After many years of being parachuted in to patch up distressed hospital systems, Aire Logic’s Michael Hardman is advocating for a radical new approach to healthcare IT. 

His leadership in guiding national-scale healthcare programmes through critical transformation has led him to the conclusion that it’s time to start over and think differently. 

Just as Monzo transformed the banking industry, Michael Hardman’s view is that focusing on the digitisation of existing assets is stalling progress. Reflecting on the plans, he shares with Healthcare Today how a proposed challenger hospital model could feasibly help take the NHS 10 Year Health Plan to its ultimate conclusion. 

A bold vision needs brave interpretation

The 10 Year Health Plan indeed delivers a compelling vision: a health system that is digital-first, inclusive and resilient. The ambition is clear. Patients will benefit from better, seamless, connected care; clinicians will be equipped with real-time data and smarter tools; and healthcare will become more accessible to every community. 

But setting out this long-awaited vision is just the beginning. The more urgent question is how we translate this all into practice? Upgrading systems alone will not be enough. If we are serious about transformation on this scale, we need to go further and rethink fundamental assumptions, including those surrounding what a hospital is – and needs to be – in the decades ahead. 

It’s time to collectively challenge the status quo

Core to the new plan is the commitment to a Single Patient Record, more integrated community-based care and digital tools that support both self-management and system-wide visibility. Importantly, these goals are more than technical milestones as achieving them means tackling the deeply ingrained defaults of our current system, which is built around buildings, centralised decision-making and disjointed technologies. 

We’ve explored this call for change in a recent report, The Everywhere Hospital, posing the question: what if we were to start from scratch? What kind of care system would we design if digital capabilities, clinical intelligence and patient agency were built in from the very beginning?

Rethinking ‘Hospital’ as infrastructure, not place 

For more than a century, the hospital has been the physical heart of healthcare delivery. But what happens when the needs, behaviours, and expectations of patients – not to mention the technologies that serve them – move beyond those physical boundaries? 

A distributed care model where digital interfaces, community resources and specialist hubs work together as a unified system, could reduce waiting times, alleviate pressure on overstretched services and bring care closer to those who need it. 

The hospital therefore becomes less of a location and more of a blueprint. A flexible, responsive framework for care that moves with people, rather than asking people to move around it. 

Practical alignment with the 10 Year Health Plan 

Much of what we’ve proposed in the Everywhere Hospital concept mirrors the aspirations now embedded in the 10 Year Health Plan. A user-governed and interoperable patient record directly supports the goal of a Single Patient Record, while addressing long-standing fragmentation. 

The reimagining of the NHS App as a control centre for personal health makes sense only in a system where individuals are empowered to lead their own journeys, rather than simply receiving services. Similarly, retiring outdated legacy systems becomes more feasible when we design processes for the present instead of digitising what no longer fits. 

Perhaps most crucially, hybrid models that combine digital-first convenience with in person care, when it matters most, show how inclusion and efficiency can coexist. 

Mindset shifts, not just tech shifts 

Working with this model comes with very obvious challenges, of course. Transforming infrastructure is one thing; shifting culture and mindset is another. True change means revisiting the assumptions we’ve internalised about professional identity, institutional authority and patient participation. 

Building adaptive, modular systems can feel uncomfortable – especially in a sector where reliability, regulation and stability rightly matter. But clinging to systems only delays the kind of improvement that patients and healthcare professionals deserve. 

Bridging public and private: A shared responsibility 

The 10 Year Health Plan recognises that innovation won’t come from within the NHS alone. Successful collaboration is not about handing over control but rather creating space for experimentation, where public services, the private sector and independent thinkers can work side-by-side. 

We should welcome contributions that push the conversation forward, even when they unsettle us. That’s what we’re trying to do with The Everywhere Hospital. We don’t claim to have all the answers but we see value in constructively challenging the status quo – particularly at a time when conventional answers are proving insufficient. 

It’s important to remember that when you design digital systems in healthcare, you’re not just building software, you’re making decisions about trust, access, autonomy and equity. This also presents us with a huge window of opportunity to do things better than we’ve done them before. 

From ambition to architecture 

The 10 Year Health Plan gives us a destination and what we need now is the architecture to help get us there. In other words, the physical, cultural and technical scaffolding to support this level of transformation. 

Some of that will involve investment in new platforms and skills but, just as importantly, will be the willingness to let go of broken structures and stagnated mindsets. Perhaps the most responsible move is not to modernise but to begin again, guided by the needs of today rather than the habits of the past. 

In healthcare, as in technology, progress doesn’t always mean iteration. Sometimes it requires a radical rethink.