The Department of Health Remit to NHS Digital for 2017/18

The Health and Social Care Information Centre (publicly known as NHS Digital and referred to henceforth as NHSD) is an executive non-departmental public body, accountable to the Secretary of State for Health and to Parliament.

NHS Digital's statutory role is set out in the Health and Social Care Act 2012, and additional requirements are conferred on the organisation through the Care Act 2014. NHSD may also undertake additional functions under directions from the Department of Health (referred to hereafter as DH) or the NHS Commissioning Board (publicly known as NHS England and referred to throughout this document as NHS England) or under Mandatory Requests from other Primary Bodies, as outlined in the Act.

The operational relationship between DH and NHSD is set out in the Framework Agreement signed by both parties.

The priorities for the health and care system in operational, policy and development terms are set out in the:
 

• Shared Delivery Plan for 2016/17 and the Single Departmental Plan for 2017/18

• Five Year Forward View

• For information and technology, in the Personalised Health and Care 2020 report which has been translated into ten implementation domains currently encompassing 33 programmes, live service and statutory functions over the spending review period.

DH, NHSD, NHS England and NHS Improvement have designed a revised model for technology and information governance with the intention of clarifying accountability and assurance following operationalisation of the Health and Social Care Act 2012 in specific reference to technology and information programmes. To clarify commissioning, funding, accountability and delivery, a Chief Clinical Information Officer (CCIO) has been appointed, given a system wide remit by DH and employed by NHS England (reporting into NHS England and NHS Improvement), and the key elements of the new governance approach are:-

• DH determines policy and strategic context and sets delegated authorities and controls
• CCIO chairs the National Information Board and the Digital Delivery Board (DDB) and identifies and prioritises the technology and information requirements of the health and care system and commissions services, within the context and constraints of the information and technology implementation domains and funding
• This activity is set within a wider context where DH continues to require NHS Digital to undertake its statutory duties and other functions beyond the remit of the CCIO, or in furtherance of government policy
• DH provides capital, revenue and administrative funding directly to NHSD, for which the NHSD is accountable, reporting to DDB, DH and the NHS Digital Board.
• NHSD is the principal delivery partner for technology and information programmes and services, utilising direct delivery and wider procurement and contracts as appropriate.
• The CCIO and DH discharge prioritisation discussions and funding allocation for technology and information programmes, in full discussion with NHSD, through the Digital Delivery Board (DDB). This is the primary mechanism for oversight, approvals and assurance, although elements of key programmes sit within wider accountability and governance contexts. It also provides a single place to discuss interactions with wider NHSD activity and to drive benefits realisation.

This DH to NHSD remit enables the DH and the CCIO to set out the deliverables and requirements for a defined period, to which NHSD responds with a formal annual business plan.

The purpose of this document is to set out:   
 

• The operating context for NHSD, briefly restating accountability and funding flows

• The outcomes and organisational objectives which the DH expects NHSD to deliver and reflect in its business plan, drawn from the Single Departmental Plan and Ministerial priorities, and reflecting continuing statutory functions and continuing activity within NHSD.

• Reference to the deliverables and objectives associated with the ten implementation domains, commissioned and over seen by the CCIO, which are agreed by DDB and set out in the prioritised programme approved by DDB

• An indication of the grant-in-aid administrative, programme and capital envelope within which NHSD is expected to operate over the spending review period. Formal allocations will be confirmed annually by letter from DH

As ever, there is the need and expectation that NHSD should work collaboratively with key players across health, public health and social care in supporting the system to make the best use of resources and improving health and care outcomes. The Department will look to NHSD to play a key role, working collaboratively with key players across health, public health and social care, in transforming the use of technology, digital services and data across the system to support service improvement and effective demand management. NHSD has a responsibility to exercise financial control and also to contribute to supporting the effective management of finances across the system.

The DH will hold NHSD to account through quarterly accountability meetings for the elements of the DH remit, and for NHSD's fulfilment of its role within the wider health and care system. DH will also hold regular accountability discussions directly with CCIO in relation to the DH to CCIO remit. The purpose of these meetings is to provide the assurance which DH requires for each of its ALBs or delegated functions and to discuss issues which require DH's intervention or action. They will not duplicate actions undertaken within DDB.

The DH will continue to assure and advocate for NHSD through formal, appropriate and proportionate sponsorship arrangements, committing to these being as light touch as possible commensurate with the level of risk whilst providing adequate assurance.

Under the provisions of the agreed governance mechanism for the ten implementation domains, DH expects the CCIO, via the Digital Delivery Board, to hold NHSD to account for delivery of the domains and constituent programmes and activity and to work in partnership to ensure the seamless delivery of aligned technology and information services. The CCIO will ultimately be accountable to DH and Parliament for their system-wide functions as detailed in the DH remit to the CCIO.

NHSD remains accountable to its Chair and Board for all aspects of planning, operation and delivery. The CCIO and a senior representative from DH will also attend NHSD Board meetings as fully participating but non-voting (ex-officio) members.

The accountability mechanisms and governance for the cross-system informatics portfolio, and the respective roles of DH, NHSD, the CCIO and other parties are described in the jointly agreed Governance Paper appended at Annex C.

This DH remit, together with the prioritised set of domains and programmes agreed by the CCIO via DDB should encompass the totality of the system requirement of NHSD. 

At a high level DH and the CCIO (DDB's)'s expectations, cover:
 

• Effective delivery of the milestones and outcomes defined by the Digital Delivery Board in fulfilment of the implementation domains and programmes for Personalised Health and Care 2020, including whole programme and annual deliverables and realisation of benefits.
• Efficient financial control and management of the consolidated information and technology budget for 2017/18, overseen by the CEO as Accounting Officer
• Organisational and strategic development objectives for NHSD to enable it to fulfil the role DH requires it to play in the health and care system, with associated assurance, risk management and core corporate functions
• NHSD's statutory functions including effective support to parliament and compliance with required reporting, approvals and controls.
• NHSD's provision and monitoring of 'live services' to support the health and care system, and which form part of the critical national infrastructure. In practice the DH will expect this to be discharged by the CCIO and managed through DDB, especially in terms of service requirements for major systems and infrastructure programmes, but is included here to ensure that all live services or legacy systems provided by NHSD are fully enabled via the remit.
• NHSD's core role as the secure holder and disseminator of national health and care data, and the implementation of recommendations from the National Data Guardian's Review in respect of public consent and preference for the use of data, and the parallel upholding of 'Type 2' objections as required by the DH and the Information Commissioner.
• Data collections and activity associated with datasets required by DH, and wider national clinical audits and key populations health survey. In practice we expect that the key decisions will be made through DDB, and its supporting Data Co-ordination Board, with appropriate mechanisms for the engagement of appropriate stakeholders, and recognising that NHSD remains the owner and data controller in line with statutory functions.
• Objectives associated with public transparency and NHSD publications
• NHSD's lead role in the reduction of burden across the system, and the provision of advice and reporting to the Secretary of State
• Activity directly commissioned by other government departments or devolved administrations
• Cyber security including investigatory activity and work with the security services
• Emerging policy activity where DH requires NHSD to contribute to assessments of policy feasibility, impact, timetable and cost
• Ongoing policy objectives where NHSD has committed to delivering a service or function
• The stating of service requirements for agreed major live services and the convening of discussions through the Digital Delivery Board (DDB) to balance services levels and affordability in order to define SLAs.
• Commissions to NHSD for horizon scanning or early programme scoping arising from technology focussed work undertaken by the National Information Board and in support of the Five Year Forward View

The DH will hold the CCIO to account for delivery of the ten implementation domains and benefits realisation, and the discharge of functions conferred to the CCIO via a DH to CCIO Remit.

The scope of the DH and CCIO remit is enduring, but the deliverables will be updated annually in time to inform the business planning round (around mid-autumn).

NHSD's operating budget will comprise Capital, programme revenue grant-in-aid and admin revenue grant-in-aid funding allocated directly from the DH to NHSD. NHSD will also generate income from direct commissions from the health and care system, partner agencies or commercial activity.

The Chief Executive of NHSD will act as Accounting Officer for funding. NHSD's Board will oversee the appropriate use of funds and the approval of NHSD's Annual Report and Accounts.

Funding for programme activity within the ten implementation domains will be released via the gated approvals process agreed by the Digital Delivery Board, and continues to be subject to all the requirements of corporate financial management and to further approvals by Ministers, Cabinet Office, HM Treasury and others as required by the delegated authority or thresholds in place.

The NHSD Board retains the responsibility for approving the accounts of NHSD. It is therefore expected that operational mechanisms will be put in place between the CCIO and the Accounting Officer to enable NHSD's Board to discharge these duties in an efficient and effective manner.

NHSD has the primary responsibility in ensuring full and transparent financial reporting to NHSD's Board, DH, CCIO and to the Digital Delivery Board.

NHSD will be notified by DH Finance of the final capital and revenue allocation for NHSD for 2017/18 and the totality of the consolidated capital and revenue allocation for the information and technology portfolio to implement Personalised Health and Care 2020

The DH currently sees a number of strategic development priorities for NHSD in the period from 2016 through to the end of the financial year 2017/18, but reserves the right to alter these following the Chair's capability review.

Each of these is reiterated in Annex A - DH expectations of NHSD.

1.    Cultural change towards a professional service model of delivery, further embedding the functional changes enacted in April 2016 and progressing organisational engagement, compliance and reporting.

2.    Completion of a robust, externally facilitated, formal review of organisational capability and the generation of a comprehensive implementation plan and enabling workforce strategy. It is                  expected that early implementation actions will focus directly on securing delivery of Personalised Health and Care 2020. A section of the review will, in addition, have a particular focus on building digital capability and reviewing other 'hard to fill' professional roles.

3.     Develop a 'whole organisation' business implementation plan and associated reporting which effectively balances the requirements of the Personalised Health and Care2020 programmes with existing activity, statutory functions and direct commissions to deliver expeditiously, effectively and within the requisite annual and overall spending review funding envelope.

4.     Modernising the information and analytics approach to harness benefits of greater automation and ensure improved data quality.

5.     Work to support effective use of data in the health and care system, which sets out NHSD's contribution to and timetable for data science and an engagement with 'big data', including learning best practice.

6.      Respond to the cross-cutting themes of the DH Single Departmental Plan, ensuring that all relevant parts of NHSD work together to support relevant priorities, objectives and milestones.

7.      Implementation of the National Data Guardian's Review and working with DH and key stakeholders on the wider cyber security agenda.

8.      Deliver existing policy requirements and commissions (for example but not limited to Breast and Cosmetic Implant Register, e-MED 3 aggregated data flows to DWP, implementation of the
         MoU with the Home Office for tracing data).

Download Annex A: Department of Health to NHS Digital deliverables for 2017/18

You can also download a PDF of The Department of Health Remit to NHS Digital for 2017/18.