Rob Thompson has been given considerable authority over the NHS’s digital future. What appears less certain is whether he has won the confidence of the people expected to deliver it. In conversations with several NHS CIOs and executives, expressions of support have reportedly been difficult to find. That is a limited account of opinion, but for a national leader whose success depends on local implementation, it is an uncomfortable starting point.

Appointed Chief Digital, Data and Technology Officer across the Department of Health and Social Care and NHS England in May 2026, Thompson has responsibility for data, technology transformation, platforms, live services and cyber security. The breadth of that remit makes confidence in his leadership consequential. The NHS needs to know whether the person directing its digital ambitions understands what it will take to make them work.

A substantial CV leaves an important question unanswered

Thompson brings considerable experience, although describing him as a lifelong civil servant would be inaccurate. In his own account of joining the Home Office in 2018, he described 23 years in the private sector followed by four years at the Department for Work and Pensions. There, he led a 700-strong engineering team and the Universal Credit technology team.

He subsequently became the Home Office’s Chief Technology Officer and later its Chief Digital Information Officer. His official biography records engineering qualifications and responsibility for setting the department’s 2030 Digital Strategy. Those credentials establish experience of running substantial technology organisations; they leave open how effectively he will lead digital change in healthcare.

That distinction deserves more scrutiny than an appointment announcement usually provides. Healthcare technology operates within clinical relationships, professional responsibilities and decisions that can directly affect patient safety. A system can meet its technical specification while making a ward’s work more cumbersome or leaving an operational team without the information it needs.

An external perspective can be useful, particularly where established approaches have failed. But an outsider must demonstrate an understanding of the service quickly and convincingly. The reservations described to Distilled suggest that, among at least some senior NHS leaders, Thompson has further to go.

The people delivering the agenda need a reason to believe in it

CIOs are a particularly consequential audience for a national digital chief. They carry responsibility for making programmes work within organisations where resources are constrained and disruption has immediate consequences. Their confidence cannot be treated as a communications matter to be addressed once the strategy has been settled.

They need to believe that the centre understands the difference between announcing a capability and making it usable. A trust may require infrastructure work, clinical redesign, staff training and continuing technical support before a new system delivers its intended benefit. National expectations become difficult to defend locally when those requirements have not been adequately recognised.

The conversations supplied for this article do not establish precisely why support for Thompson appears limited. They also do not provide independently verified examples of failed decisions under his leadership. That leaves a reporting question to pursue, rather than a verdict to announce.

Nevertheless, the absence of readily expressed enthusiasm is worth taking seriously. A leader in this position should be building a constituency among the people responsible for implementation. If that confidence is weak, the centre needs to understand why and demonstrate what it is doing in response.

The NHS has heard the ambition before

The government’s 10 Year Health Plan places the move from analogue to digital among its principal reforms. Technology is expected to support a wider change in how care is organised, alongside the shifts towards community services and prevention. Thompson therefore inherits a brief in which delivery carries substantial political and operational weight.

NHS England says £1.9 billion has been invested through its Frontline Digitisation Programme to establish a baseline of digital capability across trusts. Its stated objective is better use of electronic patient records to support efficient, effective and safe care. The scale of that investment makes practical results an essential test of national leadership.

For providers, those results must be recognisable in the working day. Staff should be able to find relevant information more easily, avoid unnecessary duplication and understand where care is being delayed. Executives need evidence that technology is improving performance sufficiently to justify the resources committed to it.

AI raises the stakes further. An impressive demonstration tells a trust little about the cost of integration, the reliability of its outputs or the support needed to use it safely. Thompson must show that national enthusiasm for new capabilities is matched by a credible account of implementation.

Authority will only take him so far

DHSC lists Thompson as Director General for Technology, Digital and Data within its joint executive arrangements with NHS England. He has a seat in the machinery overseeing transformation and the opportunity to influence how it proceeds. The concern is whether that institutional position will translate into leadership that providers find persuasive and useful.

Less than five months into the role, it would be premature to judge his entire tenure. It is entirely reasonable, however, to ask what he has prioritised, how local leaders have shaped those choices and what progress providers should expect next. A clear answer would give sceptical CIOs something more substantial to assess than his previous experience.

Thompson’s background gives him a plausible claim to the job, but confidence in his NHS leadership still needs to be earned. The reservations described by senior figures should prompt a closer examination of his approach and a direct response from him. Until providers can see the difference his leadership makes, doubt is a reasonable position to hold.

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