People, not just platforms: A one-year health check on the NHS 10-Year Health Plan

One year ago, the Department of Health and Social Care (DHSC) set out an ambitious, generational vision to reshape our health service. The publication of Fit for the Future: The 10-Year Health Plan for England on 3 July 2025 arrived with a clear operational directive to drive three tectonic shifts: moving care from hospital to community, from analogue to digital systems, and from sickness to prevention. It was a blueprint designed to remodel an institution under immense strain, built on the foundations of the “Change NHS” national consultation which gathered over 250,000 contributions from patients, public, and staff.

Despite recent leadership changes and the implementation of a new organisational structure which will see NHS England being abolished and its functions transferred directly back to the DHSC, the strategic direction of the health service remains the priority. The 10-Year Health Plan, including its core shifts towards community-based care, digital systems, and prevention, continues to be the definitive operational mandate for the service.

However, translating this streamlined governance into genuine frontline efficacy means moving past high-level political rhetoric and shifting our collective mindset from industry “techno-optimism” into a necessary phase of “techno-realism”. One year on from the plan’s launch, we ask the question, ‘where are we now?’ in its delivery and where senior NHS leaders need to look next to progress the implementation of digital services that put users, interoperability and trust in the centre of their operation.

At the heart of the digital shift is the Single Patient Record (SPR), authorised under Clause 47 of the Health Bill 2026. The mandate requires all NHS trusts, general practices, social care providers and contracted private healthcare entities to securely share patient data in real time. The goal is to create a single, authoritative account of a patient’s health history. Maternity and frailty pathways are due to pioneer this consolidated framework starting in 2027, with specialised data clusters for oncology, cardiovascular disease, and mental health feeding into the platform later.

The government’s clinical and actuarial modelling projects substantial system-wide benefits from a fully realised record system:

Source: https://www.gov.uk/government/news/20000-fewer-ae-visits-a-year-thanks-to-single-patient-record

Yet, twelve months into the journey, the implementation faces a significant data controllership dispute. The British Medical Association (BMA) and its GP Committee have strongly opposed the transfer of legal controllership from local GPs to the DHSC, arguing that it risks undermining the confidential doctor-patient relationship and compromises data security.

In our experience, designing digital infrastructure across the public sector, this dispute highlights a fundamental truth: An integrated record system cannot be mandated into successful adoption from the top down. Building true adoption requires two essential commitments:

True interoperability is achieved only when clinicians and citizens feel absolute confidence in how data is accessed, managed and protected.

While the SPR establishes the data network, the NHS Federated Data Platform (FDP) has been the primary operational driver over the past year, linking disparate health databases without consolidating or moving the raw data. The technical rollout has scaled significantly, showing strong performance metrics as of June 2026:

This platform is also designed to act as the operational anchor for the broader transition of care out of hospitals and into 250 to 300 new Integrated Neighborhood Health Centres by 2030 and 2035. Following the expansion of virtual ward capacity to 12,673 digital beds, ICBs are now mandated to embed virtual wards directly into multidisciplinary neighborhood teams, using automated data flows managed via the FDP to support vulnerable patients proactively at home.

Connecting these databases across organisational boundaries is a significant step forward, but rolling out platforms like the FDP requires navigating significant public and political debate around data privacy, trust and system use. This show once again that you cannot simply drop in technology and expect success; system leaders must actively understand people’s views, attitudes and anxieties to build genuine trust and secure long-term adoption.

Alongside building this trust, we must guard against rigid, closed vendor lock-in. To make the neighbourhood model a functional reality for families, we need to activate healthcare data using open APIs, unified data governance and flexible architectures. The goal should be to build an extensible digital ecosystem where local systems can talk to each other seamlessly, allowing multidisciplinary teams to collaborate around the citizen without being stuck in proprietary tech stacks.

The 10-Year Health Plan positions the NHS App as the “digital front door” to the service, mandating that by April 2026, 95% of appointments across all care settings must be bookable via the app following appropriate triage. To meet this requirement, clinical AI-assisted triage engines went live for over one million patients across more than 200 GP practices using platforms like Rapid Health’s Smart Triage. 

Concurrently, the NIHR invested £8.1 million into six digital research projects, including the “Intelligent Navigation using AI” (INA) study led by Oxford researchers. Running from March 2026 to August 2027, INA combines digital triage with complexity systems to ensure urgent, multi-morbid patients are safely prioritised over lower-complexity cases presenting with identical acute symptoms.

However, evaluating the frontline reality one year on reveals distinct operational and algorithmic risks if these tools are deployed in a vacuum. Real-world evaluations indicate that while digital triage and automation tools can reduce initial administrative entry times, they rarely eliminate documentation labor entirely. Instead, they frequently shift clinician effort downstream into editing, correcting and validating outputs, which can increase cognitive load during highly complex clinical encounters.

Hippo believes firmly in building the right thing right for the right people. When evaluating emerging technology and algorithmic triage, our first question to senior stakeholders isn’t “How do we implement this model?” but rather, “Do you actually need an AI model here, or do you need a highly-optimised, user-validated workflow?”

Integrating automation responsibly requires a steadfast commitment to a ‘human-in-the-loop’ (HITL) delivery model. User-centred and strategic design are imperative models to follow in this regard, treating data models as tools for clinical decision support rather than automated decision-makers.

The ultimate success of the 10-Year Plan relies on shifting our entire approach from reactive treatment to proactive, community-led prevention as outlined in the plan itself. To make this work, the NHS needs to get much smarter with how it uses data. Behind the scenes, this means safely combining local health trends and screening results to spot who might be at risk of conditions like heart disease or cancer early on. But for the person at home, it simply means getting the right support and advice long before a health issue turns into an emergency.

In the case of children, true prevention doesn’t stop at the clinic door, though; it requires health and social care to work as one single team. Right now, when a family moves between regional boundaries or interacts with different public services, a dangerous “visibility gap” can open up in child health and safeguarding. Because legacy data systems don’t talk to each other, vital information like child protection plans or routine immunisation schedules can take weeks to catch up. Closing this visibility gap requires a real-time population register for child health. By building a unified, up-to-date digital register that moves with the family instantly, we can ensure that health visitors, school nurses, and social care teams always see the full picture. 

For adults, As techUK’s recent digital adult social care insights highlighted, the physical technology required to enable community care (from predictive home monitoring to digital telecare) is already mature. The missing link is systemic integration. 

However, just as with the Single Patient Record, true interoperability cannot simply be mandated top-down; national API standards and digital tools must be co-designed with the care workers, health visitors and social care teams who rely on them every day. By shaping open standards around real-world workflows, we can ensure that digital care tools feed seamlessly into local neighbourhood teams rather than operating in isolation.

One year into the 10-Year Plan, the lesson for anyone tasked with transforming healthcare is clear: sustainable change cannot be bought off the shelf. Within a tight capital environment where every pound must deliver clear value, we have to make sure our technology partnerships are focused on the things that matter most.

To turn the vision of the plan into a functional reality for families and clinical teams, we believe future delivery must focus on three core principles:

If you are looking for a collaborative partner who cares just as much about the people using the technology as the platform itself, get in touch with the Hippo team today. Let’s talk about how we can build the right thing, together.