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Insights: Digital Transformation

What it takes to deliver on digital’s potential

The promise of digital transformation has been frustratingly slow to realise in the NHS. Giving staff what they need from technology can make it happen, writes Jennifer Trueland
9 July 2025

Successive health ministers have lauded the potential of digital transformation to alleviate, if not cure, many of the ills of the NHS. But while some level of digitisation has become the norm over much of the UK’s health and social care landscape, progress has been far from uniform, and not nearly as fast as most would like.

According to a report published by The Health Foundation, in May, digitising the NHS and social care would require significant investment over the next five years. This includes £8 billion capital spending, £3 billion one-off revenue spending, and £2 billion recurring annual revenue spending each year. This needs to be accompanied by investment in implementation and ongoing support for training, maintenance and optimisation, it adds.

But even if the additional funding were to materialise, NHS organisations are at varying stages of readiness for this digital revolution. While a DHI snapshot report late last year showed improvements in digital maturity of acute trusts in England, for example, it also confirmed that there was “significant work still required to build robust and future-ready infrastructure across the NHS”.

This Insights report looks at how digital transformation can become a reality, focusing on the big topics of AI, getting more from the patient record, and the vital role of people. A key message is that transformation at scale requires culture change. As one contributor said, we need to move to a position where “every member of staff is their own digital champion”.

Produced in association with
Part 1
Unlocking the transformation potential of AI

Whether it’s questions about ethics, governance, or even whether it’s all it’s cracked up to be, AI tends to dominate today’s conversations about digital transformation.

“AI is fresh and it’s still evolving,” says Euan McComiskie, health informatics lead at the Chartered Society of Physiotherapy (CSP). “There’s a huge opportunity for AI on the more administrative side of things, such as ambient note-taking, record-keeping, data analysis and waiting list management. There’s definitely the opportunity there.

“I tell our members to think of AI as the assistant in their pockets,” he says. “It can do some tasks we’re not great at as human beings. It can do really dull and boring tasks that will frustrate you, because you’re human, and it repeats it consistently. It’s able to do some rather simplistic but huge volume work like data analysis: it can’t replace a proper analyst who will make sense of the numbers, but it can do some pretty boring number-crunching.”

Indra Joshi, director of strategic engagement at OptumUK, believes that digital transformation could help put people at the heart of their own care – and AI is an important part of that.

Joshi, a former head of AI with NHS England, where she spearheaded the creation of the AI Lab, says there has been a large amount of progress in the last five years, but there is still a way to go.

“Many digital and AI technologies are about improving outcomes – enhancing patient experience, streamlining care, and supporting prevention. This shift towards value based care is something we need to better reflect in how we commission services if we’re to successfully support and scale innovation.”

Joshi points out that AI is already making a quiet but meaningful impact across the NHS. “I believe that quite a lot of people are already using AI in office processes – things like robotic process automation is being used to streamline scheduling and workforce planning. This is happening and it’s making real difference, but it’s not seen as fun and cool, so people don’t talk about it necessarily.”

I believe that quite a lot of people are already using AI in office processes – things like robotic process automation is being used to streamline scheduling and workforce planning. This is happening and it’s making real difference, but it’s not seen as fun and cool, so people don’t talk about it necessarily.
Indra Joshi

Jon Pickering, CEO of Mizaic, cautions that AI is a complicated landscape with a wide supplier base, which can make it difficult for CIOs to decide which solutions to adopt.

“What we’re hearing loud and clear from clinicians is that they don’t want AI to make decisions for them. They want AI to help them make better, faster decisions with data, and extract value from data. I think solutions that feed into that will be more successful.”

He cautions against thinking of AI as an entity completely separate to anything else, looking at it rather as something that enhances existing processes and solutions. “I think there will be a gradual process of adoption around solutions with AI in them – these will be use cases that are supplemented or augmented with AI to make them better,” he says.

“What’s going to drive adoption of AI in any industry, not just the NHS, is gaining the confidence that it’s safe, that it will add value, that it will drive costs down, and it will free up people to spend time on other more important tasks than admin.”

Part 2
People power – leadership culture and tackling ‘change fatigue’

Transformation simply can’t happen without people, says Jacqui Cooper, chief nursing information officer for Health Innovation Manchester and NHS Greater Manchester.

“Tech is important, but you can have the best technology in the world, and if you’ve got no appetite, no leadership, no want to change, you’ll never get the benefits out of it. Tech is probably the much easier bit – it’s the transformation, it’s the hearts and minds that’s hard.”

She agrees that there is a risk of “change fatigue” in the NHS, and that it can be challenging to persuade people that digital transformation projects will be worth the effort.

“They’ve been through a global pandemic where they were the heroes of the nation, and they’re not seen as the heroes now. That was probably the hardest time for nurses specifically, and they’re tired, and there are lots of issues about pay. So saying to them that the way you work today is going to change tomorrow, that’s a really hard place to be. That’s why you need more than just one CNIO – you need an army of people who can go in and walk them through it and give them at-the-elbow support to transition the way they work.”

Doctors and nurses are used to changing how they provide care, based on evidence. It’s about applying the same approach to the use of technology.
Lee Rickles

Lee Rickles, chief information officer of Humber Teaching NHS Foundation Trust, and a member of Digital Health’s ICS Council, says getting staff on board with change is a big part of being CIO. But he says it is also important to recognise that clinicians may be ready to embrace transformation. “Doctors and nurses, for example, are generally trained to consider change management as part of their professional development and CPD,” he points out.

“If you look at something like a change in [clinical] practice, they’re very used to changing how they operate and how they provide care to patients based on evidence. It’s about applying the same approach to the use of technology, by giving them enough knowledge and ability and expert support, so they can see that what they are trying to achieve can be delivered with the technologies we may be applying.”

Digital transformation doesn’t involve recruiting an army of experts, he adds. Rather, it involves creating a culture where staff feel they are part of the process, and that they have the time and headroom to make change happen. “You need to empower the existing staff,” he says simply. “Every member of staff is their own digital champion.”

Rickles, who formerly worked in business change in the aerospace industry, says the principles are much the same wherever you are, including in healthcare. “Staff generally want to do better, they generally want an improved lifestyle, they want to do something that’s new and different, that’s a bit more exciting day-to-day. Things like implementing change can feel a bit scary, but you get a few advocates in every team, and you’ve created a massive capability.”

There’s no way that you can install a technology solution without focusing on the people component – it’s fundamental to the change that needs to happen.
Jon Pickering

Pickering emphasises the importance of ensuring that people involved in a digital transformation project are on-board, prepared and supported for what can sometimes be a significant change in work practices – which is why Mizaic has a transformation team that works with trusts throughout the process.

“There’s no way that you can install a technology solution like ours without focusing on the people component – it’s fundamental to the change that needs to happen,” says Pickering. “You’re changing from an old, outdated process into one that’s potentially being revolutionised with technology, and you need to help guide the customer through that change of how they can work and access information much easier than what they could before. This requires collaboration, great project management, training and support to implement technology like this.”

As an experienced senior nurse, Jacqui Cooper strongly believes that it’s vital to listen to clinicians, walk in their shoes, and to make sure the basics are done properly. That means ensuring that the infrastructure is there – whether that’s the actual equipment or good connectivity – and being prepared to make changes if the tech is not going to work for the people using it. That’s the best way to ensure that people see the benefits, both for themselves and those they are caring for.

“When you go back to them [after the system goes live] and say ‘you’re settled, you’re doing it, if we switched it off tomorrow would you be bothered?’ you definitely want the answer that yes, they’d be bothered. That’s the aim.”

Part 3
How to get more value from the patient record

The health service doesn’t necessarily need more data, says Mizaic’s Jon Pickering – what it needs is to gain better insight from what there already is. “Data is all around us. Data is everywhere, and I think our role is boiling that down into what’s a meaningful bit of information to present back to the clinician so that they can understand and make a decision from that.”

Again, he points to AI and its potential value in getting more from the patient record, for example by speeding up the process to accessing relevant information. He describes one situation where a cardiologist was treating a patient who had been a regular hospital attender for 15 years, generating huge amounts of data from multiple sources. The AI-enhanced solution was able to show quickly that the patient had previously had an adverse reaction to a particular drug that the doctor had been planning to prescribe.

“All that information would previously have taken hours for the clinician to go through, but he was able to uncover key insights to help him make a really safe, informed and fast decision in seconds rather than hours. In our case we are using AI to help clinicians find things in the patient record they weren’t necessarily looking for, to aid better decision-making.”

“True holistic care means understanding the full picture of someone’s life,” says Indra Joshi. “Bringing together the relevant information about individuals – not just their medications or diagnoses, but also their social circumstances. Digital can help us do that in a meaningful way.” she adds.

“Health is about people, communities, and the environments they live in. When we bring these elements into neighbourhood care or a single patient record, we can make a meaningful difference to lives. That’s why I believe that we as Optum – with our breadth of experience and reach across care settings – are well placed to help bring these threads together, so we can help support a system that is proactive, efficient and coordinated.”

She believes AI has real potential to put more power in the hands of patients. “When you give people tools and information to manage their own care where appropriate, the results can be really powerful. That’s where digital and AI can really help – by helping individuals navigate services, understand their options, and make informed decisions.”

The Yorkshire and Humber Care Record, which brings together information from multiple sources, has been a gamechanger, says Rickles, and it’s popular with staff. He cites its value to social workers, for example, who can access information at click of a mouse.

“It’s absolute gold dust – it’s saving half their working day because they’re not having to ring around to find out what’s happening with their client because they can see that they are receiving care from acute, or from mental health. It’s trying to make everyone a winner, trying to get to ‘yes’ together.”

A Digital Health Insights report in association with Mizaic and OptumUK