Building the foundations for an NHS fit for the future

By Craig Millard, MD (EVP) @ Harris Health Alliance

The NHS 10-Year Plan outlined a bold vision for a more joined-up, digitally enabled, patient-centred, and community-focused health service.

Six months on, and the headlines continue to focus on the shiny new, groundbreaking tech and its potential for transformation.

That’s all well and good, but that potential won’t be fully realised unless we get the basics right first.

And, that’s still missing from the conversation, the detail behind the headlines.

The ‘how’ behind breaking down silos between care settings to properly connect care, putting the right standards in place to support this, as well as helping innovations reach the frontline faster.

If the NHS is to truly become fit for the future, it must focus on the ‘nuts and bolts’ of digital transformation alongside the innovation that will define its next decade.

Integration and Joining Up Care: From Hospital to Neighbourhood

One of the biggest shifts in the plan relies on moving care out of the hospital into our neighbourhoods.

This will only be possible if records and data can follow the patient seamlessly, securely, and in real-time.

Historically, the NHS has struggled with this. Services are still organised around institutions, not individuals, and each is very protective of ‘their’ patient records.

Resolving data sharing agreements is one piece of the puzzle, but significant barriers also lie in connecting secondary, primary and community care systems.

Sharing records, ensuring appropriate access, and bi-directional interfacing are all complex challenges, but not insurmountable.

Deeper integration between systems, services, and sectors must be prioritised.

Greater emphasis is needed on mandating agreed standards, supporting data sharing across settings, and ensuring systems, new and old, can talk to each other.

That also means enabling effective partnerships and knowledge-sharing between NHS colleagues and suppliers, particular when it comes to providing specialist technical support that is often limited on the provider-side.

Supporting Access for Innovation and Scaling Success

The NHS is committed to embracing innovation, but access for start-ups and smaller companies is a major challenge.

The path from prototype to patient is often too slow.

Regulation, complex integration demands, and lengthy procurement processes create blockers that can stop innovation before it even gets started.

Faster, simpler and more assured, lower-cost routes to entry, that don’t compromise on safety or compliance, are needed to close the innovation gap between the NHS and other sectors.

The planned introduction of a new ‘Innovator Passport’ is a step in the right direction.

In the meantime, more established integration partners can support new entrants with, for example, platforms designed to simplify connection to the NHS ecosystem and by helping navigate the complexities of compliance.

Having the tools available is not enough, they need to be used. That brings us back to integration.

Even the very best solutions will struggle to gain clinical buy-in if they don’t integrate with core systems, share data and support workflow.

Usability, and integration are non-negotiable.

Working with the Market to Solve NHS Problems

The 10-Year Plan hints at the need to partner with health tech suppliers to bring new innovations, in particular AI, to the NHS.

A welcome call, the drive for more collaborative working to solve problems needs to be extended.

Take standards for example.

Centrally mandated standards for system integration across the entire landscape, driven in partnership with a flexible and responsive supplier community would bring structure without stagnation.

The NHS also needs to open the door wider to innovation, particularly in secondary care, where access remains more difficult and inconsistent compared to primary care, where there is often more autonomy to adopt new tools (e.g., AI scribes, triage systems).

This is about working together to deliver modern, optimised digital solutions across the service.  Done right, this partnership can be a powerful, flexible and adaptive force for transformation.

Connected Maternity Care: A Blueprint for Joined-Up Health

Left out of the wider 10-Year Plan due to ongoing review and task force work, Maternity Care will have its own action plan.

Yet it remains one of the clearest examples of why connected care matters and where siloed systems continue to fail mothers and families.

The maternity journey is long and complex, spanning community and hospital settings and touching almost every clinical specialty along the way.

Structured digital records, real-time access to information across settings, and tools that support true continuity of care should be top priorities if we are serious about reducing health inequalities and improving outcomes for every pregnant person.

Innovative technologies are also already in use.

For example, a machine-learning–driven Infant algorithm monitors both mother and foetus during labour. Far from replacing the midwife, it acts as a vital safety net, staying in the room even when the midwife must step away.

Yet, tools like this are often held back by the same caution applied to AI more broadly.

The recently announced plans for AI regulation in healthcare are a positive sign.

A welcome opportunity to build confidence, clarity, and capability so clinicians can better understand, evaluate, and safely adopt new technologies.

Fixing the Foundations Before Chasing the Headlines

The NHS stands at a pivotal moment.

The ambition set out in the 10-Year Plan is right, technology must be at the heart of a more connected, personalised, and sustainable health service. But ambition alone isn’t enough.

Transformation depends on strong foundations: clear standards, interoperability, access for innovators, and genuine collaboration between the NHS and its partners.

To unlock the full potential of innovation, the service must first ensure that data can flow freely and safely wherever care is delivered.

That means focusing on the foundations before we install the smart tech and working with partners who understand both the technical and clinical realities of the NHS.

If the next decade of health is to be truly transformative, we must shift our focus from the headlines to the hard work of building the infrastructure that underpins progress.

Only then will the NHS’s digital future become more than a promise, it will and truly enable better, safer, and more joined-up care.