Digital transformation in the NHS: a reference guide

Introduction

The NHS is undergoing significant digital transformation, driven by the ambitions set out in the government’s 10 Year Health Plan (10YHP). A central priority is the shift from analogue to digital, aiming to modernise services, improve patient outcomes and enable more efficient data-driven care. This includes the rollout of digital tools – including artificial intelligence (AI) – platforms and infrastructure to support integrated care, population health management and personalised services at a local level. 

In parallel, the new model integrated care board (ICB) and region blueprints have redefined how digital leadership is structured across the system. Under this model, digital transformation is no longer the sole responsibility of chief digital officers or IT departments. Instead, it is expected to be embedded across all roles and functions, with ICBs as strategic commissioners responsible for oversight and providers increasingly responsible for digital delivery, creating a more distributed model of leadership. 

While the 10YHP sets a bold vision, many NHS organisations are still on their journey toward digital maturity – creating a valuable opportunity for leadership and innovation. Building a shared understanding of digital concepts and their relevance to everyday roles will be key to unlocking the full potential of transformation. With the right guidance and common language, systems can align more effectively and accelerate meaningful change.

What is digital transformation?

Digital transformation is the strategic adoption of digital technologies and processes to improve healthcare in a concerted way. It is not only making services digital, but completely reimagining care models to make them more productive, patient-focused and sustainable. True digital transformation harnesses innovative technologies to reimagine how care is delivered, how systems operate and how patients engage with the NHS. 

The NHS faces mounting pressures from an ageing population and a rising number of people living with multiple long-term conditions. This rise in demand has been a key catalyst for digital transformation. Harnessing digital technologies presents a vital opportunity to boost productivity, enable neighbourhood health and to fulfil the promise of prevention by empowering people to co-manage their health in partnership with the NHS. 

In this context, digital transformation is a continuous learning and improvement concept, where the value is in embracing the ever-evolving nature of technology, rather than a final destination of change. While the public increasingly expects the NHS to reflect the convenience and connectivity of other sectors, achieving this requires an acceptance of continuous learning and adapting, and that transformation is the ability to learn and improve from embedding regular change.

Policy context and the challenges facing digital transformation

Historically, digital transformation efforts have concentrated heavily on acute care, with many technologies deployed to address elective care backlogs and reduce hospital admissions. 

As the government pursues its vision of a neighbourhood health service and the shift of resources from acute to community, digital innovation will be essential to making this a reality. 

Neighbourhood health is not just about structural reform, moving services out of acute settings and into communities; it proposes a relational reform that empowers patients and mobilises local assets within communities to work in partnership with the NHS to co-manage their health. Digital technology will be a key enabler of this transformation, helping to connect services, empower patients and support proactive care. 

Empowering people and communities to fulfil the promise of neighbourhood health requires digital transformation, as outlined in the government’s 10 Year Health Plan. Ensuring strong digital foundations is essential to realising the full potential of transformation. 

Seamless interoperable digital systems will be the key to bringing together multidisciplinary teams and local partnerships in neighbourhood health teams. While the 10 Year Health Plan sets a bold direction, continued focus on the foundational infrastructure – such as electronic patient records (EPR) and cyber security – will be vital to success.

Significant progress has been made in recent years, yet many organisations are still building the necessary infrastructure required to support modern care delivery. 

Development of digital infrastructure has consistently fallen short of the policy ambition of successive governments. A review by the Health and Social Care Select Committee found that the limited progress was largely due to insufficient funding.  

Modernising IT and legacy infrastructure will improve and accelerate clinical decision making, improve diagnoses and treatment, and enhance coordination across services

NHS England has estimated that 70 per cent of trusts will reach the standard for the core level of digitisation that was set out in What Good Looks Like by March 2026 and there are currently still nine trusts without an established EPR. Across the NHS, 45 per cent of NHS services lack a digital pathway and between 10-70 per cent of NHS trusts’ technology estates are classified as legacy. 

The British Medical Association estimates that clinicians lose more than 13.5 million hours a year due to inadequate or malfunctioning IT. Analysis shows that trusts that are highly digitised have a 13 per cent lower cost per admitted patient episode and a 4.5 per cent reduction in inpatient length of stay.

Modernising IT and legacy infrastructure will improve and accelerate clinical decision making, improve diagnoses and treatment, and enhance coordination across services. Robust digital foundations also support leaders in using population-level data to better target resources, harness prevention opportunities, track outcomes and plan services effectively. 

Investment

Successive governments have recognised the importance of digital transformation in the NHS with ambitious policy initiatives, although investment has historically fallen short of what is needed to deliver meaningful change.

A Health Foundation report estimated that over the next five years, the NHS in England will need £5 billion in capital spending, £2.25 billion in one-off revenue spending and £1.5 billion in annual revenue spending to make the shift from analogue to digital. 

The 2025 Spending Review announced up to £10 billion in NHS technology and digital transformation by 2028/29 – almost a 50 per cent increase from 2025/26. This substantial investment reflects growing recognition of the strategic importance of digital transformation and aligns closely with expert estimates of what is needed. Ensuring effective deployment across integrated care systems, regions and trusts will be key to maximising its impact – especially at a time of great organisational challenge.

Previous digital ambitions have been undermined by inconsistent and insufficient funding. As cloud-based subscription models become more prevalent, the balance between capital and revenue funding must also adapt, with greater emphasis on sustained revenue to unlock the full value of procured technologies. To achieve transformation that supports the shift to a preventative neighbourhood health service, funding must be rebalanced and comprehensive across the system. 

Crucially, successful digital transformation depends not only on technology, but on thoughtful implementation. Business cases for new technologies must include robust plans to realise the benefits of the investment, including staff training and financial support for change programmes. 

Workforce

Investing in a strong digital, data and technology (DDaT) workforce is vital to delivering transformation and NHS leaders have a critical role to play in addressing the persistent challenges facing the DDaT workforce. With the NHS employing a significantly lower proportion of digital and data professionals compared to other sectors, there is an over reliance on third-party suppliers and challenges in delivering transformation. Unfilled DDaT roles and limited in-house expertise hinder progress in delivering frontline digital priorities.  

The public sector struggles to attract and retain top digital and data talent across the board, as compensation is far below the private sector. On top of this, the roles themselves have not been prioritised, with the NHS having a low proportion of digital leaders represented in executive teams. 

NHS leaders should advocate for the elevation of digital roles within organisational structures, ensuring that digital leaders are represented at board level and empowered to shape strategic decisions

NHS Providers polled leaders in 2024 and found 36 per cent of trusts had a digital leader on their board, while it was estimated in 2023 that around 24 per cent of ICBs had a board-level digital leader. The uncertainty created by the current reorganisation of digital functions (and the delays to it) must be carefully managed so that the crucial DDaT workforce is either retained and empowered or recruited and respected as equal leaders. 

Empowering staff with the right tools and training will help build confidence, improve adoption and unlock the full value of digital transformation

Protecting and empowering existing digital teams is essential to maintaining momentum and senior leaders should also foster a culture where technology is seen as an enabler, not a burden. Many staff still perceive IT systems as outdated, slow and disruptive to workflows. Leaders can address this by promoting interoperability, supporting the DDaT workforce and ensuring all staff are equipped with the right tools and training to use digital systems confidently and effectively.

The Darzi review found that NHS staff can perceive IT as an additional burden. Much of the IT infrastructure in the NHS is out of date and runs outdated operating systems that struggle to run basic tasks and are unable to support new software, including AI. Technology can have a negative impact on workflow due to a lack of integration and interoperability between systems, or by lengthening existing tasks or adding new ones. Empowering staff with the right tools and training will help build confidence, improve adoption and unlock the full value of digital transformation.

Cyber security

Cyber security is vital to digital transformation in the NHS. Increasing reliance on digital infrastructure like EPR, virtual wards and AI mean that protecting sensitive health data and ensuring operational resilience are paramount. 

Cyber threats are rising across all sectors. In 2024 the National Cyber Security Centre responded to 50 per cent more nationally significant incidents compared to the previous year, with a threefold increase in incident severity. The NHS is at a greater risk due to the large number of different systems and high levels of duplication creating a large surface area for attacks. Improving service reliability and strengthening incident response plans will be key to building a resilient digital NHS.

Past cyber-attacks on NHS organisations have underscored the importance of proactive security measures to protect patients and the NHS. The recent proliferation of new AI tools has increased the cyber security risk facing the NHS, and earlier this year NHS England had to issue a warning against using non-compliant Ambient AI (AVT) as organisations rushed to make use of new tools. Since then, a new self-certified registry for AVT has been announced to manage demand. 

To strengthen cybersecurity across systems and NHS organisations, NHS leaders should take a proactive and strategic approach that embeds cyber resilience into core governance and operational planning. This includes ensuring cybersecurity is regularly reviewed at a  Board level, with clear executive accountability and designated leadership roles. Leaders should adopt the National Cyber Security Centre’s Cyber Assessment Framework (CAF) to assess organisational risk and guide improvement planning.

The government's plans for the Cyber Security and Resilience Bill, outlined in April 2025, will require more organisations and suppliers to meet robust cyber security requirements, including risk assessments to minimise the impact of attacks, improve data protection and network security. Under the plans, regulators will have more tools to improve cyber security and organisations will be required to report more incidents. 

INHS suppliers have been urged to sign a charter of cyber security best practice, which includes 24/7 cyber monitoring, multi-factor authentication and working collaboratively and openly in partnership with NHS England if a cyber-attack occurs. Alongside the charter, NHS England will be launching a self-assessment form in autumn 2025, for suppliers to work through as well as a series of summits and engagements to collaborate on security.

Data transparency and usability

Data is the backbone of shifting care to a preventative neighbourhood model of health. By linking data together, the NHS can unlock powerful insights to support more proactive, personalised and equitable healthcare. Routine data collection in the NHS holds immense opportunity to tackle key challenges and target interventions effectively based on forecasting and data analysis. 

When used strategically, data can help measure future inequalities, understand their causes, allocate resources more equitably and inform workforce planning to ensure services are responsive to population demands and future needs. 

The NHS comprises different organisations which have developed their own digital operational systems provided by different companies, therefore data custodianship is distributed across different organisations. This, combined with the patchwork of computer systems procured by different NHS organisations, mean that the infrastructure in place in the NHS makes interoperability a challenge. 

Health data in the NHS is governed by a number of pieces of cross-sector and health-specific policy. The Sudlow review argues for a culture shift towards a health data ecosystem that promotes the use of health data for patient and public benefit and rewards and incentivises organisations that drive this. 

Over the last 18 months, ministers have made high-profile announcements on data, such as the Health Data Research Service, national data opt-out reform, reform of legal frameworks around the secondary use of data, and single patient record in the NHS App. Legislative activity will support these changes (for instance via forthcoming secondary legislation on health IT standards).

The vast majority of people in the UK support the use of their health data to benefit themselves and others but also want clarity around how their data is used and stored and how their privacy is protected. The NHS is by far the most trusted organisation with data, garnering high levels of support. Research from NHS England shows 72 per cent of people trust the NHS with their data, and a study from Boston Consulting Group found 90 per cent support sharing their data with the NHS for any purpose. 

A minority of people oppose their health data being used by anyone for any reason. Studies put this figure somewhere between 14 per cent and 21 per cent of the population. There is low awareness of how data is used to improve health and care services, according to research by Understanding Patient Data. A majority know ‘nothing at all’ (20 per cent) or ‘a little’ (34 per cent) about how patient data is used. 

This is echoed by similar findings from the Health Foundation. 57 per cent of people do not recall ever receiving any information about the data held in their records. Public misconceptions about data are common, including who can access data, what data is in people’s patient records and how the data is used. For instance, 61 per cent of people in England incorrectly believe there is already a single national patient record in place.  

Research has found that caution about sharing data is primarily driven by a fear of data breaches, unscrupulous profit-seeking, and that trust is driven by faith in data protection regulations. In England, reporting on health data initiatives has often focused on the risks of using data. This, coupled with lobbying from privacy campaigners and parts of the medical profession, has led to media coverage about patient data leaning negative and further increasing public scepticism. 

Improving transparency and public engagement will be key to building trust and unlocking the full value of health data. NHS leaders play a pivotal role in ensuring that health data is used transparently, securely and in ways that build public trust. As care increasingly shifts from hospital to community settings, leaders must actively engage the public to explain how their data supports population health management and integrated care. Improving transparency and fostering meaningful public engagement are essential to unlocking the full value of health data.

As set out in our Frontline Digitisation report (2024), efforts toward EPR system convergence have sparked valuable strategic discussions within and across trusts and ICSs about streamlining clinical and administrative services. However, there is benefit for NHS leaders in prioritising interoperability rather than pursuing full convergence of EPR systems. This means enabling staff across organisations to access consistent, shared data sets, regardless of the systems in use. A focus on interoperability is vital to avoid any one vendor dominating the market and allow for flexibility to local needs. 

Examples such as the London Care Record and OpenSAFELY demonstrate the potential of joined-up data. The London Care Record brings together data from five ICSs, including 111, London Ambulance Service, hospitals, primary care, mental health and community as well as social care. The extent to which different sources of data are included varies across local authorities. The London Care Record uses the Health Information Exchange (HIE) from Oracle, comprising one central HIE connected to a series of HIEs in each integrated care system around London, to join up data.  

At the population level, OpenSAFELY  joins up the health records of 58 million people in England and includes the GP records of the entire population in England. OpenSAFELY has achieved this by implementing their software inside the data centres of the biggest EPR providers for general practice. Data is never moved out of the secure environment, and their analysts run large scale computation across pseudonymised patient data for research. 

Public demand, trust and inclusion

The success of digital transformation in the NHS is reliant on public engagement and confidence. The public increasingly expect healthcare services to reflect the digital convenience they experience in other sectors, and this growing expectation presents a powerful opportunity to modernise care delivery and improve patient experience.

In 2024, the NHS Confederation’s report on patient empowerment – in partnership with Google – found that  across all age groups more 72 per cent of adults would use technology to avoid a hospital admission, with a similar proportion happy to use technology to monitor their health and share information and data with their doctors. 

Delays in communication are a key area for improvement. The King’s Fund found that 32 per cent of the public think the NHS is poor at keeping people informed about their care and treatment and 20 per cent said they had received an invitation to an appointment after the date of the appointment. 

Data privacy and security, clinical safety and digital inclusion are the key dimensions for securing public trust and demand for digital transformation in the NHS

Digital technology, including EPR and the proposed single patient record as well as automated admin processes using AI and the NHS App, could all work to improve this basic function and in turn patient experience. The vast majority of the public and NHS staff are supportive of the use of AI in administrative tasks (61 per cent and 81 per cent respectively). These findings highlight strong public support for digital innovation that improves communication and access.

Data privacy and security, clinical safety and digital inclusion are the key dimensions for securing public trust and demand for digital transformation in the NHS. Digital clinical tools must be rigorously evaluated for clinical efficacy and safety, something that is being developed through expanding National Institute for Health and Care Excellence’s remit to cover devices, diagnostics and digital products as part of the drive for a faster, fairer rollout of high-impact technology. 

Lastly, digital inclusion is vital to ensure the uptake of effective digital solutions do not worsen existing health inequalities. People at risk of exclusion fall into three main groups:

• those without affordable devices or reliable internet
• those lacking digital skills or confidence
• those who prefer traditional channels. 

Older people express particular concern that technology might distance them from NHS staff. The Health Foundation found that four in ten individuals over 65 name face-to-face interaction as their most important consideration when using NHS technology. Across the UK there are 7.9 million people without basic digital skills, while 1.6 million do not have a smartphone, tablet or laptop and 21 million struggle to afford their mobile contract. Addressing digital exclusion is critical to ensuring that digital transformation supports equity and does not deepen existing disparities.    

Co-designing digitally enabled services with patients, carers and clinicians and embedding their insights at every stage ensures relevance, builds trust and drives meaningful adoption of technologies. While the ambition to deliver a digital-first NHS is important, a hybrid model that combines digital convenience with face-to-face connection is key to inclusive transformation.

National programmes

Digital transformation in the NHS is underpinned by a suite of national programmes that are setting direction, driving standards for frontline digitisation and enabling innovation at scale. The 10 Year Health Plan committed to establishing the NHS App as the front door for all healthcare services as well as an expansion of the app to include AI-powered features. This will be enabled by the single patient record which will consolidate patient information across secondary, primary and community care. 

It also committed to invest in AI infrastructure, including the development of a strategic AI roadmap. Further priorities include scaling up virtual wards (also known as hospital-at-home), and standardising the use of wearables in preventative, chronic and post-acute NHS treatment by 2035. 

A digital and data blueprint is expected in 2026 from NHS England that will look at technology infrastructure, the digital profession and operating standards for technology in the context of these key national programmes. This blueprint will provide a clearer framework for implementation and help align local efforts with national priorities.

Patient records and the single patient record

Electronic patient records (EPR) are computer-based software systems that store patients’ information and interactions with health services. To support this, the Frontline Digitisation Programme was launched in 2021 with the core goal of getting an EPR into every NHS trust by March 2025. As of May 2025, 91 per cent of secondary care trusts have an EPR system, the government is aiming for 100 per cent by March 2026.  

Currently EPRs are the central piece of digital architecture in the NHS. However, the picture of integrated and interoperable EPR varies greatly across the country, reflecting the need for more consistent, long-term strategic planning. 

Initiatives such as GP Connect and shared care records have resulted in some areas already having a single view of the patient. The London Care Record is a good example of this, as well as Interweave in Humberside. 

In October 2024, the government announced plans to create a single patient record, which will summarise patient information and will be accessible through the NHS App from 2028.  

The single patient record will:

• Consolidate patient information by bringing together a patient's health information, test results and letters into one unified and accessible place.
• Allow coordinated care by providing a comprehensive view of a patient's health history and, when fully implemented, the SPR will offer real-time data sharing across different care settings, including primary, secondary and community care. This means that relevant healthcare professionals will have immediate access to the most up-to-date information, regardless of where the patient is being treated.
• Enable improved population health management, allowing for better understanding of health trends and needs across communities, earlier detection of health issues and more timely interventions.
• Be interoperable between various NHS silos and data systems, a critical step in overcoming the current fragmentation of patient data, integrating with various local and national platforms including the FDP.  

The Federated Data Platform

The Federated Data Platform (FDP) offers an important opportunity to connect data across different NHS organisations. A ‘federated’ data platform means that every organisation can have their own platform, which can connect and collaborate with other data platforms as a ‘federation’ making it easier for health and care organisations to work together. In 2023 a contract was awarded to Palantir to create the Federated Data Platform (FDP); the roll out began in March 2024. 

The Medium Term Planning Framework (2025) sets out that by 2028/29 all acute, community and mental health providers will be using the FDP to provide elective recovery, cancer, and urgent and emergency care. This also included using the FDP’s population health management tool for ICBs to deliver on strategic commissioning.

While this target and ambition is not unexpected, the roll out of the FDP use cases (the separate functions) began in 2023 and although all ICSs and most trusts have committed to using the FDP, the extent of their engagement with the platform varies. As of the 30 October 2025, 150 trusts were signed up, while 77 are using the FDP.

The FDP has been positioned as a transformative tool for data sharing and decision-making across the NHS, but its rollout has surfaced a number of concerns from local systems and leaders. Many NHS Confederation members from ICBs and trusts have warned that adopting FDP tools could reduce the functionality of existing local systems, at least until future enhancements are properly and usefully introduced to the FDP. Additionally, the platform’s reliance on a single software stack has raised questions about its ability to integrate with existing tools and promote true interoperability. 

Trust and transparency have also emerged as key issues, with concerns about how sensitive health data is handled and shared. Primary care providers - which deliver NHS services but are not directly NHS organisations and therefore not obliged to engage with the FDP – many of which are opting not to engage and share data given their ethical objections to the FDP provider. Without primary care data in some areas, the FDP is limited in its  with the rollout  being criticised for limited engagement with ICBs and primary care, leading to confusion about how the platform aligns with  strategic goals of population health management commissioning.   

Despite these challenges, uptake is increasing, and early adopters have reported some operational benefits. However, for the FDP to realise its full potential, it must evolve to be more responsive to local needs, transparent in its governance, and adaptable in its technical design.

 

NHS App

The NHS App was first launched in 2018 with use significantly increasing over the course of the COVID-19 pandemic, when the app hosted the COVID-19 pass. Currently over 25 per cent of the population log into the NHS App each month. The 10 Year Health Plan outlines a vision for the NHS App being the front door to the NHS. Its widespread adoption presents a strong foundation for expanding digital services and improving patient engagement.

Currently the NHS App allows users to view messages, order repeat prescriptions and access some of their health records, book flu and COVID-19 vaccinations, access test results and complete online consultations. A feature to track prescriptions launched in May 2025 was used by nearly 400,000 people in the first 10 weeks. This feature will save pharmacies and GP practices time answering queries about the status of prescriptions. 

Looking ahead, the app is set to evolve into a personalised health hub. Planned enhancements include:

• integration with wearable devices
• appointment management
• AI-powered tools for health advice and service comparison
• digital health checks. 

Patients will also be able to enrol in clinical trials, access a modernised digital ‘Red Book’ for child health, and benefit from expanded mental health support, including virtual therapy and crisis monitoring. With patient consent, data will be securely shared across accredited providers to support coordinated care. These developments aim to make the NHS App a cornerstone of preventative, personalised and digitally enabled healthcare.

However, despite its growing reach and potential, the NHS App’s functionality is not yet consistent across the country, with digital inclusion a factor that is imperative in local implementation. If some communities and demographics have more inclusive capability to access features than others, this can limit the app’s effectiveness in delivering a truly universal digital experience for all. Addressing these disparities will be key to ensuring the app fulfils its role as the national front door to healthcare.

Virtual wards / hospital at home

Virtual wards allow patients to be treated in their own homes with care that would traditionally be in hospital. The national virtual ward programme was launched in 2022 to roll out virtual wards at pace across the country; there are now 12,000 virtual ward beds currently available and they are used across every ICS. The 10 Year Health Plan outlines that ICSs will be expected to plan virtual ward capacity in coordination with ambulance services and NHS 111.

Virtual wards can be a cost-effective, efficient alternative to in-person health services. By enabling earlier discharges and avoiding unnecessary hospital admissions, virtual wards contribute to reducing backlogs and alleviating associated pressures. 

Together with other non-physical care delivery methods such as telecare, remote monitoring, wearable tech and hands-free tech, they are addressing workforce constraints and limited capacity for face-to-face interactions. By releasing capacity and resources from the wider system, virtual care helps alleviate the strain caused by high demand and long wait times.

However, models of virtual wards vary across the country, reflecting differences in patient populations clinical pathways, technology platforms and staffing approaches. This variation makes evaluation of their impact challenging. While the evidence base for virtual wards has been mixed, a recent independent evaluation of 29 virtual ward programmes in the South East, found that there was an annual net saving of £10.4 million. More mature models shower greater effectiveness, with one non-elective admission avoided for every virtual ward admission – compared to 2.5 virtual ward admissions in newer programmes.  

When implemented well, virtual wards can reduce admissions, improve patient outcomes and deliver cost savings to the NHS. However, their success is limited by the digital foundations, particularly a lack of integrated patient data, limited interoperability and availability of an effective multidisciplinary workforce across the NHS, social care and voluntary sector to manage patient care. 

Wearables

Wearables are digital devices worn on the body by patients – such as smartwatches, biosensors and medical grade monitors – that collect data in real time to help support health monitoring and diagnostics. In the NHS, wearables are increasingly integrated into virtual wards and chronic disease management programmes offering new ways to monitor more patents remotely and provide patients with flexibility and choice. 

The 10 Year Health Plan outlined that wearables will be standard in preventative, chronic and post-acute NHS treatment by 2035, with free provision in areas with high deprivation or health need. The first step in harnessing wearables’ potential and this vision is enabling citizens to integrate their personal devices to the NHS App and the single patient record, feeding into platforms like ‘My Health’ tool which will provide personalised health advice. 

However, a report by the Professional Record Standards Body found that though user feedback on wearables is generally positive, there is limited evidence showing the effectiveness of such digital tools and that clinicians do not see the full benefits.

Artificial intelligence

Artificial Intelligence describes computer systems that can perform tasks that would usually require human intelligence. AI can be used in a number of ways in health services:

• enhance diagnostic processes
• personalise treatment plans
• manage healthcare data
• transcribe meetings and consultations
• clinical research.

More use cases are evolving. The 10 Year Health Plan outlined that AI will be key to the government’s vision of digital transformation in the NHS. It outlined a number of AI tools, such as My Companion (AI-powered advice), to be integrated into the NHS App as well as validated AI diagnostic tools and AI administrative tools including ambient voice technology to be scaled NHS wide and announced the development of a national roadmap for AI. The newly launched National Commission on the Regulation of AI in Healthcare will support the acceleration of safe access to AI in the NHS by developing a new regulatory framework that will be published in 2026.

Computer vision is a type of AI that has been used reliably in the NHS – it can be used to identify and locate objects in digital images with many useful applications in diagnostic imaging. For example, computer vision AI is used in the NHS for chest X-rays to detect lung cancer and other abnormalities and is also used to detect skin cancer in thermoscopic images of skin lesions.

Ambient voice technology (AVT) is increasingly being used to transcribe patient consultations into clinical notes. A recent trial of the TORTUS ambient AI led by Great Ormond Street Hospital found it was effective in freeing up clinicians’ time, showing a 23.5 per cent increase in direct patient interaction during appointments and a 13.4 per cent increase in the number of patients seen per shift. The technology also had positive effects on clinicians feeling overwhelmed.  

As this trial demonstrates, the use of AVT in primary care and specialist care is increasing and this is leading to improvements in relation to time and productivity. AVT can also bring patient benefits, as clinicians can have more clinical engagement time during appointments. Crucial to the effective deployment of AVT is allocating sufficient time to gain consent and to check through accuracy as the responsibility of accuracy and confidentiality still remains with the healthcare worker.

NHS England has released guidance on using AVT in health and care settings, which provides an overview of ambient scribing products and key considerations for their adoption including, as a part of an ongoing series of documents to support AI adoption. 

Alongside this, a new national self-certified registry for AVT is expected to be published that will include clear business capabilities and application requirements for all AVT suppliers to evidence compliance, following concerns about AVT models being adopted that did not comply with national standards. 

In the interim, NHS Shared Business Services has launched a framework agreement for procuring digital dictation, speech recognition and outsourced transcription services including some AVT solutions. NHS leaders can also access the buyer’s guide to artificial intelligence in health and care which provides decisions to help organisations make well-informed decisions about procuring AI products. The buyer’s guide is due to be updated to reflect developments in AI.

Another recent trial, of Copilot AI involving 30,000 NHS workers, has demonstrated that AI administrative assistance could save staff on average 43 minutes per staff member per day. Copilot is now available across the health service at no additional cost. Copilot is a generative AI that uses a combination of large language models including GPT from OpenAI. 

There are concerns that only the most digitally advanced providers are in a position to scale their use of AI. The use of AI in the NHS is limited by the digital infrastructure in place in many organisations – 10-50 per cent of NHS technology systems need to be modernised, and old devices are unable to support AI. As AI tools, including AVT, are scaled across NHS organisations, staff need to be given training to use new digital technologies and maximise their potential. Without appropriate training, this could mean more time is taken to perform tasks, limiting productivity benefits. 

Additionally, the extent to which AI can learn from health data is limited by the extent to which data is accessible across different siloed systems. Effective implementation of AI will benefit from access to national data infrastructure such as the FDP or SPR.

Forthcoming developments: a timeline

Digital transformation in action

Glossary

Key resources