Reliance on Private Sector to Meet Ambitious Goals
NHS England has acknowledged it cannot achieve the demanding digital goals of the government's 10-Year Health Plan using internal resources alone. As a result, the health service will need to procure specialist digital expertise and resources from the private sector to deliver its extensive transformation agenda. This concession highlights a major difficulty in the NHS's digital strategy, which aims to replace fragmented analogue systems with seamless, integrated digital platforms. The overall objective is to improve patient access, simplify care pathways, and support preventive care models, primarily through innovations like a single patient record and advanced functionality for the NHS App.
The Scale of the Challenge
The 10-Year Health Plan, introduced in mid-2025, sets ambitious targets for modernisation, including the implementation of data-driven pathways and digital tools designed to empower patients and improve continuity of care. However, translating these aspirations into practical reality has proven challenging, even in the initial implementation stages. Reports predating 2026 had already pointed out that existing NHS IT systems were frequently outdated, fragmented, and lacked adequate interoperability across different health and care settings.
Internal Capacity Deficits and Lack of Confidence
A departmental engagement report accompanying the 10-Year Health Plan revealed significant doubts among many NHS organisations and partners regarding the health service's capability to execute the necessary digital shift. Key obstacles identified included outdated infrastructure and a substantial backlog of digital systems needing renewal due to years of underinvestment. Furthermore, there was concern over insufficient workforce capability coupled with high workforce pressures, burnout, and inadequate budgets within existing digital teams. Surveys of digital professionals confirmed these findings, with many expressing that they felt unprepared to deliver critical components such as the single patient record or the enhanced NHS App front door, leading to a noticeable system-wide lack of confidence in the pace of transformation.
The Hybrid Delivery Model and Governance Concerns
Faced with these limitations, NHS England is now moving towards a hybrid delivery model. Sources indicate this will involve the targeted procurement of specialist digital skills and technical development from the private sector, specifically to bolster internal teams and speed up deployment. This approach aligns with a broader trend across UK public services of engaging technology firms, particularly those with experience in large-scale digital deployment, to overcome capacity shortages. However, increased reliance on external suppliers has raised concerns among clinicians, policymakers, and civil liberties groups regarding data governance, the risk of proprietary vendor lock-in, and the security of core health systems. Any expanded private sector involvement will necessitate robust oversight to maintain public trust and data security.
Critical Areas for Attention: Inclusion and Workforce
Beyond infrastructure and capacity deficits, two critical areas require immediate attention. Firstly, Digital Exclusion: Regulators like the Care Quality Commission (CQC) have cautioned that a rapid "digital by default" policy risks exacerbating inequalities, potentially marginalising vulnerable groups, such as older adults or those with low digital literacy. Equitable access and inclusion must be a foundational element in designing enhanced digital services. Secondly, Workforce Imperatives: The acknowledged need for external support reflects persistent workforce shortages and skills gaps within the NHS's technology and data domain. Competition from the private sector makes the recruitment and retention of specialists difficult. Industry bodies emphasise that digital and tech skills must be integrated into core NHS workforce planning, with training and career pathways prioritised alongside clinical roles.
Recalibration and Outlook
Delays or inconsistencies in digital transformation have tangible consequences, including increased administrative burdens for clinicians when digital systems fail and difficulties for patients navigating care pathways. The success of the digital strategy is also crucial for broader policy objectives, such as improving population health management and preventive care, which fundamentally rely on high-quality data and seamless information sharing. NHS England’s decision to seek private sector assistance is therefore a pragmatic recalibration aimed at sustaining the momentum of the 10-Year Health Plan. Success will depend on clear governance, strong contractual safeguards, and a sustained, system-wide focus—involving clinicians, technologists, and policymakers—to ensure the vision of an integrated, patient-centred service is achieved.
