Sandeep Chauhan, chief executive and co-founder of Definition Health, writes that delivering on NHS England’s 2025/26 priorities will require a system-wide shift.
NHS England’s 2025/26 Priorities and Operational Planning Guidance sets a clear direction for the coming year, focusing on tackling elective care backlogs, improving urgent and emergency care, and enhancing access to primary and mental health services. While the reduced number of national priorities offers sharper focus, achieving these goals amid tight financial constraints will demand radical transformation.
One of the biggest challenges remains elective care. An ambitious new target for 65% of patients to receive treatment within 18 weeks by March 2026 will require local NHS leaders to make tough, and potentially very unpopular, decisions about resource allocation. From my experience as a surgeon in the NHS, the key question is not just about efficiency but about how we can deliver more care without compromising patient safety.
From digital adoption to digital integration
The guidance sets clear expectations for driving the transition from analogue to digital, urging systems and providers to leverage digital tools to support reform and ensure the NHS is fit for the future. While broader adoption of the NHS App, Federated Data Platform, electronic patient record (EPR) systems and electronic prescriptions will be welcome, their implementation alone is not enough. To truly transform surgical care in the UK, a system-wide shift is required, one that rethinks how digital tools are integrated into healthcare delivery. This goes beyond digitising existing processes; it involves the creation of digitally enabled care pathways.
This shift requires a fundamental re-evaluation of how care is designed, delivered and supported through digital innovation. It means moving beyond simply digitising paper-based workflows to strategically embedding digital tools throughout the patient journey. This includes leveraging capabilities such as predictive analytics, remote monitoring, virtual consultations and AI-driven decision support. Rather than using technology to replicate outdated processes, we must harness it to develop more agile, responsive and patient-centred models of care.
The ability to schedule and track appointments digitally through the NHS App is a start, but we must go further. Data-driven technology can predict demand, triage patients more effectively, and identify those most at risk. Virtual care models can streamline both pre-operative and post-operative pathways, which reduces unnecessary hospital visits and enables patients to recover safely at home with continuous digital support.
The shift to a more proactive, data-driven and digital-first approach will empower care teams to anticipate patient needs, optimise resource allocation and improve patient experiences. Embedding digital tools into everyday clinical workflows is crucial, ensuring they are intuitive, interoperable, and designed with frontline staff in mind. This will reduce delays and enable clinicians to deliver high-quality, patient-centred care more effectively.
Turn vision to reality
For me, the case for a system-wide shift is undeniable. But I also appreciate the process will be challenging. The guidance lays out bold targets, but these cannot be achieved through incremental changes alone. Recognising the transformative potential of digital health is just the first step. Turning this vision into tangible patient care improvements requires overcoming technical, cultural, organisational, and financial barriers.
Progress across regions continues to intensify the digital divide. Recent reports indicate parts of the NHS are making glacially slow progress in digital transformation which leads to inconsistent adoption of tech and disparities in care. Outdated and disconnected IT hinders interoperability, impedes data sharing, and delays clinical decision-making. Even some modern systems can exacerbate this issue, as their proprietary nature makes it difficult to integrate more effective, specialised digital solutions. Trusts are often encouraged to rely on their EPR, despite the availability of better tools designed to address specific challenges more effectively.
Regulatory complexity and a risk-averse culture also slow down adoption, as rigid procurement processes, inflexible policies and time-consuming bureaucracy discourage trusts from exploring new solutions. This conservative approach limits agility and delays the benefits of digital transformation. Workforce engagement and digital literacy gaps are also significant challenges. I’ve seen firsthand how limited frontline staff involvement and inadequate training impede effective adoption. Compounding these issues are concerns around data governance and trust, with inconsistent practices and fears about data security undermining confidence.
At times, the sheer scale of these challenges feels overwhelming, as if the system is being asked to climb a mountain with no clear path to the summit.
Invest in the future
The government’s recent commitment to invest £2 billion in NHS technology and digital is a much-needed step in the right direction, but it is critical to ensure that this funding delivers real transformation. The guidance states that, to live within budget, providers must reduce their cost base by at least 1% and achieve a 4% overall improvement in productivity, targets that are among the most demanding in recent years. To meet these stretching ambitions will require more than investment alone; it will require a strategic approach to how digital tools are integrated into care pathways.
The Treasury’s pledge to modernise IT infrastructure, improve cyber security and enhance patient access through the NHS App is a step forward. Without a clear strategy to scale innovations and embed best-in-class, clinically validated digital solutions across the system, however, the NHS risks failing to unlock the full potential of this funding.
A long-term approach is needed, one that prioritises interoperability, ensures technology works for frontline staff and expands digital adoption beyond the tech outlined in the guidance.
A sustainable future for the NHS
The 2025/26 guidance echoes the government’s strong focus on bringing down long waiting lists. While the reduction in the number of priorities offers clarity, to achieve long-term sustainability requires both recovery and reform. Of course, digital transformation is not a silver bullet, but it is a necessary enabler of improved efficiency, safety and outcomes.
The emphasis on digital solutions as a mechanism to cut elective waiting lists is welcome. But for the NHS to be truly fit for the future, as ministers have committed, the forthcoming 10-year plan for health will need to show greater radicalism.
What’s needed now is bold action, innovative thinking, and a commitment to embed digital at the heart of service redesign.
The future of the NHS depends on it.
