest saving...probably enough to cover the costs of the Public Accounts Committee enquiry into why it went 10x over budget and to issue a statement about lessons learned, yadda yadda yadda...
I see downvotes, so I'll give you one example.
https://obr.uk/efo/economic-and-fiscal-outlook-march-2023/#ftn29-backlink
You can see that in the given example OBR just copies the data from HMRC and don't question that the methodology is rubbish and numbers are massaged to give desired outcome.
I've said it before and I'm saying it again, the folding money will only go the the IT favourites, Palantir, ATOS, Capita, Microshaft, Amazon. Did I miss someone ? Ah, yes Oracle! Here we go again, let's build an IT system not fir for purpose, then we get to re-invent the IT wheel in another 10 years or so of over budget and under delivery.
Please tell me exactly how this world wonder health system will include ANY of the complimentary health practices, lie chiropractics, homeopathy, herbalisms including the use of the politically repugmant cannabis for skin cancer treatment, ADHD. Psilocybin and lions mane for treating depression, etc.
What we will have is another generous gift of sweeties to the American pharmacey/insurance fascists. Maybe our Tory twats have shares in these edifices of serious IT blunder ? Maybe it's the rich twats who fund the Tory Party who have the shares ? Who gives a rats arse. It wasn't the lack of an IT system that caused 5 year wait to get on an NHS dentists panel, 4 x attempts over 5 years to hopefully get an ADHD assessment, still waiting, etc...etc...
Just give the Tories the UK's purse strings and 2p deductions in Tax and Employment Insurance should keep the Goggle Box watching British in their places, queueing...........
Don't make me laugh, I just broke a couple of ribs, and after being advised by 111 to attend the A&E I saved them an ambulance 4hours wait by getting myself there at 6pm. 4 hours later, I am told there is 7 to 8 hour wait to see a doctor. I have had a basic examination to satisfy that I will last 7 to 8 hours in the waiting room and decide to go home without an X-ray, just in case they decide at 6am that I need to stay in hospital. If I am going to die from broken ribs, I'd prefer to be at home with my family rather knowing that I'm going to die whilst waiting in A&E.
It's the continued lack of spending on dentists, doctors and nurses, not the massive free gifts to American companies that is killing the NHS. Think of all the money them Tories will make when we all have to go private in order to get ANY treatment.
ALF not convinced...........
No need for doctors anymore, our systems have profiled every person on the planet and determined exactly which ailments they will have before they have them, and exactly which medication they will need, with the magic of AI.
We've determined that you will soon be suffering from depression. Here's your advance prescription for antidepressants. Feel free to reach out to us if you would prefer to exchange it for a 10% discount voucher at Dignitas
Please note, this service may be terminated without notice when we get bored of it
Late last year, in a weak moment I signed up for allowing my data to be used for NHS research projects because it seemed like A Good Thing To Do. This was after ferreting round the available online information because I wanted to know about the currently running research projects and see what new problems & diseases the combined data of us all could fix. All looked good, though I was a little surprised that there were apparently no current research projects running and there was no information at all about the Federated Database - but at least Palantir seemed not to be involved.
Then two days later I saw a note saying that the new all singing, all dancing NHS Federated Database was just the Palantir-provided COVID tracking database with a new coat of paint.
So, remembering all the dodgy things that outfit has done, i.e. the BREXIT shenanigans, it was the work of a moment to cancel my link to the NHS Federated Whatsit, though I do wonder if they kept their word about not using my data: the NHS blurb said that they would only use data about signed-up citizens and would delete data about anybody leaving the project.
Definitely an area that can be improved. Someone cancels their appointment, offer it to someone else automatically. Then offer the appointment that they had to someone else (or even back to the original canceller so they don't end up at the back of the queue, just a straight swap) etc.
No staff interaction needed, and people get to move up the queue.
There's no question that the NHS needs more effective IT systems but it'll never get it done for a sensible cost whilst it keeps chopping and changing it's mind based on the whims of the political taskmasters. I'd argue that the NHS needs a committee of IT and medical experts to agree a data standard for patient records and communications, a standard as clear and as technical as those that under pin things like USB, TCP/IP etc. etc.
Once anyone and their dog can write software that's compatible and that makes it possible to interchange data, then the commercial markets will finally be able to actually compete with each other and deliver software that saves time and money. Yes, there'll be shitty pieces of software out there, but those will die out over time.
The NHS needs its own health open systems profile, which mandates open standards for medical data interchange, obviously, a fast way to achieve this is to make various proprietary standards, Standard essential and thus subject to FRAND; this being a contractual condition of supply.
Once the NHS effectively owns its own data formats, it become possible to interchange data and thus create the opportunity for people to write compatible software, some of which might be open source.
I'd argue that the NHS needs a committee of IT and medical experts to agree a data standard for patient records and communications
Already a solved problem. Let me introduce you to HL7 and friends.
My preference is for the up and coming FHIR as it supports XML and JSON and is RESTful.
NHS Digital now also offers standardised APIs for accessing data across different systems.
The UK has rejoined the Horizon program, so maybe they'll be contributing to the EEHRxF updates (including FHIR) and EHDS
https://digitalhealthuptake.eu/resources/the-interoperability-of-ehr-systems-and-health-apps-in-the-european-health-data-space/
and allow some other frontrunner to trip over the gaps. And improve medical treatment for UK travellers in Europe.
Let the politicians have a xml tag in the spec for whatever political slogan they must include in "their" system.
One of the biggest issues is there is no such thing as the NHS.
Each hospital trust has a CIO (yet to meet one who could manage a help desk) and and least 3-4 more senior managers in IT with C titles all earning over £100k. This is for organisations that normally have less than 10k staff.
This means each hospital has its own help desk, processes and standards which are not the same as any other hospital.
I am working as a PM on a project with 6 hospitals to implement a digital system for one small area of clinical practice. The IT is simple the herding of egos and people change is almost impossible so we are 2 years late and £1m over budget
Oh yes, it goes very slow and you need people on the ground to constantly persuade the folks and move the whole thing forward. Nothing can be done fast and there is a risk that some new legislation render everything useless. But once it is in place you get your 5 year contracts and the stable revenue stream and you can be proud of doing something useful.
I would not be that harsh towards salaried people though, the responsibilities are quite high and they could always earn more in the industry. The fact that they can get those “IT” people is interesting though. Aside from that I found IT departments in public orgs terrible anyway, they are probably understaffed and constrained by contracts but still …
I know a board member of a major hospital trust.
She says she has a very long list of small improvements - all of which are common sense.
She complains that if she is lucky she can get one item implemented each year.
It is ego's of senior management, and the resistance to any change by the unions, that are the biggest blockages she sees to improvement.
Let us be realistic here, quoted costs £3.4 billion, actually £5-6 billion, savings quoted £35 billion, actual £1.50 and bag of pork crunchies, delivered 10 years late and barely does half the job promised, just in time for the next IT investment and for the political parties to play blame ping pong.
"The UK's finance minister has promised the country's National Health Service (NHS) £3.4 billion ($4.33 billion) in IT investment, claiming it would unlock £35 billion ($44 billion) in efficiency savings by the end of the decade."
Oh, yeah, that's going to work superbly!
We all know that that's how it usually goes. Especially since our ministers are so excellent with technology and science. And there's no cronyism or other corruption at all to worry about. Just like when Covid happened.
