Beyond digital tools: A platform approach to realising the 10-Year Plan

Having worked at the intersection of clinical practice and healthcare technology for over a decade, I’ve witnessed countless digital initiatives that promised transformation but delivered limited to little impact. The difference between success and expensive failure lies not in the sophistication of individual tools, but in our approach to the digital ecosystem itself. The NHS of 2035 won’t be built on better versions of today’s fragmented systems – it will emerge from a fundamentally different architectural philosophy.

The NHS 10-Year Plan: A vision of connected care

Cast your mind forward to a Tuesday morning in the future of the NHS. A community nurse in a rural town reviews their patient roster through an integrated care platform that seamlessly combines hospital discharge summaries, GP records, social care assessments, and real-time physiological data from wearable devices. The nurse doesn’t switch between systems or re-enter data; everything flows through a unified platform that respects data governance while enabling comprehensive care coordination. The platform supports the nurse by making suggestions about optimising care and personalised next steps focused on the best outcome for that individual.

Meanwhile, in an urban teaching hospital, an emergency physician accesses the complete care journey of a patient presenting with chest pain – including their cardiac rehabilitation progress from a different trust, recent pharmacy dispensing patterns suggesting medication non-adherence, and predictive analytics highlighting elevated risk factors. This isn’t science fiction, it’s the logical outcome of platform thinking applied to healthcare delivery.

This future NHS will be characterised by:

• Seamless data liquidity: High quality information flows freely yet securely between care settings, guided by robust governance frameworks and patient consent models. The frustration of data silos becomes a distant memory, replaced by an ecosystem where every authorised clinician has access to the complete picture they need to make informed decisions.
• Predictive and preventive care at scale: Machine learning algorithms continuously analyse population health patterns, identifying at-risk cohorts before crisis points. But crucially, these insights are operationalised through integrated workflows that prompt timely interventions, not trapped in analytical dashboards that few have time to review.
• Empowered patients as active participants: Patients’ agency is high, facilitated through intuitive digital interfaces that provide genuine agency – booking appointments, accessing records, contributing data, and engaging in shared decision-making. The antiquated model of healthcare gives way to genuine partnership.
• Adaptive workforce capabilities: Healthcare professionals work at the top of their licence, supported by AI that handles routine tasks and administrative activity while surfacing critical insights. Workforce stress is managed by reducing cognitive burden and supporting day-to-day decision making. Digital literacy isn’t an add-on skill but fundamental to professional practice, supported by continuous learning platforms that evolve with technological capabilities.

The platform imperative: Why traditional approaches fall short

The conventional approach to healthcare digitisation – implementing point solutions for specific problems – has created the very fragmentation that the system is now struggling to overcome. Each new system, however excellent in isolation, adds another layer to our digital archaeology, another silo to bridge, another interface for care teams to grapple with.

Consider the typical trust’s technology landscape: separate systems for patient administration, clinical noting, prescribing, pathology, radiology, theatres, and countless departmental solutions. Each represents significant investment, each has its champions, and each guards its data jealously. The result? Clinicians become reluctant data clerks, patients repeat their stories endlessly, and critical information remains hidden at crucial moments.#

Platform thinking offers a radically different paradigm. Rather than adding more tools, a platform approach creates a foundational digital infrastructure upon which diverse capabilities can be built, integrated, and evolved. Think of it as the difference between constructing individual buildings versus developing an entire city’s infrastructure – roads, utilities, and communications networks that enable any structure to connect and function within the whole.

Beware though, not all platforms are created equally. Monolithic EPRs call for a rip-and-replace approach, removing trusted clinical solutions with limited engagement. This is often referred to as a walled garden of applications from a single vendor, and can result in vendor lock-in and exposure to price gouging. Many healthcare systems pay astronomical annual licence and support fees while being at the mercy of vendor-defined product roadmaps, stifling innovation and progress.

A true healthcare platform exhibits several critical characteristics:

• Interoperability by design: Built on open standards like FHIR, platforms assume data exchange as a fundamental requirement, not an afterthought. Every component speaks the same language, eliminating the need for complex, brittle integration projects.
• Modular architecture: New capabilities plug in without disrupting existing functions. As medical knowledge advances and care models evolve, the platform adapts through configuration rather than reconstruction.
• Single source of truth: Patient data exists once, accessed many times. Updates propagate instantly across all connected services, ensuring everyone works from the same current information.
• Workflow integration: Rather than forcing users to adapt to system requirements, platforms mould themselves around clinical workflows, reducing cognitive burden and improving adoption.
• Scalable intelligence: AI and analytics operate on comprehensive datasets rather than fragments, generating insights that account for the full complexity of patient journeys.

A framework for transformation: From vision to reality

Understanding the destination is one thing; navigating the journey is another and it is this journey that has proven so taxing for the NHS. There is a long history of recognising the important role of digital technology, but a less successful recognition of the key enablers for true digital change to take place. Trusts face enormous challenges: legacy system dependencies, workforce readiness gaps, funding constraints, and the relentless pressure of operational delivery. How can NHS organisations move toward this platform future while maintaining safe, effective care today?

The following framework provides a pragmatic pathway:

Phase one: Foundation setting

• Assess and align: Conduct a ruthless inventory of current systems, identifying which enable platform approaches and which perpetuate fragmentation. This isn’t about wholesale replacement but understanding your starting position.
• Build the coalition: Transformation at this scale requires unified leadership. Establish a digital transformation board combining clinical, operational, and technical expertise. Ensure frontline clinicians have genuine influence, not token representation.
• Define your north star: Develop a clear, measurable vision for your digital future. What specific outcomes will you achieve? How will patient experience improve? What efficiencies will you realise? Make these concrete, not aspirational.
• Pilot platform approaches: Select a discrete area – perhaps emergency care or outpatients – to demonstrate platform benefits. Choose something significant enough to matter but contained enough to manage. Success here builds momentum for broader change.

Phase two: Capability building

• Establish data governance: Create robust frameworks for data quality, security, and sharing. This isn’t bureaucracy; it’s the foundation upon which everything else builds. Poor data governance kills platform initiatives before they begin.
• Invest in digital literacy: Launch comprehensive workforce development programmes. Every staff member, from porter to professor, needs basic digital skills. Clinical leaders need deeper capabilities to shape technology deployment effectively.
• Develop integration standards: Define and enforce standards for any new system procurement. Every addition to your technology estate should enhance platform capabilities, not create new silos.
• Create quick wins: Identify and resolve specific pain points through platform approaches. Perhaps it’s eliminating duplicate documentation or providing unified views for multidisciplinary teams. Visible improvements maintain stakeholder engagement.

Phase three: Scaling success

• Expand platform coverage: Gradually extend platform capabilities across more departments and workflows. Each expansion should feel natural, building on established successes rather than forcing change.
• Enhance intelligence layers: Begin implementing advanced analytics and AI capabilities. Start with clinical decision support and operational optimisation before moving to predictive models.
• Connect the ecosystem: Establish connections with regional partners – other trusts, primary care networks, social care providers. The platform’s value multiplies with each connection.
• Measure and iterate: Continuously assess impact against your defined outcomes. Be prepared to adjust approach based on evidence, while maintaining strategic direction.

Phase four: Transformation realisation

• Achieve interoperability: Reach a state where data flows seamlessly across your entire care network. This isn’t just technical achievement but operational transformation.
• Empower innovation: With robust platform infrastructure, enable rapid deployment of new capabilities. What once took years now takes months or weeks.
• Demonstrate value: Quantify and communicate benefits – reduced readmissions, improved staff satisfaction, enhanced patient experience. These become the business case for continued investment.
• Share learning: Contribute to national best practice, helping other trusts navigate similar journeys. The NHS succeeds collectively or not at all.

Overcoming the inevitable obstacles

No transformation of this magnitude proceeds smoothly. Trusts will encounter predictable challenges that, if not addressed proactively, can derail even the most promising initiatives.

• Legacy systems: These represent massive investments that can’t be wholesale replaced – instead, modern platforms should wrap these systems, exposing their functionality through contemporary interfaces while planning measured retirement.
• Scepticism: Similarly, healthcare professionals who’ve witnessed multiple failed IT initiatives approach new systems with justified scepticism. Address this through genuine clinical engagement from the start, ensuring technology serves clinical need rather than forcing adaptation.
• Funding: Traditional capital-based procurement models don’t suit platform approaches, which require ongoing capability investment rather than one-time purchases – work with commissioners to develop funding mechanisms that recognise platform economics.
• Information governance: While essential, data governance can become paralysis, legitimate data protection concerns creating barriers to appropriate sharing. Establish clear, risk-based frameworks that enable safe data use rather than preventing it; remember that siloed data unable to help patients represents its own risk.
• Partnership: Finally, beware vendor lock-in from suppliers preferring closed ecosystems that maximise their control. Insist on open standards, data portability, and modular architectures. The best partners enhance your platform capabilities without creating dependencies, understanding that true transformation requires ecosystem collaboration rather than proprietary control.

The imperative for action

The NHS 10-Year Plan sets ambitious goals that simply cannot be achieved through incremental digitisation. We need fundamental transformation in how we conceive, implement, and leverage digital capabilities. Platform thinking offers that transformation pathway – not as theoretical concept but as a practical approach already demonstrating value in progressive trusts.

The choice facing NHS organisations isn’t whether to embrace platform approaches but how quickly they can begin. Further delay perpetuates fragmentation, frustrates staff, and compromises patient care. Conversely, every step toward platform maturity enhances capabilities, improves experiences, and positions organisations for sustainable success.

This transformation won’t be easy. It requires vision, commitment, and sustained effort over years. It demands new thinking about technology, new models of working, and new forms of collaboration. It is more than an EPR. But the alternative – continuing with fragmented, siloed approaches – isn’t viable. The NHS of the future will be built on platforms, or it won’t be fit for purpose.

Starting the conversation

The journey toward platform-enabled healthcare is too important for any organisation to navigate alone. It requires collective wisdom, shared learning, and collaborative problem-solving. Whether you’re a trust executive contemplating transformation, a clinical leader advocating for change, or a technology professional seeking better approaches, the conversation starts now.

At Alcidion, we’ve spent years developing and refining platform approaches to healthcare digitisation, working with trusts across the UK and internationally to overcome fragmentation and realise the benefits of truly integrated care. We’ve learned what works, what doesn’t, and what makes the difference between transformation and expensive disappointment.

But this isn’t about our platform or any single vendor’s solution. It’s about establishing the principles, practices, and partnerships that will define healthcare delivery for the next generation. It’s about ensuring that when we look back 10 years from now, we can say we made the brave decisions that enabled genuine transformation rather than settling for digital decoration of outdated models.

The NHS 10-Year Plan provides the mandate. Platform thinking provides the methodology. The only question remaining is whether we’ll have the courage and commitment to realise this vision. Our patients of the future are counting on the decisions we make today.

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Dr Paul Deffley is Chief Medical Officer at Alcidion, where he leads clinical strategy and innovation. A practicing physician with extensive experience in healthcare transformation, Paul works with NHS trusts to navigate digital change whilst maintaining focus on clinical outcomes and patient experience. He welcomes dialogue about platform approaches to healthcare digitisation and can be reached through Alcidion’s clinical advisory services.

To explore how platform thinking could transform your organisation’s approach to the NHS 10 Year Plan, or to share your own transformation experiences, please connect with Paul and the Alcidion team.