The NHS in England is preparing to spend more on technology than at any point in its history. Over the next three financial years, the government has committed up to £10 billion for new systems, infrastructure and services. This is a staggering rise from the £2.1 billion spent in the previous year, according to the Health Service Journal. With such a leap in investment, NHS England (NHSE) is determined to ensure it gets something in return.
The health service’s leadership is now signalling a “quid pro quo” approach to technology contracts. The logic is simple: if the NHS is to commit billions to digital suppliers, those suppliers must offer not only competitive pricing but also stronger service guarantees and greater accountability. The aim is to use the health service’s sheer purchasing power to secure better deals, not simply to throw money at technology providers and hope for improvement.
For too long, large technology contracts in public services have been signed on terms that heavily favour suppliers. This has often left taxpayers funding systems that run over budget, underperform or lock the organisation into costly arrangements that are hard to exit. NHSE’s new strategy appears to acknowledge this risk. By openly stating that deals must be mutually beneficial, it is drawing a line in the sand.
Part of the plan involves looking at whether new legislation could strengthen the NHS’s hand in negotiations. This could give the organisation greater control over procurement rules and contract terms, reducing the likelihood of being outmanoeuvred by global tech giants with far greater resources. Given the scale of public money at stake, there is a strong argument for ensuring the legal framework matches the ambition of the investment.
The technology budget will not be spent solely on headline-grabbing innovations. NHSE recognises the importance of building strong digital foundations, which means investing in reliable core systems and modern hardware. This is not glamorous work, but it is essential. Without robust infrastructure, the most sophisticated software in the world will fail to deliver.
However, there are also ongoing concerns about the handling of patient data. These concerns have been sharpened by developments around the Federated Data Platform, a project that aims to bring together information from across the NHS to improve services. Critics worry about how private companies might use or profit from this data. In a health service where public trust is paramount, any perception of data misuse could undermine confidence in the entire digital transformation agenda.
That is why transparency and accountability must be central to every technology contract the NHS signs. Patients must be able to trust that their data is being used appropriately, stored securely and never exploited for purposes beyond the public good. The NHS’s relationship with technology firms must be built on more than cost savings and service level agreements; it must rest on a shared commitment to safeguarding public interest. There is a wider context to this shift in strategy. The NHS, like other public services, has often been caught in a cycle of paying for technology that is already outdated by the time it is fully deployed. Long procurement processes, rigid contracts and slow rollouts have left the health service struggling to keep pace with rapid advances in digital tools. By adopting a more assertive, value-driven approach, NHSE has a chance to break that cycle.
Still, the challenge should not be underestimated. Large technology companies have extensive experience in negotiating with public bodies. They also know that the NHS is under intense pressure to modernise and deliver efficiencies. This urgency can be used against the health service in talks. A patient, strategic approach will be needed to ensure that speed does not come at the expense of long-term value.
Ultimately, the NHS’s vast new technology budget is both an opportunity and a risk. It offers the possibility of transforming patient care, improving staff efficiency and strengthening the resilience of the health system. But it also opens the door to costly missteps if the money is not spent wisely.
If NHSE is serious about a quid pro quo, it must not flinch when negotiations get tough. Suppliers should know that a contract with the NHS is a privilege, not a guaranteed payday. Every pound of the £10 billion must work as hard for patients as the staff who serve them. The stakes are too high for anything less.
