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

By Barbara Harpham

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.

Digital Implementation, Featured, News, Thought Leadership August 20, 2025

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

By Dr Paul Deffley

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

By Integrated Care Journal

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)*

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

By Dr Harry Thirkettle

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.

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

By Kath Dean

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.

Raising the bar: Why clinical standards are essential for the responsible use of tech in healthcare

By Julian Coe

Digital tools like Ambient Voice Technology are redefining primary care – but with great power comes great responsibility. Julian Coe, Managing Director at X-on Health, explains why robust clinical standards are not barriers to innovation, but the bedrock of trustworthy, scalable, and safe digital transformation in the NHS.

As primary care evolves, digital innovation offers a practical way to support clinicians and improve patient care. Digital telephony has been widely adopted but there is much that can be done to improve the utilisation of the advanced features now available, and Ambient Voice Technology (AVT) is increasingly part of this conversation – not as a distant ambition, but as a sensible step forward. With such powerful tools, however, comes the responsibility to implement them thoughtfully and ethically.

The recent NHS England letter advising primary care providers to halt the use of AVT that does not meet stringent specifications served as a clarifying moment. It makes clear to all stakeholders that while the promise of AI is strong, governance, safety, and data protection must come first. These aren’t constraints –in reality, they are the foundation of meaningful and safe innovation.

Clinical safety standards have been in place since 2012, and for good reason. Too often, they are framed as red tape but that’s a fundamental misunderstanding. Standards like DCB0160 and structured Data Protection Impact Assessments (DPIAs) are not obstacles, they are accelerators of safe and scalable innovation, and need to be embraced. As a legal requirement, they ensure management invests in making sufficient resources available, and when implemented thoughtfully, they serve as quality control systems that enhance, rather than inhibit, digital transformation.

On a wider scale, the UK is considered to have a robust and responsible regulatory system by international standards, having only recently branched away from the EU. The UK still very much mirrors EU regulations, although the direction of travel in the UK is towards clarification, a greater risk-based approach, but to remain internationally harmonised. The government vision is for the UK to be the best place to develop AI and healthtech responsibly, allowing it to be used in the UK and around the world.

With this in mind, we must remember that healthcare is not like other sectors: the cost of error is potentially high and personal, the margin for misjudgement is slim, and as a supplier, the trust we hold with clinicians is of utmost importance. In healthcare, we have to do things in an evidence-driven way, and clinical standards, therefore, must not only be met, they must be elevated.

Building trust through standards

AVT, when built on strong clinical standards, offers truly transformative potential. Designed to automate the generation of clinical notes, referral letters and administrative tasks in real time, these tools can operate during face-to-face, telephone and video consultations.

Some providers are now offering AVT tools and AI scribes that integrate seamlessly into existing practice workflows and telephony systems. For example, Surgery Intellect powered by Tortus AI will be integrated into our digital telephony system. It listens to consultations and automatically generates accurate clinical notes, referral letters, clinical coding, and administrative tasks in real-time. It’s accessible to all GP practices, regardless of a practice’s current telephony provider, through our software, ensuring that no surgery is excluded due to infrastructure constraints.

When done correctly, AVT tools don’t simply record, they understand, contextualise, and accurately summarise clinical interactions. The result is not merely increased efficiency but enhanced clinical confidence, and doctors that feel better in providing more time for their patients.

The combination of our product offerings will provide surgeries with their first comprehensive intelligent care navigation system. By integrating into the NHS App and clinical management systems, and using the latest technology including AVT and AI voice agents, we will free significant additional clinical time for every surgery.

But functionality alone is insufficient. What underpins trust in such systems is rigorous adherence to frameworks and standards, robust data protection protocols, and a governance-first approach.

Delivering a governance-informed approach

As one of the largest healthtech companies in primary care in the UK, we handle over 40 million calls every month and have a duty of care to ensure that our services meet and exceed all specifications. Many organisations are looking into AI medical scribes, but only a few are committed to achieve the highest level of clinical safety standards.

Partnerships play a critical role in ensuring these new technologies align with NHS expectations and we’ve collaborated with a select few organisations known for their governance-first approach and know that a rigorous approach to clinical safety shows how safety can be adopted into the fabric of a company’s innovation, rather than being seen as an unwelcome overhead.

In addition to our own external Clinical Safety Officer, we have also commissioned a specialist advisory firm to hold us to account, so GP practices can confidently adopt our cutting-edge AI technologies knowing they meet NHS clinical safety standards and data protection requirements. We believe safety and speed, when aligned through proper governance, can go hand-in-hand.

Beyond compliance, toward transformation

The future of AI in healthcare will be shaped not by who moves the fastest, but by who moves the safest and we are confident that our product will be the first available to primary care that will gain Class IIa medical device approval. Many AVT solutions may appear impressive in demonstrations, but only those able to meet and exceed NHS clinical safety standards will stand the test of scale and scrutiny.

Innovation without governance is a gamble. Governance without innovation is stagnation. The NHS deserves both: the boldness to embrace cutting-edge technologies and the discipline to hold them to the highest clinical and ethical standards.

As we continue to navigate this digital evolution in healthcare, clinical standards must remain our guide. Not only do they protect patients and clinicians, but they also create the conditions for the kind of sustainable, transformative innovation that primary care so urgently needs.

The future of healthcare AI doesn’t belong to those who innovate recklessly, and safety is not a one-off thing. It belongs to those who understand that true progress is governed, tested, and trusted. In the inspired words of Dr Dom Pimenta, CEO of Tortus AI, we should move as fast as we can, but as slow as we need to.

Julian Coe, Managing Director, X-on Health

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.

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.

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.