Over the past few weeks, there has been a lot of very familiar talk about the NHS IT market “opening up”. However, this time round and following renewed announcements by the Department of Health about the dismantling of the National Programme for IT, there appears to be a sense that companies, which have latterly been shut out of NHS IT, might finally get a chance to have the door re-opened to them.

But with all the optimism comes the question over whether there is really any place for SME’s in the market. Moreover, do the inroads exist to enable them to take advantage of opportunities that do come along?

A couple of weeks ago, one of our industry advisors, Jeremy Nettle, blogged about whether there is likely to be a procurement spate or blight. So far, it seems that trusts have used the DH announcement to move forward with procurements that had previously been put on ice. So, you would think that this is music to the ears of smaller NHS IT providers waiting to strike.

But instead, at several recent events I’ve noticed a common trend of frustration from the small and medium size companies. Companies appear exasperated that despite the big announcement from the DH, there are no mechanisms in place to allow them to even attempt to compete with enormous, multi-national corporations who have big balance sheets or big reputations behind them.

On a number of occasions I’ve heard how big players, whose primary focus is not healthcare, are winning trust procurements without even having the product that the trust initially tendered for.

Stories of how small companies, who have fantastic working and proven products that address all of the tender specifications and are being dismissed at the first hurdle, appear to be coming increasingly frequent. With the big players then subcontracting them to provide the service instead.

Whilst this method works in some ways, defining a company’s ability to provide for the NHS on their balance sheet as opposed to their product, could have some major implications.

Firstly, shutting smaller companies out has the potential to prevent the QIPP agenda from being pushed forward, stifling the innovation so often shown only by smaller more agile organisations.

Perhaps more scarily is the possibility that NHS IT could turn into another National Programme for IT in all but the name, with only a handful of big and ‘trusted’ companies winning the contracts.

One thing is clear- the Department of Health needs to address this matter now. Whether it is the encouragement of collaboration within the industry, a commitment around interoperability that ensures that all systems can integrate, thus not shutting certain players out of the market, or an easier route to procurement that allows smaller companies to participate without requiring huge amounts of their resources away, it is now time to make those changes.

Sarah Bruce,
Marketing Manager at One Health Alliance
Communications and Digital Media Consultant at Highland Marketing

According to the Institute for Innovation and Improvement ‘Innovation is about doing things differently or doing different things to achieve large gains in performance.’

Often, ‘innovation’ makes us think of technological developments. Whilst new technology makes an important contribution to innovation in the NHS, another critical component is service innovation. It involves designing the process our patients go through, the way we work and the way we redesign and develop our health services.

Following the approval of the Health and Social Care Bill this week, we know there is a utopian view that Lansley can achieve both innovation, service redesign and efficiency gains with his reforms, but can we really meet these objectives without the help of private money?

Radical changes in the way we commission services already mirror many aspects of the corporate sector, using fit for purpose models as opposed to the price is right mentality. Does this signify the privatisation of the NHS? Who knows and does anyone really mind as long as the standard of patient care improves?

Already the Department of Health (DH) has given approval for one NHS hospital, Hinchingbrooke in Cambridgeshire, to be acquired by a private company, Circle Health. In additon, the DH has identified more than 30 ‘underperforming’ NHS trusts increasing the prospect of private firms taking over.

The Guardian recently published an article detailing how a German company has been in talks to take over NHS hospitals, suggesting that there is already significant activity around the tendering of entire hospitals to foreign bidders. The key questions are what are the drivers here -, effective healthcare, patient choice, or off-loading the financial burden of the NHS to the highest bidder?

Advances in medicine coupled with increasing incidence of chronic disease and an ageing population have the potential to lead the NHS into catastrophe. In many respects the government has realised that single entity enterprises of such magnitude would be more of a hindrance than an effective national service.

So are we too stuck on tradition with the romantic notion that the NHS can just keep haemorrhaging money as we grow as a nation and be free at the point of access? I’m not sure.

The Guardian has written the article that suggests scandal. However, is it time to be more open minded on this and examine the potential benefits? As long as patients continue to receive the right care at the right time and in the right way, surely that’s all that matters.

Tom Humphries, UK Business Manager at Clinical Solutions