The chief executive of an organisation championed by Matt Hancock to promote a “digital transformation” in the NHS remains in post a year after the health secretary appointed him, without interview, on a temporary basis.
NHSX has been heavily promoted by Hancock, who created it in 2019 to spur digital change in the health service. During the pandemic he has assigned it high-priority projects as part of the UK’s coronavirus response.
Excerpts from a draft Deloitte audit, compiled in January and seen by the Guardian, state that Matthew Gould, a former diplomat and civil servant, was appointed chief executive of NHSX by the health secretary on a “temporary” basis.
More than a year later, Gould remains in post and his position has not been publicly advertised. A spokesperson for the Department of Health and Social Care (DHSC) said that Gould’s position “will be advertised shortly” and would be subject to a full and open competition.
A senior NHS official said Hancock directed that Gould should be given the top job at the body when it was created. The two men had previously worked together at the culture department, where Gould was digital director while Hancock was culture secretary.
Previously the British ambassador to Israel, Gould reportedly rose up the civil service after being tasked with compiling evidence of how Brexit would damage the UK, on the advice of George Osborne. The two men have been friends since they attended St Paul’s school together.
Launched in July 2019 to deliver Hancock’s “tech vision” for the health service, NHSX has been entrusted with responsibility for key pillars of the government’s coronavirus response, including the first iteration of a Covid-19 tracing app for mobile phones.
It was also tasked with creating a “Covid–19 datastore” to consolidate vast quantities of health data previously spread across multiple divisions of the NHS to assist ministerial decision-making, and has been given responsibility for some of the IT infrastructure surrounding the rollout of Covid-19 vaccinations.
The uncertain state of the organisation in January, as revealed by the draft audit, raises questions as to why Hancock entrusted essential planks of the government’s coronavirus response to a nascent and untested body.
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“The NHSX CEO was appointed without advertisement in July 2019 under temporary arrangements,” according to the draft audit. It said ministerial approval to appoint the permanent post had been obtained and “will be advertised”.
The same audit also found that Gould’s contract and responsibilities were not finalised until several months after he had already started his job.
In May a National Audit Office report on digital transformation in the health service warned that NHSX’s creation had complicated responsibility for the expansion of digital technologies, and that “national governance arrangements for digital transformation remain confused, despite attempts to clarify them”.
Gould reports directly to Simon Stevens, the head of NHS England, while also reporting directly to Hancock.
A report by parliament’s public accounts committee from earlier this month said: “We are concerned that governance arrangements for NHSX have still not been finalised over a year after it was set up.” It added: “There is little transparency over its spending and activity.”
The chair of NHS Digital, which manages the digital infrastructure of the health service, has been tasked with overseeing a review of how responsibility for digital transformation is delineated within the various NHS bodies.
Laura Wade-Gery, who was appointed as the chair in July this year, has received the support of a team from the consultancy firm McKinsey at a cost of £588,000.
NHSX was thrust into the national spotlight after being tasked by Hancock with overseeing the creation of the Covid-19 mobile phone app, which would be installed by members of the public on their phones to help track exposure to the virus.
A DHSC spokesperson said NHSX had “played a vital part in the department’s coronavirus response”.
They added: “The creation of NHSX and the appointment of the chief executive followed due civil service process, with Mr Gould’s appointment approved by the civil service senior leadership committee.”
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