Back to the Future: Highland Marketing’s Review of the Year, 2024

The year started with the country and public services in crisis. Prime minister Rishi Sunak called a general election – and lost. Sir Keir Starmer formed a new administration. His health and social care secretary Wes Streeting described the NHS as “broken” and brought in New Labour and Brown-era advisors to help him fix it – but details must wait for a 10 Year Health Plan due in early 2025.

Amid all this change and uncertainty, the health tech market slowed, although frontline digitisation and the roll-out of pathology and radiology networks continued, and there was enthusiasm for AI. Highland Marketing looks back over 2024, as it unspooled in the Healthcare Roundup newsletter. 

January:

Junior doctors started their second period of strike action in a long-running dispute about pay and conditions (5 January). On social media, a row surfaced over the role and use of physician associates. With a general election brewing, shadow health and social care secretary Wes Streeting claimed the NHS “needs reform more than it needs money”. In health tech news, NHS England said it was looking for “tiger teams” to help trusts with electronic patient record deployments, and Greater Manchester pushed on with its digital pathology service, using Sectra technology (26 January).

February:

The BMJ’s Commission on the Future of the NHS urged the next government to declare a national health and care emergency and “relaunch the NHS.” MPs urged the government to address the crisis in social care, before it bankrupted more councils (2 February). And the Times Health Commission issued a ten-point plan for the healthcare system, built around digital health accounts or “passports” for patients. Nottingham University Hospitals NHS Trust became the first of a slate of trusts to pick Nervecentre’s cloud-based, mobile electronic patient record, as the frontline digitisation programme continued (9 February).

In Scotland, all NHS building projects were put on hold for at least two years, as the Scottish Government tried to fill a £1.5 billion hole in its budget. Audit Scotland warned, not for the first time, that the NHS in Scotland is not sustainable without a “clear vision” for its future, combined with short-term measures to control costs, bring down waiting lists, address overcrowding, and deal with staff shortages (23 February). Over in Northern Ireland, health minister Robin Swann said its system is “in very real trouble” and the priority would have to be “stabilisation” (27 February).

March:

Chancellor Jeremy Hunt held his last Budget. In a wildly irresponsible package, he cut National Insurance contributions, while building in years of public sector cuts. The NHS got enough money to avoid a real-terms funding fall in 2024-5 and £3.4 billion for IT in 2025-6 – in return for a 2% efficiency savings target (8 March). The following week, health and social care secretary Victoria Atkins asked former M&S boss Steve Rowe to become NHS ‘productivity tsar.’ Frank Hester, the chief executive of TPP and a major Conservative donor, came under scrutiny for disparaging comments about women and minorities that drew in Labour MP Diane Abbott (15 March).  

April:

With the new financial year starting, NHS England published the priorities and planning guidance that normally appears on Christmas Eve. The annual ‘to do list’ told managers to cut staff numbers to pre-Covid levels, improve productivity, and get on top of the finances, even if his meant restricting or reducing services (5 April). Consultants settled their pay dispute with the government. KPMG was awarded £8.5 million to encourage trusts to use the Federated Data Platform, built on Palantir and IQVIA technology. The Good Law Project forced NHS England to publish their multi-million contracts (19 April).

May:

Tim Ferris, the US medic who spent two-years as NHS England’s transformation director, and launched frontline digitisation, returned to advise the NHS on technology (3 May). NHS Dumfries and Galloway suffered the first of two, big, cyber-attacks on the NHS, when it lost 3 terabytes of data to ransomware hackers. The health board’s chief executive described this as “utterly abhorrent criminal activity (10 May).” The Phillips Ives review, which was joint-led by Highland Marketing advisory board member Natasha Phillips, called for significant investment in digital skills for the nursing and midwifery professions, and a ‘digital passport’ to record “competence and capability.”

Labour leader Sir Keir Starmer made cutting NHS waiting times one of six pledges to be included on a pledge card for voters. Streeting said this would be achieved by delivering an additional 40,000 appointments per week, through a mix of overtime and use of the private sector, paid for by a crack-down on ‘non-doms’ (17 May). The following week, prime minister Rishi Sunak gave in to the inevitable and called a general election, while standing outside 10 Downing Street in the pouring rain, as ‘Mr Stop Brexit’ played the New Labour anthem ‘Things Can Only Get Better’ in the background (24 May).

June:

As the rain continued, so did the general election campaign. The Liberal Democrats were the only party to raise social care. In London, two trusts were hugely impacted by a cyber-attack on Synnovis, the public-private partnership that runs their pathology services (7 June). In better health tech news, Belfast and South Eastern health and social care trusts went live with Encompass, Northern Ireland’s Epic-based digital health care record. They also went live with the Clinisys WinPath laboratory information system, which underpins a pathology transformation programme (11 June). The Northern Ireland Blood Transfusion Service went live with the LIMS at around the same time.

July:

As predicted by the polls, the Labour Party won the general election with a huge majority. Sir Keir became prime minister and appointed his shadow team to the Cabinet. Streeting took over at health and social care, as political correspondents predicted there would be roles for members of the Blair and Brown governments in helping to “fix” an NHS that Streeting labelled “broken” (5 July). Lord Ara Darzi was promptly asked to lead an independent review of the NHS to feed into a new 10 Year Health Plan. While chancellor Rachel Reeves uncovered an in-year, £20 billion “black hole” in the nation’s finances (26 July).

August:

Labour made a pay offer to the British Medical Association that brought the debilitating junior doctors’ dispute to a close. However, GPs promptly voted to work to rule (2 August). The Information Commissioner’s Office fined OneAdvanced more than £6 million for a data breach during a cyber security outage in August 2022 (9 August). In a busy month for EPR news, North Cumbria Integrated Care NHS Foundation Trust picked Alcidion as its preferred supplier. East and North Hertfordshire NHS Trust picked the ORBIS U system that Dedalus brought to the UK to replace Lorenzo (16 August). And two more trusts picked Nervecentre.

Meanwhile, the Tony Blair Institute for Global Change urged the government to create “a digital health record for every citizen.” A report argued this should be “a single source of truth” for health and care data, with portals for patients, clinicians and insurers (in context, NHS policy makers and planners). It also argued a DHR could be used to underpin the development of AI (23 August). This is the kind of ‘big idea’ that could well feature in the 10 Year Health Plan. But the summer ended on a grimly realistic note, with Sir Keir warning of a “painful” Budget and Whitehall being ordered to make cuts (30 August).   

September:

Lord Darzi published his rapid review of the state of the NHS and concluded that it is “in serious trouble”, with people “struggling to see a GP”, waiting lists “ballooning”, A&E “in an awful state” and cancer and cardiovascular disease treatment going backwards. Lord Darzi blamed austerity, the Lansley reforms, and repeated failures to back ‘left shift’ policies for the problems; but argued the system has strong fundamentals and can recover with the right treatment (13 September). At the Labour Party conference, Streeting said the NHS’ choices are now “reform or die” (26 September).

October:

First, however, the NHS will need to get through the winter. NHS England urged those eligible to get Covid, flu and RSV vaccines, to try and prevent a “tripledemic” (3 October). But University Hospitals of Leicester NHS Trust became the first to declare a ‘critical incident’ because of demand just a week later. In health tech news, Clanwilliam brought its Epic Care system to the UK, to support care homes (11 October). While the government said it wanted to create “a single patient record”, improve interoperability, and expand smart monitoring in a release launching a “national conversation” on the future of the NHS (25 October).

November:

Reeves finally got to present her first Budget, with a big increase in tax and borrowing for public services and investment to drive growth. There was a small increase in NHS funding, alongside £1.5 billion for capacity and scanners and £2 billion for digital and technology – that looked a lot like Hunt’s money (1 November). Streeting picked-up an old Milburn idea and said he’d like to reintroduce league tables (15 November). He also announced eleven 10 Year Health Plan working groups. Tim Ferris and FDP-promoter Ming Tang are leading a digital and data group alongside Charlotte Refsum from the Tony Blair Institute for Global Change.  

The DHSC was forced to launch an independent review of the role of physician associates. Northern Ireland’s CoreLIMS programme completed its third phase with a Clinisys WinPath go-live at Northern Health and Social Care Trust. East Sussex Healthcare NHS Trust became the ninth to pick Nervecentre. But OneAdvanced withdrew its Carenotes EPR, which was involved in the cyber incident for which it was fined earlier in the year (22 November). C2-Ai pointed one direction for the future of data with a case study about the work it has been doing with Karolinska University Hospital on “extreme transparency” (29 November).

December:

The government’s consultation on its 10 Year Health Plan continued, as NHS leaders expressed concern about a growing gap between its talk of reform and the impact of a new bout of financial stringency on the ground (6 December). As winter drew closer, NHS England announced that 125 emergency departments have adopted High Intensity Use services, in which an AI tool is used to identify “frequent fliers” for one-to-one support. Unfortunately, the initiative will be a drop in the ocean if a “tidal wave” of flu hits this winter, as part of a “quad-demic” of flu, Covid, RSV, and norovirus… (13 December).