Overview of the Situation

The UK government has recognized that its major digital initiatives for the NHS are facing considerable delivery challenges. This acknowledgment stems from a history of NHS IT projects that have consistently underestimated costs, complexity, and timelines.

Key Insights from the Impact Statement

• An impact statement regarding the NHS’s 10-year health plan was released by the Department of Health and Social Care (DHSC) on January 12, 2026.
• The initiative to create a single patient record (SPR) is projected to take several years, drawing on lessons from past NHS digital programs.
• The government has indicated that the project may exceed initial time and cost estimates, as noted in the HM Treasury Green Book, which highlights a tendency for project appraisers to be overly optimistic.

Challenges and Risks Identified

The DHSC has outlined several challenges associated with the SPR:

• The scale and technical complexity of the program, which will incur costs related to:
  1. Product development
  2. Technology and data integration
  3. Collaboration with external vendors
  4. Delivery and administration
• Integration with existing legacy systems poses additional risks.
• Investment is necessary to ensure that all healthcare staff, including paramedics and community pharmacists, have equal access to patient data.
• Data collected through the NHS App and wearable devices will lead to additional revenue and operational costs.

Concerns Regarding Supplier Dependency

There are significant concerns about reliance on a single supplier, which could lead to vendor lock-in, making it costly to switch providers. Additionally, data security and privacy issues have been raised:

• While many support data sharing to enhance care, there may be clinical resistance if data sharing safeguards are perceived as inadequate.
• Public trust in the NHS to secure patient data is high, with 83% of respondents expressing confidence, yet concerns about cyber attacks and potential data mishandling persist.

Adoption of the NHS App

The NHS App is envisioned as a tool for 24/7 access to healthcare services. However, risks exist if it does not become the preferred option for patients, which could hinder the desired transformation in health service access. Barriers to adoption include:

• Patient preference for phone or in-person contact.
• Lack of staff skills or confidence in using the app.
• App functionality not meeting the needs of patients and GP practices.

Potential of Artificial Intelligence

The DHSC has noted that AI could lead to long-term cost savings through operational efficiencies. However, challenges include:

• Slow adoption due to initial implementation costs.
• Wider risks associated with AI, such as ensuring patient data protection and using high-quality evidence for training models that reflect diverse population groups.

In summary, while the NHS’s digital transformation holds promise, it is essential to address the identified risks and challenges to ensure successful implementation and delivery.