The UK's progression towards a national digital ID framework, alongside the NHS's ongoing efforts to enhance identity and access management, ministers frequently present as a simple solution to persistent challenges: fragmented patient information, redundant identity verification processes, and excessive administrative time. However, the situation is far from simple. While the 2025 proposals undeniably offer tangible operational improvements for the NHS, they simultaneously introduce significant concerns regarding privacy, the potential for excluding certain populations, and the system's robustness. Before full-scale implementation, ministers must clearly answer these critical questions.
A reliable digital credential offers appealing potential benefits: it could transform the patient experience and clinical efficiency. Patients would prove their identity just once, streamlining registration, minimising duplicate records, and enabling clinicians to gain quicker, authorised access to the correct patient data. This would cut down on time wasted on phone calls and secure clinical continuity across primary care (GP), community, and hospital settings. Teams are already working to modernise NHS identity systems. Initiatives such as the Care Identity Service roadmap and the recent 2025 Identity & Access Management roadshows demonstrate active efforts to harmonise technical standards and prepare organisations for secure identity processes. These foundational steps are vital for safely integrating a digital ID solution into the clinical workflow.
The focus rapidly shifted from the digital ID's benefits to its potential risks. Cybersecurity experts and civil-liberties groups voiced concerns that a unified, widely-adopted credential presents an attractive target for hackers, and that the gradual expansion of its use beyond its initial scope could undermine public trust. Although the government offered assurances in late 2025 that the digital ID will respect privacy and require user consent, critics emphasise that robust legal and operational protections must complement these technical safeguards before the NHS integrates the scheme for access control. The NCSC stressed the necessity for strong cryptographic architectures and thorough threat modelling.
A significant and equally important concern is digital exclusion. Evidence from the UK and internationally shows that certain groups, specifically older adults, those with limited literacy, and individuals on low incomes are less likely to use smartphone-based services. If a virtual identity becomes the standard, rapid pathway to accessing care, this risks isolating the very patients who most need straightforward access. This will happen unless we not only guarantee non-digital alternatives but also adequately resource and actively promote them. While parliamentary briefings and recent reports indicate government plans for alternatives, healthcare trusts should avoid assuming universal digital adoption among the population.
A national Digital ID system is a promising fix for the NHS data strain, but its success requires three core principles: absolute trust, radical inclusion, and ironclad security. Failing to prioritise these risks turning a technical solution into a major governance problem, potentially causing public trust erosion, deepening health inequality, and creating legal liabilities. Fear of breaches could lead patients to withhold data. Exclusionary systems will disenfranchise the digitally excluded. Rushed deployment risks cyber-attacks and GDPR non-compliance.
Therefore, the NHS Digital ID must be approached as a national transformation project prioritising: Trust by Design (via transparency, patient control, and oversight), Inclusion by Default (via non-digital access), and Security as a Prerequisite (via state-of-the-art encryption and monitoring). This holistic approach ensures the Digital ID streamlines services, empowers patients, and acts as a source of resilience.
