The NHS 10-Year Health Plan, released in July 2025, establishes three fundamental shifts: analogue to digital, treatment to prevention, and hospital to community care.
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For system leaders, these shifts represent both unprecedented opportunity and significant operational challenges requiring strategic coordination and practical solutions.
The digital implementation challenge
The plan’s vision of digital-first healthcare offers compelling benefits, with AI and technological advances promising to free up staff time and improve service efficiency. However, current implementation approaches reveal systemic inefficiencies that threaten these strategic objectives.
NHS systems currently operate independent technology procurement processes, creating measurable problems. Each system evaluates identical solutions separately, requiring individual business cases, procurement teams, and implementation resources. This fragmentation prevents economies of scale and delays deployment of proven technologies by months.
The administrative burden is substantial: multiple systems conduct parallel evaluations of the same technologies, each navigating separate spending control reviews and evidence generation processes. This duplication wastes resources and impedes the development of interoperable systems essential for transformative patient care.
The case for centralised digital governance
The evidence supporting centralised technology approval and implementation is overwhelming. Current governance structures create unnecessary duplication and prevent rapid system-wide deployment of proven innovations.
NHS England should establish unified evaluation processes for digital health technologies, creating standardised assessment criteria and centralised procurement frameworks. This approach would reduce duplicate evaluation costs, accelerate technology deployment, and enable bulk purchasing agreements while ensuring interoperability standards across all implementations.
Leadership in a consolidating system
The challenge of identifying clinical and digital leaders becomes particularly acute as NHS systems consolidate by 50 per cent. This restructuring presents both risk and opportunity: fewer systems mean reduced leadership positions, but also potential for more strategic, coordinated approaches to digital transformation.
Current data shows significant variation in digital maturity across systems, with some lacking basic electronic health records while others implement AI-powered diagnostic tools. System leaders must identify individuals capable of managing digital transformation across newly consolidated entities, requiring technical expertise, change management experience, and the ability to integrate different organisational cultures.
Community-centred innovation: the Farnborough project (six-month project)
The Farnborough community pharmacy heart valve detection project provides concrete evidence of how digital technology can support all three strategic shifts simultaneously.
In this initiative, a single community pharmacist used digital screening technology to identify patients at risk of heart valve disease within targeted patient cohorts.
This project demonstrates practical implementation of the NHS transformation agenda:
- Analogue to digital: Traditional referral pathways were replaced with digital screening tools and direct data integration with GP systems, eliminating paper-based processes.
- Treatment to prevention: The initiative identified asymptomatic patients before symptoms developed, enabling early intervention and preventing progression to emergency presentations.
- Hospital to community: Screening services were delivered in community settings, reducing demand on hospital-based cardiology services while maintaining clinical quality.
- Measured outcomes: The project delivered benefits across multiple stakeholders. Patients received early detection, enabling timely treatment and improved clinical outcomes. The system benefited from reduced cardiology referrals and hospital admissions. The community pharmacy generated additional revenue streams while enhancing its professional role in preventive care.
Community pharmacy as prevention infrastructure
Community pharmacies represent significant underutilised assets in the NHS prevention strategy. With more than 11,000 pharmacies across England providing accessible healthcare touchpoints, many offer services such as Pharmacy First, but also contain the potential for digital health implementation.
The Farnborough model demonstrates that community pharmacists can effectively operate digital diagnostic tools with appropriate training. This approach leverages existing pharmacy infrastructure with extended hours and convenient locations, reducing pressure on overstretched primary care services while conducting routine screening for asymptomatic populations.
This positioning creates a triple benefit model: enhanced patient access to preventive care, reduced system demand for acute services, and sustainable revenue streams for local pharmacies through expanded service provision.
Conclusion
The NHS 10-Year Health Plan presents a defining opportunity to transform healthcare delivery through strategic digital innovation. The Farnborough heart valve detection project provides a replicable model for community-based digital health services that simultaneously addresses all strategic shifts while delivering measurable benefits.
However, scaling such initiatives requires fundamental changes to digital governance, procurement processes, and leadership development. As system leaders, our success depends on using current policy structures such as Pharmacy First to help the collective approach progress towards a digitally transformed NHS, which serves patients more effectively, operates more efficiently, and strengthens community health infrastructure.
The evidence is clear that digital transformation works when properly implemented. The challenge now is systematic deployment across the entire NHS system through immediate, coordinated action to centralise governance, eliminate duplication, and leverage community assets for prevention services.
