Digital transformation in the NHS: a reference guide
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.
Spotlight on policy: Shared care records
Shared care records are integrated digital records designed to synthesise key health and social care information from multiple providers into a single, secure view of an individual’s care history. They enable authorised professionals – across general practice, hospitals, community services, mental health and social care – to access timely and relevant data to support direct care.
Access to shared care records is governed by strict information governance protocols and individuals retain the right to opt out or restrict access to specific elements of their record, in line with national data protection standards.
Further information
Read NHS England on shared care records.
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.
Exploring the NHS Federated Data Platform
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.