Featured, News, Systems July 14, 2025

Delivering on the NHS 10-Year Plan: Financial flows, workforce, and integrating care

By Gabriel Blaazer

As the government sets out its 10-Year Health Plan, health leaders gathered to discuss the critical enablers of long-term transformation – from fixing fragmented funding flows and investing in digital capability, to equipping the workforce and tackling the wider determinants of health. Can collaboration and local adaptation turn strategy into sustainable change?

On 10 July 2025, Salma Yasmeen (Chief Executive, Sheffield Health and Social Care NHS Foundation Trust), Dr Toli Onon (Joint Chief Medical Officer and Responsible Officer at Manchester University NHS Foundation Trust and incoming Chief Inspector of Hospitals, CQC) and Siobhan Melia (Chief Executive, Sussex Community NHS Foundation Trust and National Adviser for Community Health Services, NHS England), joined PPP and PwC for a specially convened breakfast meeting, exploring next steps following the publication of the 10-Year Health Plan.

Chaired by PPP Chair, the Rt Hon. Stephen Dorrell, and held under the Chatham House Rule, the meeting addressed some of the key implications for health and care services now that the 10-Year Plan has been made public.

Fixing fragmented funding flows

Multiple speakers and attendees highlighted the need to reform NHS financial flows, and in particular, block contracts, which hinder system responsiveness and effective resource allocation. Transitioning to activity and outcome-based funding models, such as year-of-care tariffs, was cited as complex but the direction of travel the NHS should aim for. As the Darzi Report highlighted, acute sector spending has increased from 47 per cent in 2006 to 58 per cent today – a ‘right drift’ rather than the left shift that has been pursued by successive governments, both in the UK and abroad.

As such, current funding models run contrary to the ambitions expressed in the 10-Year Plan, particularly shifting more care away from hospital settings. Since patient journeys span sector siloes, a genuinely integrated and aligned funding model would see financial resources following the patient, not the institution or provider; or, as one speaker explained: “we need funding to flow across interfaces.”

“If you’re a system in deficit, nine times out of 10 that deficit sits within the acute trust; Payment by Results creates a cultural disincentive to trade your way out of financial problems.”

There was particular weight given to shifting investment into partnerships that deliver outcomes for defined cohorts, rather than individual services. “If we can work out how money can flow into partnerships of integration…and incentivise providers collectively to deliver the right outcomes for patients, that would be a gamechanger,” said one speaker.

*(L-R) Dr Toli Onon, Rt Hon. Stephen Dorrell, Salma Yasmeen, Siobhan Melia*

Health and public services: Addressing the real determinants of health

The plan’s emphasis on the wider determinants of health – such as housing, employment and social connection – was welcomed by speakers, particularly with reference to mental health. One speaker celebrated that “this is the first time in many years that we’re dealing with the root causes of mental health,” but cautioned that protecting universal access to mental healthcare must be a priority amid continuing cuts to mental health services.

There was also recognition that more locally responsive models of care are needed, with community-level co-design and diverse participation at their core. “Equity doesn’t happen by chance,” said one speaker: “we need to build it in from the start.” This is particularly relevant when considering rural and urban populations, where the needs of communities and accessibility of health and care services can vary substantially. For example, some rural areas have found success in building Integrated Neighbourhood Teams (INTs) using existing primary care network boundaries, whereas an urban area might benefit from the co-location of GP and community nurses, social workers or pharmacists in a community health hub.

Whatever foundation is used to deliver neighbourhood care, however, speakers argued for the close participation of VCSE partners in core service design and delivery, to ensure that services are reflective of local need and to avoid the creation of “mini institutions” within neighbourhoods.

However, realising the vision of community-centred care will be next to impossible if current multimorbidity trends continue; this means substantial investment into neighbourhoods, communities, employment and housing.

Equipping and supporting the workforce

Speakers noted that the Plan’s emphasis on community and neighbourhood-based care has major implications for workforce readiness; the left shift cannot happen without reshaping training and education of healthcare professionals, nor without truly supporting new models of practice.

Those expected to deliver care in new or unfamiliar environments must be trained to do so. Speakers emphasised that outside of ‘box-ticking exercises’ on undergraduate courses, for instance, healthcare professionals receive little training for delivering care within patients’ homes.

“We need proper treatment programmes in real-world settings, but our current training doesn’t prepare people for that.”

Beyond clinical skills, workforce development also requires addressing the emotional burden faced by staff, particularly in the context of public criticism of NHS staff and professional shortages. “The resident doctors’ industrial action is a symptom of a demoralised workforce,” explained one speaker. Another added that we cannot continue routinely blaming midwives and doctors for systemic failures evident across maternity care, particularly given their shortage across the NHS, and called on the CQC to take a more constructive approach to assessment and regulation of services.

Data, digital and system learning

Concerns were raised regarding the readiness of the NHS workforce to deliver the data-led, digital-first NHS that the 10-Year Plan envisages. Attendees confronted the “assumption that AI will solve all of our problems and reduce the need for analysts,” expressing instead that AI should be viewed as a tool to be used by analysts.

Speakers also noted that while the Plan features a heavy emphasis on technology as a means of alleviating pressure on the health system, there is a significant gap in both infrastructure and capability across the NHS. Digital maturity varies substantially from one system to another, with some providers conducting robotics-assisted surgeries while others still lack access to interoperable patient records.

Investment in digital capability was seen as critical, but several cautioned that funding must also focus on the people needed to interpret and apply data, rather than solely digital infrastructure.

Low data literacy among the workforce was also identified as a particular issue, as biases or gaps within datasets can easily translate into poor service design and exacerbate access and outcome inequalities. It was argued that the government’s £10 billion investment in upgrading NHS technology and delivering a single patient record will be undermined if there is not a similar effort to upskill staff, ensuring they can handle and interpret patient data safely, accurately and with due consideration of potential biases within datasets.

Achieving a meaningful left shift depends heavily on digital maturity across both systems and the workforce. For instance, moving outpatient care out of hospital relies on seamless digital interfaces between primary, secondary and community providers. Similarly, a more connected system would allow GPs to access specialist advice more efficiently, and enable patients to view and manage their own health information.

System-wide digital maturity is essential to demonstrating the value of integrated care. With the right data infrastructure in place, it becomes possible to show how targeted investment – such as in joint models between primary, community and mental health providers – can lead to better patient outcomes, more efficient use of public funds, and a stronger return on investment for taxpayers. This kind of evidence is key to guiding where resources should be deployed in future.

Looking ahead to implementation

Though the plan marks a significant inflection point for the NHS, attendees were mindful of the implementation challenges ahead, and the mixed record of past strategies. One audience member cautioned that: “we’ve had the Five Year Forward View, the Refresh, the Long-Term Plan, the Recovery Plan… maybe a third gets implemented, maybe a third of that has any impact.”

Speakers also noted the absence of strategy for actually delivering the 10-Year Plan, as well as the challenges inherent for integrated care boards in delivering proposed changes alongside 50 per cent running cost reductions. There is also the question of social care, a plan for which is currently being shaped by Baroness Louise Casey’s independent review, and is expected to be released in 2028 at the soonest.

Nonetheless, participants expressed a shared optimism and commitment to shaping the next phase of delivery. For some, the priority is neighbourhood-based support for mental health. For others, it’s recalibrating funding to better serve integrated care.

As one speaker concluded, no single organisation can solve these challenges in isolation; humility, collaboration and local adaptation will be essential to delivering on the 10-Year Plan, and building what comes next.

Next steps

PPP will continue exploring the future of health and care transformation and the implications of the 10-Year Health Plan at our next breakfast event, Implementing the 10-Year Health Plan, on 3 September 2025. We will be joined by the Rt Hon. Alan Milburn, Lead Non-Executive Director for the Department of Health and Social Care, to examine what the 10-Year Plan means for services and local system.

To find out more and secure your place*, please visit the event page.

*Please note that places are limited.

All news

North East initiative unlocks support for tens of thousands of “hidden” carers

By Integrated Care Journal

More than one in ten people living in the North East are known to be providing care for someone – the highest proportion in the UK.

Tens of thousands of unpaid carers living across the North East of England have unlocked crucial support over the last year, thanks to the launch of a landmark initiative. The tech-powered initiative was first rolled out across the North East in June 2024 and has already boosted support for 95,000 unpaid carers living in the region.

Delivered through a collaboration between thirteen local authorities in partnership with the carer-led community Mobilise, the initiative provides the North East’s vital caring community with access to an added layer of on-demand support, through services including an online community forum and tools to help claim financial support. This builds upon the support available through local carers organisations.

The North East has the largest proportion of unpaid carers in the UK, with more than one in ten people living in the region known to be providing care for someone – although the true figure could be far higher.

Digital services boost support for “hidden” carers

According to new research, more than a third of people looking after someone take over three years to recognise their caring roles, meaning many may not realise they are entitled to support. The North East initiative is unlocking support sooner for these ‘hidden’ carers: 4 in 5 (81 per cent) people accessing the online services had not previously engaged with any support.

The online services, which can be accessed 24/7 as well as remotely, are also empowering local carers to access ‘out of hours’ support. More than half (58 per cent) of those who have found support through the initiative are relying on the services outside of working hours.

Steph Downey, Strategic Director for Integrated Adults and Social Care Services (DASS) at Gateshead Council, said of the initiative: “We are so proud of the impact this initiative is having for unpaid carers within our community. Reaching and supporting those with caring responsibilities is a vital priority – and we’re especially keen to reach more ‘hidden’ carers who may not have accessed support before. This partnership is helping us to identify these people sooner and provide on-demand support to anyone who is caring in the region.”

The impact of the North East initiative highlights the need for increased awareness of different caring roles, and the role which round-the-clock support can play in widening access to support. For example, those who juggle caring with paid jobs or care full-time may be restricted around the times that they can access support.

Peter from Redcar and Cleveland who cares for his wife, said: “I’ve been married to my wife for 42 years, and cared for her for the past 11 plus years. I’ve juggled my caring role with full time work for the majority of this time. Currently, I spend all the hours of the day that I can visiting my wife whilst she’s in hospital. This means that dinner time is the only real chance I get to focus on myself and reflect. Being a carer isn’t easy, and it can be during these quieter moments that I’ve found myself struggling in the past and looking for support. This is when having a support network available 24/7 can make all the difference. Other Mobilise users and care experts – people with first-hand experience of what I’m going through – are always there to reply, relate, and urge me on.”

Suzanne Bourne, Head of Carer Support at Mobilise, added: “Not everyone identifies as a carer. But everyone who looks after someone should be aware of their entitlement to support, and be able to access services that fit around their schedules and needs. It’s so encouraging to see the impact that our online community is having across the North East, especially for those who are accessing support for the first time. It’s a privilege to be working with the Local Authorities, Carers Centres’ and caring organisations across the region to help more carers feel seen and supported.”

The digital services are available across all of the following North East regions: South Tyneside, Northumberland, County Durham, Cumberland, Stockton-on-Tees, Redcar and Cleveland, Middlesbrough, Sunderland, Newcastle-Upon-Tyne, Hartlepool, North Tyneside, Gateshead, and Darlington.

To access the support, see here. For more information about the Mobilise community, see here.

Integrating care records is good. Using intelligence to make them active is better

By Dr Paul Deffley

What is needed for the single patient record to deliver intended benefits? Dr Paul Deffley, Chief Medical Officer for Alcidion and former NHS commissioning professional, considers how emerging policy could help patient record systems to become more active and intelligent, enhancing the delivery of care.

A single patient record already exists in the NHS. Or at least, that’s a perception shared by many. A survey of a thousand members of the public, conducted by NHS Confederation-hosted organisation Understanding Patient Data, found that more than six in 10 UK citizens believed information on their NHS history was already collated in a single repository.

A somewhat different reality is known to most people working in the health service. Anyone who has worked in healthcare policy long enough will know that overcoming the challenge of fragmented records has long been a priority for successive NHS and Department of Health leaders.

Following the publication of the NHS 10-Year Health Plan, it is timely to reflect on how the pervasive matter of fragmented records will be overcome. It appears that money will be available after Chancellor Rachel Reeves committed £10bn for NHS digitisation in June’s spending review, which specifies that a single patient NHS record will mean “every part of the health service has a full picture of a patient’s care”.

Integrating care records is good. But unless we make them active – capable of surfacing insights, prompting actions, and working seamlessly within clinical workflows – we risk building a vast digital filing cabinet that gathers dust.

Providers, systems, suppliers, and the thousands of data controllers that exist in healthcare, will all have a role to play in making such a plan reality and undoubtedly, with historic attempts having been abandoned in the past, issues such as the safeguarding of data will be key.

Many other questions must also be asked as the ambition advances to finally overcome data silos. Here’s what four of those questions might be:

Liberating data: What’s the opportunity?

There is already an enormous amount of data captured throughout the patient’s journey. Much of this data sits within the fragmented landscape of applications that form the backbone of health IT systems. Pulling all this data into a single patient record represents enormous complexity and cost, and much of the data will not be of value to future care needs.

The key to a valuable single digital patient record is accessing the pertinent information when it is needed. Liberating the valuable information pertinent to the situation.

Before we go into how an active integrated patient record might be achieved, asking why such a record needs to be created is essential. Some answers have been very well documented over the years – with integrated data opening opportunities for patients not having to repeat themselves, for better informed care, informed patients, and informed research, as well as enhancing decisions that lead to safer care provision.

Whatever transcends into policy or even legislation, designing and delivering record systems that are both useful and used poses two questions: What do clinicians really need from an integrated record? And what will benefit patients?

Patient empowerment will be key against a policy backdrop of prevention – and records will undoubtedly need to prompt and present individuals with the right information to make informed choices about their care. However, the way patients continue to both consume and contribute to that data will change – and strategic approaches must respond accordingly.

Wearables, for example, have become a rich source of data that often remains excluded from patient records. We need to think about how that data and other datasets that haven’t even been conceived yet can be better contribute to the comprehensive picture of a patient’s health. And we need to consider how data in a new single record can be integrated into the digital systems that clinicians actually use in their workflows, rather than creating a standalone silo that sits in the corner of a ward or on an app that never gets accessed.

How can emerging intelligence enable record solutions to be more active?

So, how could a single patient record be put into practice? Simply building a bigger record risks creating a very large database of patient data – something many NHS providers and professionals I speak to are eager to avoid. Particularly those already benefitting from solutions that alleviate the clinical cognitive burden and that are proactive in clinical decision support.

We need to build a solution that can work as an ally to patients and clinicians alike, and that is futureproofed to leverage emerging technologies. Every health and care worker might soon have their own generative AI assistant that can interrogate an integrated record, provide them with support or guidance, and advise on the likelihood of certain actions being a success.

The AI assistant is likely to have the capability to go out and interrogate a wide range of data sources to enrich the integrated record, making a large ‘single’ database unnecessary. Busy clinicians will no longer need to spend their time and effort searching for insight. As we develop record solutions that will take advantage of these capabilities, it is vital that the integrated care record becomes available for every health and care workflow.

The evidence that this works can already be seen in existing technology deployments – I’ve witnessed first-hand the recent benefits of integrating the Great North Care Record in one trust’s EPR, a valuable data source that has exploded in use by making it easy for clinical teams to access. It’s about more than creating a view of such data – this is about integrating data into the forms, pathways, and processes that clinicians use.

Does the NHS need a single record? Or a platform? Or both?

A single patient record is a fantastically clear way to articulate what is trying to be achieved. However, a single patient record does not mean a very large database, poorly designed into care workflows. Access to an integrated record that is populated with contextually rich and relevant data from multiple sources is a much more realistic and powerful way of delivering this capability to our clinicians. In making this happen, we need to be equally articulate about how we will get there from the earliest of stages.

That in part means learning from what has come before so that the programme can be differentiated. Large digital health programmes around the world have sometimes encountered failed adoption and escalating cost, when they have built first, and thought later, about how to integrate the data and insights into clinical workflows.

There is a need to think actively about the application of data in a clinical context, then design the data and intelligence layer that sits behind an integrated record in order to make the system a success, and to ensure we deliver active systems of engagement, rather than simply passive records.

Integrated care systems have a crucial role here – not just in adoption, but in defining what success looks like for local populations. The single patient record must be flexible enough to accommodate these differing priorities, without becoming fragmented all over again. We must be cautious not to conflate ‘single’ with ‘centralised’. A national strategy must enable local adaptability – so that records can support different services, care models, and patient needs across systems.

Who are we building this for?

Population health, research possibilities, changing our understanding of illness – all critical use cases for liberating and consolidating patient data. However, we need to start by meeting the needs of frontline clinicians and patients.

Clinicians need to be able to make good decisions first time to avoid duplication and waste that a stretched system can no longer withstand.

The record has to be an integral point of a patient encounter for it to be an effective partner and one that can then share insights across the integrated system. Imagine if were possible to prevent unnecessary readmissions by flagging patients at risk based on their complete care history, or eliminate duplicate diagnostic tests by providing real-time visibility into recent procedures across different departments and facilities.

Consider the efficiency gains when emergency department clinicians can instantly access a patient’s complete medication history, allergies, and recent specialist consultations rather than starting from scratch or waiting for paper records to be located. This reduces diagnostic time, prevents adverse drug interactions, and enables more targeted treatment protocols.

In surgical settings, integrated records can streamline pre-operative assessments by automatically surfacing relevant imaging, lab results, and specialist recommendations, reducing the need for repeat consultations and accelerating time to surgery. Post-operatively, the same system can trigger appropriate follow-up care protocols and coordinate discharge planning across multiple disciplines.

The efficiency multiplier effect becomes clear when considering how many hours clinicians currently spend searching for information, making phone calls to other departments, or repeating assessments that have already been completed elsewhere in the system. An integrated record that serves as a true clinical partner transforms these time-intensive activities into seamless, data-driven workflows that keep clinicians focused on direct patient care rather than administrative tasks.

From blame to learning: how digital incident reporting can transform patient safety culture

By Vatix

Patient safety is a cornerstone of healthcare, directly affecting the well-being of individuals, the confidence of their families, and the overall trust in the healthcare system.

This content was kindly supported by Vatix.

Keeping safety at the forefront helps reduce serious incidents and prioritise the delivery of quality care.

A key way of ensuring patient safety within any healthcare organisation is to instil the right culture.

Traditionally, the approach to reporting patient safety events has tended to be blame-focused rather than learning-oriented. In recent years, however, a shift has been taking place. The introduction of the Patient Safety Incident Report Framework (PSIRF) and new innovations in digital incident reporting systems have encouraged a culture change.

But before discussing how things are set to change, let’s examine the underlying problem.

The problem: a blame culture in healthcare

A blame culture is when individuals are punished or blamed for mistakes, rather than looking at the bigger picture of why something went wrong. It’s particularly prominent in healthcare as mistakes are often very serious and can be life-threatening.

For example, this could look like blaming a nurse for a medication error without looking into the broader context to see if there could be an issue with unclear labelling or a lack of resources.

This also has a knock-on effect on reporting figures, as people may be wary of reporting events for fear of punishment. And often, the true root cause of the issue is not discovered, meaning that there’s a higher chance of incidents being repeated.

The Serious Incident Framework (SIF) was the old process for reporting patient safety issues in healthcare. It tended to zero in on how the actions of individuals, rather than systems or processes, resulted in mistakes. This emphasis on individual responsibility for a mistake bred a culture of punitive action within some organisations and shifted the focus away from learning and prevention.

Why a learning culture matters for patient safety

A learning culture is built around the value of shared and continuous improvement. Instead of blaming an individual when a mistake is made, organisations should look at the wider context and root cause of the incident.

Incidents should be viewed as a learning experience and encourage open and honest communication about why the event occurred.

The Patient Safety Incident Response Framework (PSIRF) was brought in to replace SIF, which was recognised across the healthcare sector as problematic. PSIRF moves away from blame and towards learning and improvement.

Some of the core benefits of implementing a culture of learning within healthcare organisations include:

Encouraging honest reporting of incidents.
Identifying patterns and trends rather than isolated mistakes.
Promoting proactive safety measures rather than reactive discipline.

However, cultivating a learning mindset doesn’t just happen overnight; effort needs to be put in to ensure it’s fully embedded into an organisation’s culture.

Best practices for creating a sustainable learning culture

Creating a learning culture that is truly embedded in an organisation’s values and operations must begin with a clear commitment from leadership. Leaders must encourage reporting, model transparency, and create an environment where everyone feels safe to speak up without judgment or repercussions.

Regular training and reflection sessions for staff also help keep learning front of mind. The key takeaways from any major incident should be circulated to avoid reoccurrence and assign any relevant corrective actions. During this process, there should be a focus on system-wide issues or the greater context that led to an event rather than individual fault.

Another very important element of creating a lasting safety culture is ensuring that there is an effective and user-friendly digital system in place for reporting and managing incidents.

The role of digital incident reporting in creating a learning culture

Typically, filing a report was paper based, meaning that information could be scattered over several different systems and that it was hard to keep track of learnings and outcomes.

Modern digital reporting tools make reporting incidents easier for staff, patients, and family members. People are more likely to report an incident if it’s simple and they know it will be followed up on.

Digital tools help organisations shift away from a blame culture in a number of ways:

Anonymity and psychological safety: Ensures staff feel safe to report without fear.
Real-time data analysis: Helps identify trends and root causes.
Standardised reporting: Reduces human bias and ensures incidents are reviewed fairly.
Automated feedback and learning: Digital tools can provide instant feedback, resources, or training suggestions based on reported incidents.

The future of patient safety through digital learning

Creating a learning culture in healthcare is vital for improving safety, transparency, and quality of care. Moving away from a culture of blame and towards one focused on shared learning allows staff to feel confident speaking up and participating in meaningful change.

Digital incident reporting systems like Vatix’s are key enablers of this transformation. Vatix makes it easy for staff, patients, and families to report incidents through a secure, user-friendly platform – removing barriers to reporting and encouraging early intervention. Its system supports real-time data analysis and customisable workflows that help organisations spot patterns, address risks proactively, and track actions taken.

With features such as reporting via QR code, mobile access, and seamless integration with other compliance tools, Vatix empowers healthcare organisations to meet safety standards and continually learn, improve, and deliver safer outcomes for everyone.

If you’d like to find out more about how Vatix can help embed a safety culture within your organisation, get in touch today.

How to build digital twins within healthcare

By Ram Rajaraman

As NHS waiting lists climb and pressures on healthcare delivery mount, digital twin technology offers a potentially transformative opportunity. Ram Rajaraman, Healthcare and Life Sciences Industry Leader at Quantexa, explores how creating real-time, data-driven digital replicas of healthcare systems and patient populations could revolutionise prevention, care delivery, and resource planning across the NHS – unlocking a smarter, more predictive approach to population health.

In May, the NHS announced that waiting lists for routine treatment in hospitals had risen for the first time in seven months, despite being out of winter pressure season. The waiting list sits at 7.42mn appointments at the end of March, a steep increase of 18,751 from February.

While it is wholly acknowledged that waiting lists tend to fluctuate with natural spikes in the system, this data comes at a time in which the Labour government finds itself under the spotlight to reduce waiting lists and improve overall NHS performance.

Wes Streeting, whose mission for this parliamentary term is to revamp healthcare efficiency, has already made some radical changes with a view to delivering on this promise. The new 10-Year Health Plan laid out the importance of making the NHS the most “digitally accessible” system in the world. Moves have been made in this direction by announcing promising upgrades to the NHS App that enable its use as a digital front door to the entire NHS.

The department has also teased its ambition to develop a ‘Single Patient Record’ for each NHS patient, using their appointment history and medical records across care specialties. The ambition is that each patient can then seamlessly access care providers across the NHS, without having to repeat their story.

I’d argue for taking this one step further and creating a 360-degree identity of each citizen within their context. Connecting their data across government departments, educational institutions and other public services will allow healthcare providers a full understanding of each patient case.

What are digital twins?

It’s not enough to address individual problem areas such as growing concerns about mental health or challenges with the demand and strain on the system. Instead, there is increasing pressure on government to tackle these systemic issues at their core – using patient data to create a 360-degree identity of each citizen within their context and improve overall population health.

One of the ways to meet these challenges effectively is by embracing digital twins. Digital twins are gaining significant traction as more industries recognise their value in identifying how we tackle complex problems. Put simply, a digital twin works by replicating a physical asset in a digital world, created using smart sensors and data from the original source to model and predict how something will or could behave.

System digital twins are a virtual representation of a real-world system. The twin is made first as a digital model of the real system, using simulations, 3D models or system diagrams. System data can then be integrated into the model continuously or at regular intervals, allowing it to update in real-time. People, places and concepts can be fed into the twin to mirror the current state of the physical system. That means if something in the real system changes, the twin can reflect this immediately.

Simulating society through data integration

Digital twins are currently most often used across supply chain industries to improve real-time insights around customer journeys, in-transit inventory and staffing, and modelling against supply chain variability (McKinsey). The technology is gradually becoming more commonplace – often used in the manufacturing industry to produce models – and Gartner projects that by 2034, global revenue for simulation digital twins will reach $379 billion.

The healthcare industry is starting to adopt digital twins, with pharmaceutical companies embracing them for shipment operations and forecasting in clinical trial labs. But their potential expands beyond clinical trials, and they can be implemented to forecast trends and make predictive analysis about population health. If NHS patient data is fed into the digital twin, data engineers can then model scenarios on the patient population, to gather patient-level insights in the case of unexpected scenarios. To unpack how we can use this innovation to improve health outcomes, it first needs to be understood.

For example, Britain’s life expectancy crisis is developing, with one community reporting male life expectancy on par with war-torn Syria. Digital twins would allow for analysis of why life expectancy is worsening, using a trial-and-error approach to solutions without the need to run studies on the public. Alternatively, if the UK sees a sudden rapid rise of immigration, engineers can simulate the effect on population health with a rise in the spread of foreign diseases and an increase in pressure on the NHS.

Digital twins can be used to develop clinical trials that will get quick and accurate results. Now that the government has announced it will be automatically inviting patients to join clinical trials based on their health data and additional insights, digital twins can map clinical trial outcomes to optimise design for ideal outcomes. This also allows researchers to scale drug discovery, as they can model patient data to get faster and more personalised research.

A third opportunity for digital twins to contribute to healthcare and patient wellbeing is through overall hospital management design and care coordination. By taking a more predictive lens on patient outcomes, hospital staff can staff their treatment centres accordingly and apply the right level of resource.

There is great opportunity for predictive analytics that traditional models of aggregated intelligence didn’t have. As one of the government’s key pillars is “prevention over treatment”, taking advantage of this technology will give the UK’s health service a leg up in the future of its population health.

Rethinking local healthcare with digital twins

The NHS’s regional split must also be used to the system’s advantage when dealing with population health. Integrated care boards (ICBs) and NHS trusts have access to a whole network of health data that applies to their local region, and regional health datasets can be instrumental to the national health ecosystem.

To paint the picture of why regional health data is important, regions with ageing populations may see patterns in diseases that affect an older age group and therefore may be disproportionately reliant on community care. Urban populations may see more illnesses spike from air and water quality issues than a rural population. While all patient data feeds into a wider system, it’s important for ICBs to understand their own geographical challenges.

Regional and local data is incredibly valuable, but currently underused. By beginning to implement digital twin technology at a regional level, ICBs and trusts can start analysing their regional health trends to understand resourcing through a predictive lens. This means that under increasing waiting list pressure or staff shortages, organisations within the NHS can see where they’re lacking, and apply more resources to specific care specialties that will be most valuable for their patients.

Digital twins can also be used to identify regional cohorts of patients that would benefit from prevention initiatives – for example the child flu vaccine, or a diabetes prevention programme. Through a digital twin simulation, local organisations can identify preventative programmes that will be beneficial for their population. And conversely, understanding the potential outcomes of these patients through a digital twin can help determine the cohort.

If able to tackle public health through greater predictivity and prevention, digital twins quickly unlock benefits and rapid innovation to begin improving outcomes at scale. The potential benefits for digital twins go beyond hospital management and improving the efficiency of patient care – there are additional benefits like drug discovery, R&D and disease prevention that have the potential to improve overall population health.

The National Digital Twin Programme has been developed to ensure that the digital twin market is built on secure, trustworthy and ethical standards, while maintaining interoperability and adaptability. There is still a lot of debate around the ethics of using NHS patient data. The way I see it, is that using patient data is not only acceptable – but necessary – when the outcome goes back into patient health. It’s not about arbitrarily collecting patient data, but the safe and secure management of patient data for good.

It is in all our interests to prevent the impact of the next global pandemic, or even just ensure that our neighbours are all receiving a high standard of care. The NHS is one of the largest banks of healthcare data in the world, and we need to use it to improve care for generations to come.

Ram Rajaraman is Healthcare and Life Sciences Industry Lead at Quantexa.

The 10-Year Health Plan: A win for community pharmacy?

By Samantha Semmeling

The government’s 10-Year Health Plan outlines a major shift in NHS priorities, aiming to move care closer to communities, emphasise prevention, and harness digital tools. Central to this vision is an expanded role for community pharmacy, raising questions about how the sector will adapt and whether it is equipped to meet these ambitions.

The government’s 10-Year Health Plan sets out an ambitious transformation for the NHS underpinned by three major shifts: hospital to community, analogue to digital, and sickness to prevention. At the heart of this transformation is the proposed development of a ‘Neighbourhood Health Service’, where pharmacy is set to play a vital role.

The plan outlines a clear transition for community pharmacy, from a predominantly dispensing to a more clinical, preventative and digitally-enabled role. Over the next five years, the government proposes that community pharmacies will:

Manage long-term conditions such as obesity, high blood pressure and high cholesterol
Deliver more preventative services, including vaccinations and screening for cardiovascular disease and diabetes
Support complex medication regimes and offer independent prescribing
Be linked into the Single Patient Record, enabling more seamless service delivery

These proposals build on the success of existing services like Pharmacy First and hypertension case-finding, both of which demonstrate the value of pharmacy in improving access and early intervention. However, this success hinged on public awareness, strong pharmacy leadership, and swift IT integration – which must be central strategies if ambitions for the sector are to be realised.

Pharmacies are critical for prevention as they are well-embedded in local communities, but particularly so in underserved areas that often face the highest burden of chronic disease. However, pharmacies must be equipped with the right tools and training. Innovative diagnostic technologies, such as point-of-care testing, can support early detection and intervention. Although there have been some promising pilots, they are not yet used at scale. Deploying such tools in tandem with workforce training will be essential to delivering preventative services in community pharmacies.

Public Policy Projects (PPP) has previously advocated for a more integrated role for community pharmacy, parity across primary care and a broader understanding of the sector’s role beyond clinical services and medicines optimisation.

Community pharmacies are hyper-local, highly trusted and universally accessible, offering huge potential to deliver social value. From providing culturally sensitive health advice, supporting marginalised populations, or acting as an informal hub for wellbeing, community pharmacies are ideal settings to form part of the emerging Neighbourhood Health Service.

However, unlike general practice, community pharmacies do not hold registered patient lists and often serve individuals who move across geographical boundaries. As such, new services must be designed around the needs of patients, not tied to artificial catchment areas. Primary care contracts which are complementary and integrated by nature, allowing providers to collaborate, not compete, will be essential to seamless service delivery.

The 10-Year Health Plan marks a pivotal moment for community pharmacy. It recognises many of the sector’s often overlooked strengths and proposes a more strategic role for pharmacies in health and care delivery. However, these opportunities must be matched with sustainable funding, contractual reform, and meaningful collaboration across all system partners.

Next steps

To further explore the implications of the 10-Year Health Plan and engage with PPP’s Pharmacy and Medicines work, please contact: Samantha Semmeling, Policy and Programmes Manager, Public Policy Projects (samantha.semmeling@publicpolicyprojects.com)

SAR pressures on the NHS: Why automation is now critical

By Sara Yirrell

Subject Access Requests (SARs) are rising sharply across the NHS, placing increasing strain on trusts. With mounting regulatory pressure and limited resources, Bradford District Care NHS Foundation Trust has taken action, introducing automation to ensure timely responses and protect sensitive patient data.

The number of Subject Access Requests (SARs) being submitted to the NHS is mushrooming year-on-year, and if trusts are left to manage with their current technology set up, many run the risk of falling behind the one-month deadline to complete each request and falling foul of regulations because they have neither the time, nor capacity to keep up with demand.

With the NHS 10-Year Plan also now published, aimed at modernising the health service in England and ensuring it is fit for purpose, decisions must be made on how to streamline core processes and make the whole experience better for not only people working within the NHS, but crucially, the people using it: the patients.

Regulatory requirements such as the UK GDPR and the Data Protection Act 2018 are growing in complexity, and healthcare organisations need robust systems in place to protect sensitive data, and help them respond quickly and efficiently to demands.

Case study: Bradford District Care NHS Foundation Trust

Bradford District Care NHS Foundation Trust is seeing the number of SARs increase by around 100 a year, and has currently received around 700 requests in so far 2025.

Sarah Briggs, Data Protection Manager at the Trust, explains that the SARs were from mixed sources and varied, including from the patients themselves; a solicitor acting on their behalf; police officers that are carrying out investigations; or councils that might be looking into protection orders. They also come from regulatory bodies looking at the Trust’s fitness to practice within the NHS.

She says the Trust had seen an increase in people exercising other rights as well, such as the right to rectification, having things amended or removed completely, and reporting that their records have been accessed inappropriately.

The matter has been exacerbated by the inclusion of emails and email trails, which increases the number of documents needing attention, she added.

Drowning in administration

Briggs said the sheer number of SARs was beginning to weigh the team down and cause sleepless nights.

“The sheer volume of SARs and the different challenges for different types of requests is our biggest challenge,” she says. “We’re a mental health Trust, so some of the records we have on patients with a long history of mental health issues can mean their records are huge. The problems start with struggling to get the records out of the system due to the size of the file which crashed the systems.”

Briggs says the more requests that came in, the more the team were stretched, and the harder it became to hit deadlines.

“You’re not on top of your targets or your workload, and it is really flattening for people not being able to feel like they were doing a good job. As the requests increased, we were not able to spend the time we wanted and it often felt like we were just firefighting,” Briggs adds.

Finding a better alternative

It was the above challenges, and the need for a new approach to SARs, that spurred the Trust to start looking into alternative technology

Briggs says that when she and her team started using Smartbox.ai technology, the functionality it added helped to reduce stress among her team almost immediately.

“The fact Smartbox.ai could handle emails was a massive thing. As was one of the functions – de-threading – which meant we could get rid of duplicates and identify chains of emails,” she says. “It also meant we didn’t have to import Exchange files into our own Outlook, meaning that multiple people could be working on a SAR at the same time which helps to save time and allows us to swap and change tasks when we need to.”

Briggs says that one example of a SAR she received involved 19,000 emails, but by using Smartbox.ai’s technology to remove duplicates, it reduced the number down to a ‘more manageable’ 1,800 files.

“It made such a difference about my own approach to a task and made you feel better about doing it,” Briggs emphasises. “We can also split documents into manageable chunks with Smartbox, rather than feeling overwhelmed.”

Another feature that was a game-changer – the Dictionary function – allows users to create lists of words or ‘risk indicators’ that need to be removed/redacted and implement them immediately.

“With mental health records there is a lot of content in there and sensitive words such as suicide, assault, termination,” explains Briggs. “This tool will help us ensure we don’t miss anything that could cause somebody harm and distress.”

She added that the option to use different colour redaction highlighters was a useful function which made it easier to explain away the information underneath should questions arise.

Communication is key

Another key positive about working with Smartbox.ai is its willingness to listen to feedback and act on it, Briggs claims.

For example, when her Trust first started using the technology, redactions were in black, but Bradford District Care NHS Foundation Trust always redacts information in white, which could have been a serious issue. But after a consultation with Smartbox.ai, the Trust’s needs were taken into account, and that functionality was built into their version of the software.

Simply by listening to its customer needs and acting on it, Smartbox.ai made a big impact, Briggs concludes, leaving her happy to recommend the technology to other Trusts.

“If you are working with technology like Smartbox.ai that is more intuitive and is keeping up with and adapting to how you need to work, it is easier for us to bring on new staff to train and it is easier for them to learn. I would say it is worth other Trusts, particularly Mental Health Trusts, looking into Smartbox.ai.”

If you need help streamlining your SAR processes and are drowning in administrative paperwork, get in touch with Smartbox.ai today and see how we can help you.

UK healthcare industry at the robotics crossroads: Why readiness matters

By Naomi Battison

Despite being a global leader in robotics research, the UK lags far behind in real-world adoption – especially in healthcare, where pressures on the NHS are mounting. With billions in potential savings and significant efficiency gains on the table, now is the time to bridge the gap between innovation and implementation, writes Naomi Battison from The National Robotarium.

The UK has always been a little backward when it comes to going forward. We don’t like to rush things. But our adoption of robotics is slow even by our own national standards. While robotic technologies are revolutionising working practices globally, many fear the NHS and healthcare providers here are simply not seeing the potential of robotics to help alleviate the pressures the NHS in particular is facing. Even a modest 0.1 per cent efficiency improvement via robotics could save more than £190 million annually, with greater adoption potentially unlocking billions more in savings and economic value.

The UK’s robotics paradox

Despite being home to world-class academic research in robotics and artificial intelligence, the UK faces a troubling implementation gap. We currently rank just 24th globally in industrial robot density, lagging significantly behind other G7 nations including France and Italy.

However, the democratisation of robotics, driven by the rapid rise of Generative AI, means the technology is increasingly within reach, even for those with challenging budgets constraints.

Challenges and barriers

Health leaders will cite issues such as cost, uncertainty and the challenge of integrating robotics into their processes as barriers to adoption, but this isn’t simply about spending money and purchasing equipment – it requires strategic planning, workforce training, and operational adjustments.

Of course, of critical concern in healthcare is safety, and around a third of UK decision-makers cite safety risks and inadequate policy frameworks surrounding the use of robotics. This may be the reason that promising startups chose to target foreign markets when trialling or launching their tech.

For example, Touchlab has created an electronic skin for robots which enables them to feel almost as humans do. Despite being UK-based, the company had to run its trials in Finland. Similarly, Bioliberty, which is developing a soft robotic glove for stroke rehabilitation, has chosen to launch its tech in the USA.

The readiness gap

But the need far outweighs the risk. With an ageing population and a system already struggling to cope, help must be sought from somewhere.

To address this gap, the National Robotarium in Edinburgh, a world-leading centre in robotics and AI, based at Heriot-Watt University, is launching a series of Robotics Readiness Review Workshops. These sessions provide an unbiased, expert-led assessment of an organisation’s readiness for robotic integration. Participants receive bespoke guidance to help them realistically evaluate their current position, understand available technologies, and plan the steps needed for effective implementation.

The workshops, which are free to attend, are designed to demystify robotics, and create practical roadmaps for adoption that align with each business’s specific needs and capabilities. By addressing common barriers – from technical knowledge gaps to concerns about return on investment – the aim is to accelerate the responsible integration of robotics across the UK.

Proof of concept

There are some good news stories out there.

NICE has approved the use of eleven cutting-edge robotic surgery systems for soft tissue and orthopaedic procedures. The technology, which is capable of movements more precise than the human hand, has the potential to transform care for patients being operated on by surgeons in specialist NHS centres.

Indeed, between 2016 and 2023, there were a total of 259,000 robot-assisted procedures carried out in the NHS and private sector. This represents a 524 per cent increase since 2016 (11,180 procedures) to 2023 (69,795 procedures). There is no question that these are encouraging figures.

At Calderdale and Huddersfield NHS Foundation Trust, one robot can perform the work equivalent to 4.5 full-time equivalent staff, with five bots delivering the output of 22.5 staff members. In surgical settings, robotic-assisted surgery (RAS) allows procedures to be completed with fewer team members and enables staff to be redeployed during operations, further improving workflow and productivity.

And just ask the family of four-month-old Mohammed from Manchester for their opinion of robotics in healthcare. Mohammed became the youngest child in the world to successfully have surgery using the Versius Surgical System, which surgeons have called a “game changer” for reconstructive surgery.

If further proof of the benefit of robotics were needed, a study of robotic surgery for radical prostatectomy in the NHS in England found that adopting robotic technology led to a 50 per cent reduction in patient length of stay (LoS), a 49 per cent decrease in post-operative LoS and a 29 per cent improvement in labour productivity among urology surgeons.

The promise of an automated future

The future of the NHS is very much up for debate but a greater willingness to embrace robotic technologies as tools to enhance productivity, efficiency and patient care can surely only be a positive step.

Amazon’s founder Jeff Bezos once said, “When we combine human creativity with robotic precision and endurance, we unlock… possibilities that were previously unimaginable.”

So, the real question is not whether robotics will be transformational, but whether the country will have taken the necessary steps to reap the rewards.

For more information about the National Robotarium’s Robotics Readiness Review Workshops, please contact Naomi at n.battison@hw.ac.uk or visit the National Robotarium website.

New report launched to improve productivity measurement in healthcare

By Integrated Care Journal

The report calls on the NHS to adopt multi-faceted measures that better reflect long-term investment, patient outcomes and workforce resilience, alongside greater evaluative and technical integration to bridge the gap between local insights and national decision-making.

A new technical report on Measuring Productivity in Health Care has been published by NHS Arden & GEM Commissioning Support Unit (CSU). Commissioned by the Health Foundation, the report provides an in-depth examination of how productivity in the NHS is currently assessed and how it should evolve to meet the growing challenges facing the health system.

Set against a backdrop of increasing demand, constrained resources and post-pandemic recovery, the report looks at how we measure, and how we should measure productivity in such a complex system as the NHS.

Katie Fozzard, Senior Economist at the Health Foundation, said: “The government has placed significant emphasis on increasing NHS productivity – setting a stretching target for the health service to deliver 2 per cent annual productivity growth. The way productivity is measured, and whether it captures what matters most, is therefore of crucial importance. This report is a vital resource to help us understand the different ways that productivity is measured and areas for improvement.”

Drawing on a wide body of literature and engagement with stakeholders across government, academia, NHS England and local health systems, the report explores the current strengths and limitations of existing productivity metrics, also looking forward to recent developments in productivity measurement, as set out in the ONS recent Public Services Productivity Review. It highlights persistent challenges such as fragmented data, inconsistent coverage across settings, and a lack of tools to evaluate long-term investment, preventative care and workforce resilience.

Rose Taylor, Executive Director Health and Care Transformation at Arden & GEM said: “Understanding and improving NHS productivity is essential to delivering high-quality care with finite resources. This report provides a fresh lens on how we measure productivity in such a complex system, highlighting where current metrics fall short and where new approaches can drive meaningful change.”

The report highlights the breadth of reasons for measuring health care productivity and corresponding approaches. It proposes a new classification framework to better align metrics with their intended use, whether for system-level planning, local service improvement, evaluating resource allocation or national financial accountability.

Among its key areas for development, the report calls for:

The adoption of multi-faceted measures that better reflect long-term investment, patient outcomes and workforce resilience, to strengthen how measures align with future service needs
Greater integration of micro-level evaluative and macro-level technical approaches to bridge the gap between local insights and national decision-making
Investment in metrics that account for the value of preventative care beyond short-term costs
Improved tools to measure productivity across evolving care pathways and system partners, including social care and the independent sector

The Health Foundation will build on these findings in future work to support better long-term decision making across health and social care.

The full Measuring Productivity in Health Care report is available here.

NHS long-term plan, in the short-term: Where tech must help now.

By Dr Mark Ratnarajah

Strategic realignment over the next 10 years is important. But what are the practical, inarguable early wins the government must try to achieve for an NHS now? Dr Mark Ratnarajah, UK Managing Director of C2-Ai and practising NHS paediatrician, offers some answers.

As the unveiling of the long-awaited NHS 10-Year Health Plan rapidly approaches, the need for certainty and direction has never been more pressing.

Staff at the centre are already being reorganised, systems are being re-defined, and productivity and workforce pressures facing the frontline mean that new ways of solving pervasive problems are all but guaranteed to be heralded as the plan hits the shelves.

The Chancellor’s June spending review has earmarked £10bn for digital – but looking beyond the NHS App and a new single patient record, how might this money be used to respond to pressures with new care models, and what must be done much more immediately rather than over the decade?

Here’s seven priorities the new long-term plan must address in the short-term.

Managing electives, preventing demand escalation

A key election pledge, the elective backlog will undoubtedly be prominent in the plan. Though important progress has been observed, NHS Confederation’s recent annual conference reminded delegates that millions of people are still on waiting lists. Addressing the real problem is however more complex than counting numbers.

The underpinning matter is how to manage demand and serve those in greatest need when they need it, so that they don’t deteriorate and subsequently compound demand growth. That’s a complex question but it is possible to answer by a shift in thinking: one where systems respond to a complete individual’s risks and consider the wider human impact, so that we don’t just shift demand from outpatients to A&E or primary care, and inadvertently push patients into other costly parts of the health system.

An immediate opportunity is to learn from pioneers, who have put technology to good use in identifying patients at risk of harm or added complexity while waiting. Trusts and systems have responded with interventions in the community to prevent downstream escalations. In those examples entire patient cohorts have been better supported, and have shown reduced emergency attendances, complications, and lengths of stay.

The plan’s response must be about more than keeping things hanging together. It must be about supporting the customer: the patient; especially if the NHS is to manage an anticipated overall 40 per cent growth in demand in the next 10 years – suggested by compound growth metrics being observed.

Driving prevention, anticipatory health, new citizen responsibilities

Prevention too has sat on healthcare conference agendas for decades. Now it must become reality. In part that means surfacing hidden risks, targeting interventions in communities to avoid harm, and looking beyond boundaries: enabling collaborative data insights on risk across NHS and local government.

New anticipatory pathways are what this really means in practice: predicting health needs at the earliest point. Proactive, rather than passive, healthcare means reducing reliance on the reactive and ensuring fewer patients coming through the front door. We need to address individuals’ needs at-scale before they manifest themselves in expensive ways that are not optimal for the patient or system.

Giving patients agency with targeted data is a must so they are participants and empowered to direct their own health decisions; and to ensure better readiness for the inevitable encounters such as surgery.

As citizens we need to take more responsibility. In mental health services patients are sometimes asked to commit to a contract that includes their responsibility. We might see more of that in managing more long-term conditions. That can only work if we can understand what specifically we expect patients to do to make a difference – technology-driven insight can make that relevant for each patient’s risks. We might better alert patients to the community activities that can help them, and we might better ensure the provision of those facilities to move from medicalisation to a wellness and wellbeing focus.

Supporting the new ICS landscape to manage local demand

Organisations designed by nature to enable cross-organisation convergence around patients, integrated care boards are seeing systemic overhaul just a few years after their creation.

As budgets and headcount are cut, and ICS consolidation advances, they could benefit from technology more than ever in gaining the insights to understand local needs and organise health and social care service configurations.

These organisations will remain central in enabling care to move closer to communities and in preventing downstream cost and pressure. Technology suppliers must support them during a turbulent time so that they can evidence decisions on where and how to deploy resource to address wider determinants of ill health, to respond to citizens and not just patient needs, and to avoid a refocus back on acute care.

Delivering the digital and data revolution

Digital to analogue is something that must now succeed to enable integrated care and decision-making.

New and innovative ideas must be able to scale where they show impact. And we must make a success where commitment has been made. Politics aside, imagine the conversations we could have been having about digital, rather than a focus on moving away from paper, if the National Programme for IT had actually succeeded.

We now need to focus on turning insight into action, on building optimised pathways of care, and on how we can make better decisions with amenable and accessible data that can change practice.

Improving maternity and peri-natal safety

Not in itself one of the three shifts, but maternity safety continues to hit headlines. The ability to deliver safe care here is the barometer for the health service. Well mothers and babies must expect to go in healthy and come out healthy. If we fail that, then we have a key confidence issue for the wider NHS.

Equally, if we can get maternity right, then we can probably get everything else right. In the short term the plan has an opportunity to bring about renewed transparency in quality and safety. That means more than investigations and reports that only shed light on matters after they have become scandals. It also means doing more than measuring compliance with processes through audit.

At least some of the billions being used for technology could be turned to address and prevent avoidable harm in maternity through data-driven insight, that allows early identification of service and system-level problems. There is an opportunity to create new intelligence, but only if we embrace a learning culture.

Building a learning, safe NHS

The fact that safety scandals continue to emerge shows there is more to do to ensure a culture of learning in the health service. Just as real-time insights could prevent harm happening for maternity, the same is true for other services across health and care. Reliance on reports that take place once every few years is not enough. A culture of ongoing transparency, where we can be open about mistakes, must be the direction of travel.

Some of the best performing hospitals in the world are already doing this. Karolinska University Hospital in Sweden, for example, delivers some of the best survival and complication outcomes in the world for severely injured and unwell patients. It has used UK grown technology to prove this, and in a relentless pursuit of quality, continuously works to understand and act on any sub-optimal outcomes. Such approaches could be equally impactful in the UK to allow us to both celebrate excellence and deliver support where it is needed most.

Health equals wealth, and vice versa?

There was a reassuring investment in health in the spending review. But with cuts to other government departments, and the need to respond to ever rising global insecurity, public spending is under closer scrutiny than ever.

To deliver best value, the coming plan might therefore ask: what must we stop doing in order to fund new models of care delivery.

It might also ask questions about the relevance of industries that sit around the NHS to GDP – notably health tech, pharma and life sciences. Could the globally competitive nature of these UK companies be of interest as a means of wealth generation for the country, and to ensure it can continue to afford a health service?

And with phrases like ‘wealth is health, and health is wealth’ being increasingly heard, the plan might consider how a thriving SME sector that invests in the communities it serves could be a positive source for tackling inequity that so often leads to costly ill-health – wealth being a driver of health, and indeed the resilience of the nation.