Category: Thought Leadership

Digital Implementation, Featured, News, Thought Leadership

The 10-Year Plan: Achieving its vision for technology through meaningful patient involvement

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With the launch of the Government’s 10-Year Health Plan, patient involvement has suddenly become a major focus of healthcare reform. Barbara Harpham, Chair of the Medical Technology Group, looks at what the NHS needs to do to ensure patients are involved in decision-making in a meaningful way.

The new 10-Year Health Plan places a large emphasis on improving care through patient choice and consultation. Integrated Care Boards (ICBs) are already obliged to involve patients and communities in decisions about their healthcare. But the reality is this function in the health service is not currently prepared for providing the meaningful insight that can support the rapid transformation of the health service being envisaged.

The Medical Technology Group (MTG) is a coalition of patient groups and life sciences companies campaigning for better access to technologies and innovation on the NHS. Meaningfully embedding the insights of patients into decisions and evaluations of new technology and innovation can be particularly powerful in delivering effective services and improving outcomes at both a patient and system level. Patients often provide insight that no dataset or performance metric can reveal – recognising where something has been poorly implemented, or how it could be adapted to improve. They are often the first to spot gaps between policy intention and patient reality.

The need for meaningful patient involvement has only grown with the reforms set out by the 10-Year Health Plan. The operating model envisages foundation trusts becoming more devolved, performance-led Integrated Health Organisations (IHOs), incentivised to focus on outcomes for the local communities they serve.

Meaningfully understanding patient experience across the pathway and post-discharge will also be of importance to new value-based procurement models, now weighted according to long-term social value alongside immediate financial cost.

But what does meaningful patient involvement look like? Our research suggests that its potential is far from being fully realised. Many members of our patient groups have expressed concern that current processes are inadequate, particularly in relation to new technology and innovation, where consultation can often appear inconsistent, tokenistic, and undervalued.

Patient involvement – meaningful or tokenistic?

Prior to the 10-Year Plan, research by the MTG into the structures, policies and processes of the country’s 42 ICBs found significant barriers to meaningful patient involvement. 40 per cent of the boards had no formal patient involvement in meetings and subcommittees in place.

Last year, the MTG hosted its patient involvement forum, bringing together our patient group members to reflect on their experience of how well the system is seeking to understand these insights and integrating them into decision making processes.

The research identified six areas where NHS bodies – including ICBs – must improve if the patient voice is to have a meaningful impact on the technology transformation agenda:

1. Comprehensive training for patients

Patients asked to join committees or technology working groups often receive inadequate training. Some reported that induction sessions were more about “ticking the box” of engagement than equipping them to contribute.

Without understanding policy context, decision-making structures, and the technical aspects of new innovations, patients cannot engage as equal partners. This is particularly critical in discussions around digital tools and AI, where jargon and complexity can exclude all but the most experienced advocates.

What’s needed: Co-designed training programmes developed jointly by NHS organisations and patient groups, tailored to the specific technologies or service changes being discussed.

2. Support mechanisms and resources

True diversity in patient voice cannot be achieved without addressing the practical barriers to participation. Patients with disabilities, those facing language barriers, and those without digital access require tailored support.

Financial considerations matter too. Attending committees often means unpaid time and out-of-pocket expenses, which can exclude those from lower-income backgrounds.

What’s needed: Funded participation schemes through local innovation budgets, accessible meeting formats, and easy-to-understand briefing materials for all technological initiatives.

3. Better promotion of opportunities

Too often, roles for patient representatives are advertised narrowly – via social media or closed networks – limiting the diversity of applicants. Over-reliance on “expert patients” means the same voices are heard repeatedly, reducing representation of the average patient experience.

Even when adverts are seen, the use of technical language can deter those without prior advocacy experience.

What’s needed: Clear, jargon-free adverts promoted through community networks, GP surgeries, and local media, with explicit role expectations.

4. Diversity in experience

Patients with deep knowledge of their own condition are valuable contributors, but if they dominate engagement structures, decisions may overlook broader perspectives. MTG warns that this risks turning involvement into a box-ticking exercise, with limited insight into the needs of underrepresented groups.

What’s needed: Recruitment strategies that actively seek patients from varied cultural, socio-economic, and geographic backgrounds, ensuring innovations work for everyone.

5. Closing the Feedback Loop

Patients consistently report that they rarely hear what happens to their input. Without structured feedback, it’s impossible to know whether patient perspectives shaped the final outcome – or whether they were heard at all.

What’s needed: Standardised feedback processes, such as NICE’s practice of providing clear, written explanations showing where patient insight influenced decisions.

6. Real Decision-making power

Being in the room is not the same as having influence. In too many cases, patients are invited to observe or comment, but not to co-create or vote on final decisions.

In the context of the 10-Year Plan’s technology roll-out, this risks embedding solutions that do not fit patient needs, increasing the likelihood of low adoption or misuse.

What’s needed: formal roles for patients in governance structures, with clear rights and responsibilities in decision-making.

NHS reform without meaningful patient involvement risks failure

There is a real danger in assuming that technology, by itself, will deliver better outcomes. History shows that poorly implemented systems – no matter how advanced – can create new inefficiencies, frustrate users, and even harm patient trust. Embedding the patient voice from the start of this transformation means these risks are spotted earlier, mitigated faster, and are less likely to derail the benefits that innovations promise.

Technology must be matched with processes and resources that put patients at the centre of design and decision-making. This requires cultural change across the NHS, alongside practical reforms:

  • Set national standards for patient involvement in technology rollouts
  • Fund patient participation as part of innovation budgets
  • Mandate diversity and transparency in patient recruitment for ICB committees
  • Evaluate patient experience as a core metric of technology success

At present, too much change is driven by one-way processes led solely by policymakers, clinicians, and technologists. This must become an ongoing dialogue, in which patients are embedded as equal partners in design, decision-making, and evaluation.

Without this, we risk creating a “technology-first” NHS that fails to meet patients’ real-world needs, and misses the chance to harness the patient voice as a catalyst for innovation that works in practice as well as in principle.

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Digital Implementation, Featured, News, Thought Leadership

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

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The NHS 10-Year Plan represents more than a roadmap for healthcare transformation – it’s a clarion call for fundamental change in how we conceive, implement, and leverage digital capabilities across our health system. As we pause for reflection, the question isn’t whether we’ll digitise, but whether we’ll do so in a way that truly transforms care delivery.

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.

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.

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IHOs: Another NHS rebrand? Why ‘integrated care’ is doomed without a financial revolution

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For thirty years, the NHS has chased the dream of integrated care through a dizzying series of reforms. The latest buzzword is the ‘Integrated Healthcare Organisation’ (IHO), but it is doomed to fail just like its predecessors, unless we radically reform the financial incentives that pit hospitals against community care. By Lucia De Santis, Consultant at Edge Health. 

Ghosts of reforms past: A thirty-year journey of fragmentation

Before the market reforms, District Health Authorities (DHAs) ran the whole show. They planned services and managed the hospitals and community care for their local population. It was an integrated model by design, but it had a fatal flaw. Funding was based on history, not on how many patients were treated, how complex their needs were, or the quality of the care provided. This gave hospitals little reason to innovate or improve, feeding the waiting list crisis of the late 1980s – with median waiting times for inpatient treatment (the only recorded metric at the time) hitting over 22 weeks.

The 1989 Working for Patients white paper blew this model apart, introducing the “purchaser-provider split” that would define the NHS for the next thirty years. The theory was simple: separate the buyers of care (commissioners) from the sellers (providers) and let competition drive everything forward. Money was the carrot – and the stick.

What followed, however, was a dizzying series of reorganisations, as successive governments tweaked the model, moving from GP Fundholding to Primary Care Trusts and finally to Clinical Commissioning Groups (CCGs). This market-based philosophy reached its peak with the 2012 Health and Social Care Act, which put competition at the very heart of the NHS.

Timeline of NHS policies on the provider-commissioner split that led to the creation of ICBs and the premise for IHOs (Image credit: Edge Health)

The market’s hangover

By the mid-2010s, it was clear the market experiment had struggled to deliver, and left a legacy of fragmentation. One could argue fragmentation has its merits – less bureaucracy, can drive high activity levels (which, until recently, was the key marker of performance). However, fragmentation shows its flaws when it comes to caring for a population with increasingly complex, long-term conditions. This requires seamless coordination between GPs, hospitals, and community services.

Plus, collaboration becomes an even greater struggle when community and secondary care are made to argue over who gets the slice of the pie needed to sustain services. Under Payment by Results, a hospital admission generates income. This wouldn’t be as much of an issue if prices were truly reflective of costs. In reality, costs change with activity (economies of scale) and often prices aren’t set to the actual cost, translating in significant cross-subsidies to sustain “loss-making” services. This creates a perverse, if logical, reality: moving care into the community isn’t just a different way of working; for a hospital trust, it is a direct threat to its bottom line.

The 2022 Health and Care Act officially buried the purchaser-provider split, establishing integrated care systems (ICSs) to bring everyone back to the same table. But while the law changed, the culture (and the money) didn’t. Today’s integrated care boards (ICBs) are left trying to align the priorities of hospitals and community providers in a system still wired for competition and cost management. This has bred a deep-seated scarcity mindset. For decades, providers have been forced to focus on their own financial preservation, diverting energy from transformation to simply keeping the lights on.

And so, we are back to a single organisation – the IHO. However, this model is fundamentally different from ICBs. If the NHS chose to mimic international counterparts, it would mean giving a single provider organisation total control over the budget for a population’s entire care journey. The hope is palpable: under one leadership and budget, integration could finally become a reality.

Making IHOs work: Follow the money

In dismantling the old command-and-control model, the reforms of the past threw the baby out with the bathwater. A single organisation overseeing both hospital and community care is not inherently a bad idea. The mistake was funding them without sufficient accountability*, and the overall lack of focus on performance, need, outcomes (and data!).

If we are serious about making community and hospital services partners instead of economic rivals, giving a single provider organisation responsibility for the whole patient journey feels like the only way forward. But to break the cycle of perverse incentives we must accept that in healthcare, real change follows the money.

The solution is a tough but effective one: change the payment model to make it more financially appealing for organisations to deliver more activity in the community and less in hospitals (where appropriate, of course). This only works, however, under one non-negotiable condition: the IHO must hold the entire budget for both community and acute care for its population and be fully accountable for the level of quality that it needs to deliver. Without this, you unleash the “NHS Hunger Games” – a turf war where providers are locked in a battle for their own survival.

By giving a single IHO control over the whole budget, shifting care from a costly hospital bed to a more efficient community setting** suddenly becomes the most rational financial choice. This requires two bold moves:

  • Direct investment: We must supercharge community services to build their capacity. Ideally, this would be an “invest-to-save” model, paying a premium for care delivered out of hospital. A more painful but perhaps necessary alternative would be to pay less for hospital activity that could have been delivered in the community.
  • Tied funding: The IHO’s budget must be linked to both population need and performance. Organisations struggling to meet population needs where others in similar contexts (deprivation, demographics) have succeeded would need to be held accountable and undergo greater scrutiny to fix the drivers or be financially liable.

Betting on prevention

One obvious critique of the above is that paying community activity at a “premium” doesn’t actually save any money – at best, if funds are moved away from the acute setting, it would achieve a net neutral scenario. But here’s the key – this shift is not going to suddenly unlock billions of savings overnight. However, it feels like the necessary carrot to drive a behaviour change: invest more in prevention, rather than focus all efforts on treatment. Currently, with a healthcare infrastructure that favours acute treatment from a financial, structural and capital point of view, there’s just not enough incentives to move activity out of hospitals.

Leaders should be making a bet: that a behaviour shift favouring prevention and community care will truly deliver a healthier population. There are very good grounds to believe it true. But we can’t expect an overnight change, that’s not how physiology works. We are unlikely to see true savings for a decade at least – but it’s a worthy investment.

Three rules to make IHOs work in the NHS where others have failed (Image credit: Edge Health)

A call for bold leadership

The foundations for IHOs have already been laid by Provider Collaboratives. In places like Cheshire and Merseyside, hospital trusts are already working together at scale – and won an HSJ award in 2023 for working together to eliminate long waits. If these collaboratives were given control over a single, population-based budget and the freedom to reward prevention over cure, we might finally achieve the integration we have been promised for so long.

Of course, that is if we can eventually shift collaboratives towards conglomerates that function more as a unit (operationally, digitally, workforce-y…) rather than a chimera of different interests and operating models.

Navigating this transition will be complex, and leaders will need to be bold, grasp the nettle of financial reform to really build the integrated system that patients deserve, and staff have long been promised, rather than just shuffling chairs on the deck – again.

* In the pre-1990 DHA times, a hospital received its budget as a block grant at the start of the year, and any unspent surplus was often clawed back by the authority, creating an incentive to spend the entire allocation regardless of efficiency. There was no meaningful relationship between the funding a DHA received and the number of patients its hospitals were treating. This offered limited incentives for hospitals to innovate, improve productivity, or take on additional work. Additionally, there was no independent external agent with the power or incentive to challenge its performance. If a hospital was inefficient, its waiting list would grow.

** Research from NHS Confederation found that “On average, systems that invested more in community care saw 15 per cent lower non-elective admission rates and 10 per cent lower ambulance conveyance rates, both statistically significant differences, together with lower average activity for elective admissions and A&E attendances.”

About the author

Lucia De Santis is a Consultant and NHS-trained medical doctor. She is passionate about engaging workforce in healthcare improvements, evidence-based transformation and operational strategy. Her unique insights add depth and human element to data analysis, literature review and visualisation.

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The NHS 10-Year Plan: Five opportunities that could transform prevention

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As attention turns to delivering the NHS 10-Year Plan’s bold ambitions, Professor Rob Copeland of Sheffield Hallam University argues that its true potential lies in community-based prevention. Drawing on evidence from the Advanced Wellbeing Research Centre, he sets out five overlooked opportunities that could redefine how the NHS supports population health and tackles inequality.

While recent media coverage has focused on AI promises and workforce expansion, the NHS 10-Year Health Plan for England contains important commitments regarding community-based prevention that could prove just as transformative for health outcomes.

At Sheffield Hallam University’s Advanced Wellbeing Research Centre (AWRC), we have spent the last five years implementing and evaluating community-based prevention approaches across South Yorkshire. This experience has convinced me that the plan’s intention to shift focus from “sickness to prevention” isn’t just rhetoric, but is the necessary policy focus to re-imagine health and care and tackle inequalities. It won’t just happen, however; it needs investment.

The plan contains specific mechanisms that, if implemented effectively, could revolutionise how hospital leaders think about population health, financial incentives, and community partnerships. Here are five elements worthy of immediate consideration:

1. Health and Growth Accelerators represent an economic-health integration revolution

The plan’s commitment to establish Health and Growth Accelerators across all integrated care boards (ICBs) represents a principle we’ve been advocating for a number of years at the Advanced Wellbeing Research Centre – that health and economic outcomes are inseparable.

The commitment for all ICBs to establish “specific and measurable outcome targets on their contribution to reducing economic inactivity and unemployment” marks a significant shift in the NHS’s role from a service primarily focused on treating illness to one accountable for population-level economic outcomes. To realise this ambition, the NHS must go beyond policy and actively build the relationships and infrastructure within communities that enable prevention and wellbeing to flourish.

This approach aligns with evidence showing that for every £1 invested in community-led health initiatives, up to £8.56 in social and economic value is generated. It also reflects a growing recognition that “the biggest barriers to better health often lie in systems that make healthy choices difficult for those living in the poorest communities” – a reality we’ve long highlighted, where your postcode still largely determines your health outcomes.

Through our virtual clinic for long-COVID, we’ve demonstrated how community-based approaches can reach underserved populations who might otherwise struggle to access traditional healthcare services. By addressing the social determinants of health – employment, housing, access to green space – we can create measurable improvements in both population health and economic activity.

2. Co-location mandates could revolutionise infrastructure beyond sharing buildings

The plan’s mandate for Neighbourhood Health Centres to “co-locate NHS, local authority and voluntary sector services”, including rehabilitation services, represents the infrastructure revolution we’ve been pioneering at the National Centre for Sport and Exercise Medicine in Sheffield over the past decade.

Our model has facilitated over 120,000 annual clinical appointments in community settings, with nearly half of referrals coming from the most deprived communities. We’ve also seen examples where co-location achieves substantial reductions in secondary care referrals. Ensuring that the majority of the population has access to co-located services within 20 minutes of their home would be transformative in terms of health equity – but we’ve learned that co-location must go beyond physical proximity with success dependent on genuine community ownership and design.

This requires productive partnerships that leverage diverse skills, reduce duplication and drive innovation, prioritising investment in community-led decision making.

3. Value-based payments finally reward prevention over treatment

The plan’s commitment to ‘pay for impact on health outcomes’ represents the most significant opportunity to embed prevention at scale. Our Active Together cancer prehabilitation programme demonstrates exactly what this looks like in practice – we’ve observed a 95 per cent one-year survival rate compared to 85 per cent for non-participants, with estimated net savings of £366.36 per patient.

The introduction of Year of Care Payments that incentivise keeping patients healthy rather than treating illness represents a fundamental shift we’ve been arguing for. These payments consolidate all primary care, community health, mental health, specialist outpatient care, and emergency services into single capitated budgets, creating sharp incentives to invest in prevention rather than just treat illness, and providing a powerful drive to develop the aforementioned relationships and infrastructure with community organisations that will be essential for keeping people well.

4. Prevention workforce development remains critically underdeveloped

Despite the plan’s prevention rhetoric, it overlooks the importance of equipping existing staff with prevention skills. This reflects a missed opportunity to make rapid, yet meaningful progress. We know from our work that healthcare professionals need practical skills to have meaningful conversations about physical activity, movement, and lifestyle. The Physical Activity Clinical Champions (PACC) programme has upskilled over 58,000 healthcare workers across England, creating the capability, capacity and scalability for a prevention-focused workforce.

The plan’s commitment to overhauling education and training curricula over the next three years creates the perfect opportunity to embed physical activity promotion as a core competency. Our integrated curriculum approach at Sheffield Hallam University shows how this can work – but it requires systematic commitment, not just good intentions. Without workforce development, the prevention shift risks remaining aspirational rather than operational.

5. Prehabilitation represents untapped potential beyond cancer care

The plan’s limited detail on prehabilitation programmes represents a significant gap, particularly given the evidence of their impacts across multiple conditions and surgical outcomes. While we’ve demonstrated clinical and economic benefits in cancer care through initiatives like our Active Together programme, the potential extends far beyond oncology to orthopaedics, cardiac surgery, and other planned procedures.

Community-based prehabilitation programmes that address barriers such as geographic location and socioeconomic status create more resilient populations while reducing system pressure. Our research demonstrates that addressing common barriers to access promotes inclusivity and achieves better health outcomes for all populations.

We call for a comprehensive rehabilitation (including prehabilitation) guarantee across all ICBs by the end of this Parliament – not just for cancer care, but as a systematic approach to building population resilience across all planned procedures and long-term conditions. The evidence base exists; what’s missing is systematic implementation across the NHS.

Local innovation must bridge the implementation gaps

The plan’s success depends on local innovation to bridge the aforementioned implementation gaps in terms of capability and capacity. Therefore, hospital leaders should be supported and encouraged to focus on immediate actions such as developing prevention capabilities within existing teams via PACC training, establishing meaningful partnerships with community assets through embedded and co-funded roles, and designing prehabilitation into the pathways of planned procedures, including those that extend beyond traditional clinical boundaries.

We invite hospital leaders to visit the AWRC at the Sheffield Olympic Legacy Park to see these approaches in action. The evidence is compelling, the methods are established, and the time for action is now. As the NHS implements its 10-Year Plan, we have a unique opportunity to create a healthcare system that doesn’t just treat illness but purposefully promotes health for all communities.

 

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UK’s first AI-powered physio more than halves back pain waiting lists

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A new CQC-approved, AI-powered physiotherapy clinic, which provides same-day appointments for back pain via a smartphone app, has more than halved waiting lists for back pain in its first large-scale deployment in England.

The UK’s first AI-powered physiotherapy clinic has shown promising results in its first large-scale deployment in the NHS in England.

Called Flok Health, the clinic was created by a team of physiotherapy and AI experts based in Cambridge and saw its first large-scale UK deployment earlier this year, when it was rolled out to more than a million patients by NHS Lothian in Scotland.

The clinic is the first digital musculoskeletal (MSK) service to have been approved by the CQC, and has also achieved medical device certification under MHRA regulations.

Created using video footage of a human physiotherapist, the pioneering digital clinic is able to offer NHS patients personalised treatment for back pain at population scale, with zero waitlist, in a setting which feels like a video call with a physiotherapist.

The technology was deployed in Cambridgeshire and Peterborough in February by Cambridgeshire Community Services NHS Trust (CCS): the first NHS organisation in England to make Flok’s AI clinic available to patients across a range of community healthcare settings including self-referred and clinician-referred patients.

According to the NHS, over 30 million working days are lost to MSK conditions like back pain every year in the UK, with MSK problems accounting for up to 30 per cent of GP appointments. Addressing the causes of ill health and economic inactivity will be key to the government’s efforts to relieve pressure on care services, as well as to turn the NHS into an engine of economic growth.

Mike Passfield, Deputy Director from Cambridgeshire Community Services NHS Trust, commented: “We’re proud to have been the first NHS organisation in England to deploy Flok Health’s AI powered physiotherapy clinic at scale. The impact has been extraordinary, delivering same-day access to care for thousands of patients, reducing back pain waiting lists by over 50 per cent, and freeing up clinicians to focus on other patients with complex MSK conditions.”

AI tackles MSK waits in Cambridgeshire

Patients living in Cambridgeshire and Peterborough were able to access Flok over a twelve-week period between the beginning of February and the end of May 2025.

This was part of a pilot deployment commissioned by CCS in partnership with the GIRFT Further Faster Programme – an initiative bringing together NHS clinicians and operational teams to improve access and waiting times for patients.

When the AI clinic first went live in Cambridgeshire, waiting times for elective community musculoskeletal (MSK) services in the region stood at eighteen weeks.

An appointment question on the Flok Health clinic (click to enlarge)

Over the course of twelve weeks, the deployment of Flok (in combination with initiatives including MSK “superclinics” and community assessment days) reduced waiting times for all MSK conditions across CCS by 44 per cent, to under 10 weeks.

One patient, Sharon McMahon, a primary school teacher from Hardwick, revealed the impact that Flok had on her recovery following an incidence of back pain that left her unable to work for two weeks: “An NHS physio suggested I try Flok. I was initially disappointed not to be receiving face-to-face care. I’m not disappointed now. The AI clinic has delivered exactly the same results as I’d expect from a traditional physio – and much more quickly.

“I started my treatment the same day, and was able to get appointments and complete exercises whenever I liked. My back was back to normal after a couple of weeks, but I’m still using the app twice a week to manage pain when I get flare ups or spasms.

“If it wasn’t for Flok, I might still be waiting for an in-person appointment or be paying to see someone privately. I’d recommend the app to anyone.”

Flok’s AI clinic – the only intervention deployed specifically to treat back pain – exclusively reduced waiting lists for back pain by 55 per cent, and saved 856 hours of clinician time per month within the Trust.

Patients who accessed Flok’s digital service were able to do so immediately, experiencing waits of zero days.

Of the patients treated via the AI pathway, fewer than 2 per cent requested or required referral to a traditional face-to-face service. That means more than 98 per cent were triaged, treated and discharged via the digital service, relieving pressure on existing pathways and enabling clinicians to see patients who wanted or needed face-to-face appointments faster and for longer.

More than 2,500 patients living in Cambridge and Peterborough accessed the AI clinic over the twelve-week period.

AI physiotherapy exceeds patient satisfaction targets

After using Flok Health, 8 in 10 (80 per cent) patients in Cambridgeshire reported that their experience with Flok had been “equivalent or better” than traditional face-to-face physiotherapy.

78 per cent of patients reported that their overall experience with Flok had been “good” or “very good”, exceeding patient satisfaction targets set by CCS at the outset of the project.

Mike Passfield added: “What matters most to us is making sure patients get the right care quickly and safely and this pilot has shown that innovation like Flok can truly transform how we deliver services.

“This pilot has demonstrated how innovation, when safely and thoughtfully integrated into NHS pathways, can dramatically improve access, outcomes and patient experience. We look forward to working with Flok to explore how this service can be scaled across our region to benefit even more people.”

Finn Stevenson, co-Founder and CEO of Flok Health, said: “Seeing the impact our service has had in Cambridgeshire and Peterborough – which is also where our team lives and works – has been incredibly meaningful.

“Our AI clinic enables patients to access world-class MSK care immediately, whilst freeing up traditional clinical capacity for patients who want or need to see a clinician in person.

“We look forward to continuing to work closely with our innovative NHS partners to deliver gold-standard, scalable MSK care to patients in Cambridgeshire and across the UK.”

Data from an early trial at Cambridge University Hospitals in 2023 indicated that the AI clinic had helped reduce wait times for physiotherapy, with wait lists for in-person musculoskeletal appointments increasing by more than 50 per cent once the pilot had ended and the AI clinic was no longer in use.

Following the success of the pilot, Flok is working with CCS to explore permanently rolling out the digital service to patients in the region.

Flok co-Founders Ric da Silva (L) and Finn Stevenson (R)

 

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From plan to practice: Reacting to the 10-Year Plan in Greater Manchester

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At a recent dinner hosted by Public Policy Projects and HealthPathways, senior NHS and public health leaders from across Greater Manchester came together to reflect on the challenge that now sits at the heart of health reform in England: how to translate the ambitions of the NHS 10-Year Plan into real, measurable improvements in the lives of citizens.

The meeting, held against the backdrop of a period of seismic reform for the NHS and wider care system, revealed both the promise and pain points of system integration. Stakeholders present emphasised leadership, system-wide data use, behaviour change, and trust as critical enablers of transformation. Participants included NHS trust CEOs, ICS leaders, clinicians, and senior public health officials from across Greater Manchester, considered to be one of the most integrated health systems in England.

The dinner also featured a presentation from HealthPathways Advisor, David Meates, who previously led the integrated Canterbury Health System in New Zealand. HealthPathways supports clinicians across New Zealand, Australia, and the UK by providing access to evidence-based best practices at the point of care. Its system-wide approach to care pathway redesign has demonstrated significant benefits for patients, staff, and health systems. Notably, its work with New Zealand’s Canterbury District Health Board resulted in marked improvements in productivity and patient outcomes across the system, highlighting the importance of prioritising cultural change, intelligent incentivisation, and ongoing community and patient engagement.

Despite widespread agreement about the direction set out in the 10-Year Plan, there was a clear sense from the meeting that national policy has so far failed to address the deeper behavioural, cultural and financial architecture that will determine whether the plan succeeds or fails.

A region built for integration, still struggling with fragmentation

Greater Manchester, with its devolved governance model and longstanding commitment to integration, is arguably the most fertile ground in England for delivering on the ambitions of the 10-Year Plan. With nine provider trusts and deep collaboration with the Greater Manchester Combined Authority, the region has made major advances in data sharing, population health management, and broader public service alignment.

However, challenges for the region remain stark. There remain significant post-Covid performance pressures, and Greater Manchester has some of the longest waiting lists in the country, in addition to large-scale financial deficits. “We’ve built some of the most sophisticated integrated data infrastructure in the UK,” said one attendee, “but we still face fundamental problems of access and inequality.”

As one trust leader put it, “We’ve made progress, but we haven’t yet cracked the problem of how to enable the system to truly work as one.”

Vagueness as virtue or risk?

The 10-Year Plan has been welcomed in Greater Manchester for its broad framing and long-term outlook. However, delegates argued that the plan’s perceived vagueness is a liability to tangible service improvement. “The plan leaves the hard questions, such as trade-offs, funding and prioritisation, on the table,” one participant said. “NHS England makes a virtue of this in order to give local leaders space to develop local solutions. However, we need clarity about who is empowered to answer those questions locally.”

David Meates pointed to the opportunity inherent in this ambiguity. “Don’t wait for the centre to tell you what to do,” he said. “Use that space. Make it yours.”

There was widespread agreement that success now depends on local leaders stepping into that gap, with both strategy and delivery. “This isn’t a conversation we can leave in Whitehall,” one attendee reflected. “This is about what we do locally.”

Lessons from New Zealand

Many of the issues faced by David Meates when he took over the Canterbury system have clear parallels to NHS struggles, including a fragmented system and a lack of local cohesion. As Meates articulated, exponential increases in funding from previous New Zealand governments had yielded little to no improvement in service delivery, productivity or patient outcomes.

Meates’ team sought to create a framework for “a connected system, centred around people, that aimed not to waste their time”. This was built upon three core strategic objectives:

  • People take greater responsibility for their own health
  • People stay well in their own homes and communities
  • People receive timely and appropriate care

Crucial to addressing these issues was the creation of the community-based HealthPathways, aimed at improving the interface between secondary and primary care. After reviewing a backlog of referrals, clinicians identified that many common issues could have been prevented through better communication between hospitals and primary care providers. GPs and hospital specialists were then brought together to agree on optimal management and referral pathways for specific conditions. The HealthPathways methodology is currently gaining traction as an approach across the Northern hemisphere, including England and Wales.

The left shift: Still a distant reality?

Participants echoed a now-familiar frustration: that the NHS continues to talk about shifting care into the community while still funnelling most funding and attention toward acute settings. “NHS England isn’t taking the left shift as seriously as the Greater Manchester system is,” one leader argued.

There was deep concern that the national focus on individual provider performance and waiting list targets was actively pulling against the system logic of integration and prevention. “If we keep paying for activity, we’ll keep getting activity,” one speaker noted. “We need to change what we value and how we fund it.”

Instead of continuing to reward throughput, participants called for an urgent shift toward outcomes-based funding. “The current incentives are not aligned with what patients actually need or what the system is trying to achieve,” said another attendee.

From data to delivery

Several leaders highlighted the power of Greater Manchester’s linked datasets, which have begun to reveal critical insights into unmet need, health inequality, and clinical variation across the region. One senior clinical lead described how analysts had used linked data to identify patients receiving suboptimal care, stratify risk, and deploy neighbourhood teams to intervene.

“We’ve used data to change how we deliver care at the local level, but the opportunity is far bigger,” they said. “This is about system-wide intelligence, not just analytics.”

However, others warned that data alone would not deliver change. “We’ve got brilliant information,” one attendee noted, “but unless it’s made usable, and unless we align it with pathways and accountability, it’s just noise.”

One participant summed up the challenge: “Change happens at the speed of trust. If the system doesn’t trust the data, or the people using it, it won’t move.”

The cultural fault lines: Professions, power, and permission

The discussion often turned to the deeper cultural and behavioural dynamics holding the system back. Professional silos, legacy power structures, and the politics of hierarchy were seen as major obstacles.

“We [system partners] have irritated each other for years,” said one participant. “The radicals and the pragmatists, the commissioners and the providers. And we’re still stuck with binary questions such as: who controls the money? Who owns the patient?”

Several attendees emphasised the need to move beyond organisational identities toward collective purpose. One leader said: “There’s no such thing as integrated neighbourhood teams if you don’t have full primary care at the table. We need inclusive leadership, and we need to stop second-guessing what communities want.”

Others argued for a more clinician-led approach to transformation. “You can’t prescribe behaviour change to doctors,” one attendee noted. “Ask them to define the problem and let them solve it. That’s where the buy-in comes from.”

Funding, incentives, and the problem of productivity

A recurring theme was the mismatch between national funding mechanisms and local ambitions. “Strategic commissioning? Wasn’t commissioning always supposed to be strategic?” one participant asked.

Several leaders warned that simply rebranding roles or structures, without real changes to financial flows, will have little to no impact. “The incentives are still fundamentally wrong,” said one. “And if we don’t fix that, the 10-Year Plan is just a dream.”

There was a strong appetite for exploring new financial models, especially those that allowed local areas to reinvest savings, take managed risks, and move money around the system to meet citizen needs. “If you’re funding institutions, you protect institutions. If you’re funding outcomes, you protect people.”

Reimagining public health as everyone’s business

Public health leaders voiced concern that prevention still sits too far outside the core machinery of the NHS. One commented: “We have to stop defining health in such a narrow way. The system still treats public health as someone else’s job.”

David Meates noted that in Canterbury, integrating public health into mainstream service delivery had been one of the toughest challenges, but the most essential. “Public health has to be seen as a system-wide priority,” he said. “It’s about changing the narrative, not just the structure.”

Others called for a broader conceptualisation of prevention beyond the medical model, one which encompasses education, employment, housing, and lifestyle. “Hairdressers are frontline,” one leader said, “and professions such as taxi drivers should be considered part of the health system.”

From rhetoric to results

The dinner concluded with a clear message: the opportunities presented by the 10-Year Health Plan are real, but only if local systems seize them and develop local solutions in collaboration with system partners.

“We have to stop waiting for permission,” said one attendee. “Use alliance agreements. Build partnerships. Change the story from ‘I’ to ‘we’.”

As one final reflection summarised: “This is about codifying change, not just for the boardroom, but for the clinic, the pharmacy, the community centre. The 10-Year Plan won’t work because it’s written down. It’ll work because people make it work together.”

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Bringing the NHS 10-Year Health Plan to life: Lessons from the frontline

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As momentum builds around England’s 10-Year Health Plan, three weeks of national conversations reveal a common theme: clarity of purpose, but deep concern about delivery. Drawing on insights from health leaders across Newcastle, Manchester and London, David Meates, Member of the New Zealand Order of Merit, explores three critical shifts needed to turn vision into lasting change.

Over the past three weeks in the UK, one detail has explicitly stood out for me. The clarity of purpose in every room I’ve been in.

I’ve been fortunate to participate in a series of forums and conversations across Newcastle, Manchester, and London with a key focus on the 10-Year Health Plan for England. Energy and engagement has been central to each of these discussions. Each conversation boiled down to a clear focus and purpose going forward – to create a future-focused health and care system that shifts from hospital to community, from analogue to digital, and from treating sickness to preventing it occurring.

The ambition is bold and correctly placed. The challenge lies not in the vision, but in the execution. The critical question we’re all asking is – how do we turn this vision into something real?

The plan has generated cautious optimism, but also a shared awareness of the significant obstacles we currently face. Fiscal pressures, workforce shortages, long waiting lists, outdated systems, and real-time access issues all cast a long shadow over future ambitions.

The fact is, accelerating our current approach or upgrading our tools alone won’t be sufficient to reach our destination. Something deeper is required.

I believe that three fundamental shifts are required to deliver on the promises outlined in the 10-Year Plan.

1. Restoring hope and trust

At the heart of every effective health system is hope. The quiet, daily belief that things can get better. This belief is what drives the immense effort from all health professionals, despite relentless pressures.

Hope has always been a currency in health. But it’s also fragile. And right now, many in the system have noted this hope slipping away.

NHS professionals I spoke with across the country described feeling overwhelmed, disillusioned, and exhausted. They’re still committed to their patients, but trust in the system, and in its leaders, is wearing thin. Ongoing frustration due to decision making that seems disconnected or random is a common trend. Secondly, the restructuring processes that feel more about prioritising image over real impact

One comment stayed with me:

“We’re under more pressure than ever as I try to do my best for my patients and the system.”

It’s time we acknowledged that truth and acted on it.

Restoring hope starts with rebuilding trust. That means showing up consistently as leaders. It means involving people in the decisions that shape their work and listening to their insight, not just collecting feedback after the fact. Most importantly, it means creating safe environments where people feel supported to do the right thing – not blamed when something goes wrong.

The health system’s greatest asset isn’t a piece of tech or a shiny new facility. It’s the continuous effort of the people who power it. When that effort disappears, or individuals lose hope, everything slows – decision-making, responsiveness, innovation. Reigniting that belief is not a soft ambition. It’s a hard necessity.

2. Simplifying the system

Health and care are inherently complex. But over time, complexity has been layered upon complexity, creating systems so convoluted that even those within them can’t easily explain how they work.

When a system becomes too complicated to navigate or understand, trust and confidence begin to erode. Efficiency suffers. The focus shifts from patient-centred care to managing processes, and decision-making becomes paralysed by layers of governance and red tape.

We must simplify. Not by dumbing things down, but by designing for clarity and connection.

In Canterbury, New Zealand, where I helped lead a decade-long transformation of the health system, we faced a similarly fragmented landscape. One of the most effective enablers we developed was HealthPathways – a platform that helped us agree, document, and communicate how care should be delivered across the system.

HealthPathways was more than a website. It was a living, breathing model of shared clinical decision-making. It brought together hospital clinicians, GPs, nurses, social care providers, and community organisations to answer a fundamental question: How do we do it around here?

It became our shared operating model – linking hospital and community, translating policy into practice, and integrating digital tools with real-world care. Most importantly, it helped rebuild trust and alignment across the system.

Importantly it made the system legible again, something that captured local reality while still being evidence-informed. And it was something that simplified – not added to – the work of delivering great care.

3. Unleashing the workforce

One of the most striking things about the health sector is that it’s filled with incredibly bright, capable people. Clinicians, managers, administrators, volunteers, many who are natural problem solvers. They see the issues every day, and they often know how to fix them.

But far too often, we tie their hands.

When decision-making becomes too removed from the point of care, responsiveness grinds to a halt. The urgency and nuance of frontline issues are lost in the shuffle of distant approval chains. The result? A system that reacts to crises instead of preventing them. A system held together by band-aids rather than built on resilience.

Empowerment isn’t just about giving people freedom, it’s about enabling them to flourish.

The people delivering care need to know their judgement is valued and that their leaders will back them when they take the right risks for the right reasons. Blame cultures, micromanagement, and punitive accountability systems have no place in a future-focused health service.

“Let me solve the problem with my team. We know what to do, we just need the space to do it.”

This was the common cry from across the system. The good news is, we don’t need to invent new capabilities. We simply need to remove the obstacles that are blocking the ones we already have.

A final thought

The 10-Year Plan is an important and necessary roadmap. But roadmaps are only useful if we’re willing to start walking. What’s needed now is not another layer of strategy, but a renewed commitment to the people who will make the change real.

That means restoring hope. Not with slogans, but with visible, supportive leadership. It means simplifying a system that has become too complicated for its own good. And it means unlocking the talent that’s already here, waiting for the signal that it’s both safe and encouraged to lead.

If we can do that, the future of health and care in England isn’t just possible. It’s already within reach.

About David Meates

David is an accomplished health system innovator most noted for his time as CEO of the Canterbury District Health Board leading the Canterbury Initiative. David is a frequent commentator and presenter on health system transformation and the role that HealthPathways can play within it.

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Digital Implementation, Featured, News, Thought Leadership

Why we need challenger thinking to help realise the NHS 10-Year Plan

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To realise the ambitions of the 10-Year Health Plan, the NHS must embrace the mindset of challenger brands, putting user needs first, rethinking legacy systems, and building the digital infrastructure needed to deliver truly joined-up, preventative care, writes Dr Harry Thirkettle, Head of Health Innovation at Aire Logic.

As a former NHS surgeon and now a clinical entrepreneur at Aire Logic, an employee-owned, B-Corp certified tech consultancy, I’ve seen the NHS’s challenges and potential up close. The NHS 10-Year Health Plan offers a bold vision to transform England’s healthcare system. Its three key shifts (from sickness to prevention, from analogue to digital, and from hospitals to communities) are both necessary and ambitious. To make this vision a reality though, we must embrace purpose-driven innovation and build a robust digital infrastructure.

By 2040, 9.1 million people in England are projected to live with major illnesses, many in deprived areas facing earlier diagnoses. The plan’s focus on prevention aims to ease this burden through early intervention and healthier lifestyles, making the healthy choice the easy choice.

The shift to digital delivery is equally vital. By using technology, the NHS can make healthcare as accessible as online banking or shopping.

Central to the digital shift is the single patient record, a unified platform accessible via the NHS App. This could consolidate GP visits, hospital records and test results, enabling seamless care coordination, reducing errors and empowering patients. For example, a patient moving from hospital to community care would benefit from real-time data access, avoiding delays or duplication. But better care starts with better infrastructure. That means making systems talk, and data flow because ultimately this is what gives patients more control. When access improves, outcomes improve, and everyone wins. Prevention really is the most powerful form of care.

We are still scarred by past NHS IT projects, like the National Programme for IT, which highlighted the risks of fragmented systems and poor execution. Current records are often held locally, with limited integration. Overcoming this requires significant investment and a genuine commitment to interoperability. Public trust in data security is also critical, especially with third-party providers involved. Transparent communication and robust safeguards are essential to address privacy concerns.

Embracing challenger thinking

To deliver this transformation, we need challenger thinking, inspired by industries like banking. Companies like Monzo disrupted traditional models by designing user-centric platforms. Similarly, the NHS must prioritise the needs of patients and clinicians, creating intuitive systems that simplify health management. This means moving beyond legacy infrastructure to design a digital ecosystem that is seamless and efficient.

The plan’s proposal to use AI as a ‘trusted assistant’ for clinicians is a step in this direction. AI could streamline administrative tasks, analyse data and support decision-making, freeing up time for patient care but this requires a cultural shift within the NHS. We need to shift from scepticism to embrace technology, supported by training for staff so they know how to use it effectively.

The scope for transforming healthcare is vast. The implementation of a single patient record could fundamentally alter care delivery, provide substantial cost savings and empower data-driven research for improved public health outcomes. Community-based care aligns with the growing prevalence of chronic conditions, easing pressure on hospitals. Yet, challenges remain.

Integrating local systems into a national platform is complex, and public trust must be earned through transparency and robust data security. If digital and community are to take over from hospitals it requires a seamless, joined-up infrastructure and central to this will be achieving a single patient record that follows individuals across settings. Without that foundation, we risk layering innovation on top of fragmentation.

The NHS 10-Year Health Plan offers a transformative roadmap for the health and care service. Success, however, will require challenger thinking to design systems around user needs, not legacy constraints. When it comes to health tech, we need suppliers who truly enable change and help create a more connected, proactive and sustainable health and care system.

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Digital Implementation, News

A people-led digital NHS: Aligning technology to purpose for real transformation

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As the NHS charts a digital future through the new 10-Year Plan, technology alone won’t deliver the transformation needed, warns Kath Dean. Real change depends on redesigning processes, investing in people, and aligning tools to purpose – with safety, outcomes, and collaboration at the core.

The new 10-Year Plan for the NHS in England outlines a clear vision for a digitally-enabled health service. Acknowledging a service left behind, in terms of a modern user experience compared to other sectors and other countries, is absolutely right. However, our healthcare teams and their supporting supplier community know that technology alone will not drive the service transformation needed. That shift requires investment in people, process, culture and collaboration.

Long-term, sustainable service transformation is a journey, built-on tech, used by people and beholden to processes. Bridging the gap between them –redesigning more efficient, safer processes that work for frontline teams, operational staff, and their patients – must come first.

Invest in outcomes, enabled by technology

The NHS may be a “20th century technological laggard”, but that’s not because of a lack of investment in software and solutions. What has been missing is the alignment of technology to purpose and an unwavering focus on outcomes. Without this approach, the NHS runs the risk of repeating past mistakes, procuring expensive solutions that don’t meet evidence-based need.

Digital investment cannot be measured by infrastructure alone. The emphasis on AI, improvements to the NHS App, and the ambition to deliver a Single Patient Record are all positive steps. But if we focus on solutions before defining the problems they’re meant to solve, we risk repeating past mistakes: expensive rollouts that deliver complexity rather than clarity.

True digital productivity isn’t achieved when clinicians spend more time on their computers. It’s when technology frees them to spend more time with their patients. Every tool should be evaluated against this standard: Does it reduce burden? Does it improve safety? Does it enable better outcomes?

Redesign processes, building on safety

Much of the billions of pounds invested in digital infrastructure to date has been spent on implementing systems rather than understanding and transforming how health and care professionals actually work. True digital maturity and realisation of sustainable benefits means embedding usability principles from day one.

Rapid implementation and a system go-live tick the ‘success’ box in many cases. Ways of working are often ignored or not considered, made to fit the system without any consultation. On the busy frontline, this adds to an already heavy burden.

Clinical risk management is also, too often, a late consideration – a post-implementation afterthought. This approach fails to recognise the uncomfortable truth that we are potentially introducing new digital pathways that could put patients at risk of harm.

A far better approach would be to treat every workflow change, every new alert, every data integration point as we do with new medications, i.e., introduce them only after rigorous safety testing. Patient safety demands nothing less.

Value data as the foundation of sustainable change

Reliable, accessible data is the foundation of sustainable digital transformation. If we want to shift from reactive care to proactive, preventive models and move care safely beyond hospital walls, then we must embrace data, not just as a by-product, but as a strategic asset.

This requires more than just new systems. It requires a cultural shift: building data literacy across the workforce, fostering trust in how data is used, and ensuring that information is high-quality, governed transparently, and held securely.

With that foundation, we can unlock smarter resource planning, real-time operational insight, and more personalised care pathways. But none of this will be possible if data remains siloed, misunderstood, or mistrusted.

People, partners, purpose = realisation

Delivering the NHS’s digital future will require more than good intentions and clever technology. It’s about supporting people to work differently in a digital environment, embedding confidence, capability, and continuous improvement. That requires collaboration with trusted partners with proven technical and clinical experience, a pragmatic approach and genuine desire to effect the change the NHS needs and deserves.

By aligning technology to purpose, and putting people and safety at the heart of every decision, we can create a health and care system that’s not only more efficient but also fairer, safer, and more responsive to the needs of patients and staff alike.

Kath Dean is President of Cloud21 Ltd.

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News, Workforce

Council of Deans of Health unveils key findings on educator challenges and opportunities

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Two new reports into the state of the academic educator workforce across nursing, midwifery and allied health professionals (AHPs) in the UK’s universities and colleges make recommendations aimed at improving educator capacity and embedding a sustainable academic educator strategy across the sector.

The Council of Deans of Health has published two Academic Educator Workforce Survey reports following extensive research undertaken in August 2024 into the state of the academic educator workforce across nursing, midwifery and the allied health professions (AHPs) in the UK’s universities and colleges.

The Council of Deans of Health represents the UK’s strategic academic leaders in healthcare education and research.

The two reports present a comprehensive analysis of the challenges and opportunities shaping the future of the educator workforce in these critical fields. Drawing on the experiences of university educators across nursing, midwifery and the AHPs, the reports identify challenges, barriers and facilitators in recruitment, retention and career development.

The findings reveal several key factors affecting the educator workforce, including wider sector financial sustainability challenges, pressures to increase student and apprenticeship numbers, team profiles and skills gaps. The reports explore how these factors are impacting curriculum delivery, the administrative workload and shortfalls in educator recruitment.

In addition to recruitment, the reports examine staff retention and career development, highlighting the implications for staff retention and a loss of experience, at a time when health education is becoming ever more complex. They examine leadership profiles and their impact on programme planning and support, as well as opportunities for career progression.

The reports set out strategic actions aimed at improving educator capacity and embedding a sustainable academic educator strategy across the sector. These recommendations are designed to be scalable and adaptable, offering a practical roadmap for institutions and stakeholders to address workforce challenges collaboratively and effectively.

Key recommendations include: 

  • Promote the diversity of opportunities and roles for academic educators in health care and highlight success stories of academic leaders to attract more health professionals to careers in education.
  • Encourage universities to provide structured pathways for career progression, ensuring that educators have clear opportunities for advancement and professional growth.
  • Support partnerships between universities and practice partners to co-produce solutions to enable more flexible contracts and working arrangements for staff in academia and clinical practice.
  • Provide clear guidance on workload management and set realistic expectations for both students and staff.

Ed Hughes, CEO at the Council of Deans of Health, said: “A sustainable and properly supported academic workforce is essential to providing the health care professionals of the future. Our research, based on extensive feedback from our members, highlights the pressures which they face in recruiting, retaining and supporting academic staff in nursing, midwifery and the allied health professions. It’s vital that we work together with health and education system leaders, employers and funders to address these challenges.

Our recommendations point towards a joined-up approach to align the incentives to attract and retain academic educators. We will continue working with our members to support them to educate the next generation of health professionals, equipping students to work in new ways in a rapidly changing world.”

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