Senior digital leaders and industry figures have warned that the NHS must urgently address systemic barriers that continue to make it a “difficult” environment for innovation, as pressure mounts to accelerate the adoption of new technologies across the health service. The criticism, voiced at the Rewired 2026 conference and echoed by policymakers and industry stakeholders, highlights persistent challenges in scaling digital solutions, despite growing ambition around artificial intelligence, data platforms and personalised medicine.
Calls for a more open and “braver” innovation culture
Speakers at Rewired 2026 argued that the NHS must adopt a more open and pragmatic approach to innovation, including being more willing to take risks and learn from failure. Helen Balsdon, national chief nursing information officer at NHS England, said leaders need to be “braver” in supporting new technologies and more honest about the barriers that prevent progress.
Experts pointed to a culture that can be overly cautious and risk-averse, with complex governance processes and multiple approval layers slowing down adoption. While these safeguards are designed to protect patient safety, critics argue they can also stifle innovation and discourage suppliers from engaging with the NHS. There were also calls for greater transparency around failure, with leaders encouraged to share lessons from unsuccessful pilots rather than focusing solely on success stories.
Structural barriers continue to slow progress
Despite years of reform efforts, long-standing structural challenges remain a significant obstacle to innovation within the NHS. Procurement processes, regulatory requirements and fragmented decision-making structures were identified as key issues. Innovators often face multiple entry points into the system, each with different requirements, making it difficult to scale solutions nationally.
Industry bodies have highlighted a persistent gap between early-stage innovation and widespread adoption. A 2026 parliamentary inquiry into personalised medicine and AI is examining why cutting-edge technologies developed in the UK struggle to be implemented at scale within the NHS. Legacy systems also continue to pose challenges. Many NHS organisations still rely on outdated infrastructure, limiting interoperability and making it harder to integrate new digital tools effectively. At the same time, funding mechanisms can discourage innovation, with short-term budget pressures often taking precedence over longer-term investment in new technologies.
Digital transformation ambitions face practical hurdles
The NHS has set out ambitious plans to expand the use of digital technologies, including AI-powered tools, electronic patient records and advanced analytics. These initiatives are central to the government’s broader health strategy, which aims to improve productivity, reduce waiting times and enhance patient outcomes through digital transformation.
However, experts warn that ambition alone is not enough. Without addressing the underlying barriers to adoption, there is a risk that promising technologies will remain confined to pilot projects rather than being deployed at scale. The challenge is particularly acute for smaller companies and start-ups, which may lack the resources to navigate complex NHS processes. This can limit competition and reduce the diversity of solutions available to the health service. There are also concerns that slow adoption could undermine the UK’s position as a leader in health innovation, with companies choosing to commercialise their products in other markets where uptake is faster.
The role of data, interoperability and standards
From a health technology perspective, improving interoperability and data standards is seen as critical to unlocking innovation. Digital tools rely on access to high-quality, integrated data, yet fragmentation across systems continues to hinder progress. Efforts to standardise data and improve connectivity, such as through national platforms and shared records—are ongoing but unevenly implemented.
Experts argue that simplifying data governance frameworks and ensuring consistent standards across the NHS would make it easier for innovators to develop and deploy solutions. At the same time, maintaining public trust remains essential. Robust safeguards around data privacy and security are necessary, but must be balanced with the need to enable responsible innovation.
Bridging the gap between innovation and implementation
The debate reflects a broader challenge within the NHS: translating innovation into real-world impact. While the UK has a strong life sciences and health technology sector, the pathway from research and development to routine clinical use remains complex and often slow. Reports have repeatedly highlighted the need for better support mechanisms to help innovations move through this pipeline.
Initiatives such as the NHS Innovation Service aim to streamline this process by providing guidance and support to innovators. However, stakeholders suggest that more fundamental changes may be required to address systemic barriers.
A critical moment for NHS innovation strategy
The calls for reform come at a time when the NHS is under increasing pressure to improve performance and efficiency. Digital innovation is widely seen as a key part of the solution, offering the potential to transform care delivery and address longstanding challenges. However, realising this potential will require not only technological investment, but also organisational and cultural change.
Outlook: removing friction to unlock potential
As the NHS continues its digital transformation, the ability to support and scale innovation will be a critical determinant of success. Addressing the barriers identified by experts, ranging from procurement complexity to cultural resistance which will be essential to creating an environment where innovation can thrive.
The message from industry and NHS leaders is clear: without reform, the health service risks falling behind in the adoption of technologies that could improve care and efficiency. The challenge now is to move from recognising these issues to implementing solutions, ensuring that the NHS becomes not a barrier to innovation, but a catalyst for it.
