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Paul Taylor, head of public sector at Vodafone Business, argues that if we get NHS reform right, then digital reform can become a route to fairer, faster and more confident care.Â
The government’s NHS modernisation agenda, taken forward through the Health Bill, sets the right ambition for a more connected health service, but legislation alone will not determine whether patients feel the benefit. Patient choice, neighbourhood health, shared information and a single patient record all respond to the same challenge. Too often, patients and clinicians are still forced to work around a system that does not join up well enough.
Digital reform can solve that. Done well, it can make care faster, fairer and easier to use. It can give patients more control over their own health, while giving staff better access to the information they need.
But the success of reform will be decided in ordinary moments. A patient trying to order a repeat prescription. A clinician accessing notes during a home visit. A pensioner in a rural area trying to use an online service because the nearest physical appointment is miles away.
If the digital route does not work for them, the NHS risks creating new barriers instead of removing old ones.
Digital access to healthcare is already part of everyday life
For millions of people, the NHS is increasingly something they access through a phone, tablet or computer, as well as through a GP practice, hospital or clinic.
The NHS App shows how far this shift has already gone. In April, there were 74.8 million logins, up from 51.2 million in April last year. Over the same period, repeat prescription orders through the app rose from 5.5 million to 7.0 million.
The risk is that a more digital NHS creates a new dividing line between those who can use online routes easily and those who cannot.
The people most exposed to that divide are often those who already face barriers to care. Older patients, disabled people, rural communities, people on lower incomes and those less confident using digital services are all more likely to feel the effects if digital access is designed around ideal conditions rather than real lives.
A weak connection, poor coverage, limited access to devices or a service that does not work well in practice can all become barriers between patients and support.
Frontline staff can feel this too. Neighbourhood care, remote access, shared records and patient self-management all depend on the right information reaching the right person at the right time, wherever care is being delivered.
When systems are slow, unavailable or difficult to access, staff lose time, and patients may grow frustrated from having to repeat themselves. Decisions can be delayed, and confidence in digital services can weaken.
Connectivity has to be designed in from the start
The answer is to treat connectivity as part of service design, not something to check after a digital service has already been built.
This starts with testing services in the places people will actually use them. A patient may be at home, on a mobile phone, with patchy broadband. A clinician may be moving between homes, GP practices and care settings. A service that works well under ideal conditions may feel very different in the middle of a busy clinic or a home visit.
It also means planning properly for care outside traditional settings. If more care is going to happen in the community, staff need access to the right information wherever they are working. That requires reliable connectivity, but also systems that are secure, resilient and simple enough to use under pressure.
This is especially important when digital health services are handling some of the most sensitive information people have. Patients need to trust that their records are protected, that information is only available to the right people, and that the networks carrying it are safe and reliable. The success of initiatives such as the single patient record and the continued growth of the NHS App will depend not only on functionality, but on public confidence that services are secure, resilient and available when people need them.
Digital services also need fallback routes when systems are disrupted, while patients who need extra support should still have a clear way to access care.
None of this sits with one part of the system alone. Government, NHS bodies, technology partners and network providers all have a role in making sure digital health services are built around real-world access.
The goal should be simple. When a patient needs care, the digital route should make that care easier to reach, not harder.
The patient test
The real test of digital NHS reform is whether patients feel the benefit.
Can they get care faster? Can they access support from where they live? Do clinicians have the information they need when they need it? Are people who already face health inequalities brought closer to care, rather than pushed further away from it?
These are the questions that should guide delivery.
A more connected NHS should mean better access, better information and more joined-up care. But that will only happen if secure connectivity, resilience and digital inclusion are built in from the start.
If we get that right, digital reform can become a route to fairer, faster and more confident care. If we do not, we risk replacing old barriers with new ones and creating a digital postcode lottery where access to care depends not just on clinical need, but on connectivity, confidence, affordability and the device someone has in their hand.
