When health secretary Matt Hancock launched NHSX in April 2019 it was with much optimism and fanfare. However, over the last few months, the digital health unit has come under scrutiny due to the pressures brought on by the pandemic, highlighting concerns about its procurement strategy and fitness for purpose. 

Yesterday, NHSX chief executive Matthew Gould delivered a Q&A keynote at the HSJ Digital Strategy Virtual Summit on NHSX’s successes and weaknesses, as well as revealing its savings from the Microsoft enterprise-wide agreement for the first time. Gould emphasised the ‘extraordinary speed’ the organisation has worked at, achieving ‘years’ worth of progress’ in the first few months of the pandemic.

The successes of NHSX

When asked what NHSX has done well over the course of the pandemic, Gould also highlighted data and the NHS data store as an area of strength: "We are doing better at data that we could have predicted at the start of the year. We used emergency powers, and people's willingness to try and get clinicians the data they needed on their patients."

As part of its latest initiative, NHSX has recently launched an online information governance portal, which provides NHS frontline staff and the public with access to national information governance guidance.

Discussing the previous guide set out by NHSX, Gould said: "I think one of the most useful things we did right at the start of the pandemic was to put out a really simple one-page guide on information governance, which was very clear. It was endorsed by the Information Commissioner and the National Data Guardian, and hugely empowering to people that the frontline had a massive effect."

Remote consultations on the rise

"The shift on remote consultations was extraordinary. At the start of the year, we reckon about three per cent of GP surgeries had the capability to do online consultations, we think it's close to 99 per cent now," stated Gould. 

"In the course of the pandemic, together with NHS digital, we negotiated and signed on behalf of the system, an enterprise-wide agreement with Microsoft. It not only puts us in a much stronger place in terms of sort of consistent and strong approach to cybersecurity but it makes life a lot easier for people at the frontline who don't have to negotiate their own arrangements. We've not said this publicly before, it will save the system at least £300 million."

Elaborating on the three-year deal, Gould explains: "This was a very much a joint NHS Digital NHSX endeavour. We've negotiated a really hefty discount on the 365 package that is now on offer, which has had a sort of massive take up across the system. It's easier, it's better, and it's much cheaper."

The NHS contact tracing app

Despite the widely publicised technical issues experienced by the newly launched NHS contact tracing app, Gould expressed optimism and his thoughts for improvement: "Recently, we've just had the launch of the test and trace NHS COVID-19 app, which immediately became the fastest downloaded app in UK history. But there's a lot more we can do as we go into winter, and as the rates of COVID start to rise, I think digital again is going to need to play its part."

How can NHSX do better?

"I think we can do much more to connect between health and social care. We're going to be working very hard on that," said Gould.

Referring to one of the core parts of the NHSX's role of digitise, connect and transform, Gould admits that the final part of the mission can be improved: "Final thing I'll say is transform. That is where we have not gone as far as we need to and where we're not just automating the existing processes, but doing things better using digital technology.

"A brilliant example of this, that we've been rolling out and trialling, up till now is remote monitoring, where instead of having people go in on a frequent basis to hospitals or GP surgeries, you can monitor them continuously at home. It's more effective, it's more efficient and it's better for the patient.

"In terms of reimagining care, genuinely transforming what we do and rethinking care pathways, I think that's going to be a big focus of our work," concludes Gould.