Digital health leaders react to NHSE’s ‘back to basics’ priorities
- 31 January 2025
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- Digital health leaders have given a mixed reaction to the priorities announced by NHS England, which focus on reducing elective waiting times, increasing access to primary care and boosting urgent and emergency care
- The 2025/26 priorities and operational planning guidance sets an ambition for 65% of patients to receive elective treatment within 18 weeks by March 2026
- It says that providers must make full use of digital tools, ensuring at least 70% of elective appointments are available to manage via the NHS App in 2025
Digital health leaders have given a mixed reaction to streamlined priorities announced by NHS England, which focus on reducing elective waiting times and increasing access to urgent and emergency care.
The 2025/26 priorities and operational planning guidance, published on 30 January 2025, sees a reduction of priorities and success measures – from 32 in 2024/25 down to 18 in 2025/26.
It sets out a national ambition for 65% of patients to receive elective treatment within 18 weeks by March 2026, with every trust asked to deliver at least a 5% improvement on their performance in 2025.
To achieve this, the guidance says that local areas and providers must make full use of digital tools to drive the shift from analogue to digital and “revolutionise access to care for patients”, ensuring at least 70% of elective appointments are available to manage via the NHS App in 2025.
It also mandates that all systems adhere to the ‘federated data platform (FDP) first’ policy, connecting their own digital and data infrastructure to the FDP. NHSE will support adoption of the FDP to 85% of all secondary care trusts by March 2026.
Amanda Pritchard, chief executive of NHSE, said: “In what will undoubtedly be another tough financial year, the NHS will continue its relentless focus on boosting productivity and driving efficiencies for the benefit of patients and taxpayers.
“Our main focus will always be on supporting frontline teams to deliver what matters most to patients – so it is also right that we prioritise and streamline the work of NHS England to ensure we maximise frontline resources.
“Together with government, we have also honed down national priorities, allowing local leaders maximum flexibility to plan better and more efficient services for their population.”
The guidance says that to live within budget, providers will need to reduce their cost base by at least 1% and achieve 4% overall improvement in productivity.
It adds that integrated care boards and providers will need to “take a forensic look at their workforce and what they spend money on”. This includes reviewing spend on non-frontline staff and reducing agency expenditure, with a minimum 30% reduction on current spending across all systems.
The guidance follows the government’s Road to recovery mandate for reform of the NHS, also published on 30 January, which sets out five core objectives for the health service, including cutting waiting times, improving access to primary care and improving urgent and emergency care.
Wes Streeting, health secretary, said: “I want to empower NHS leaders to deliver the innovation and reform required to fix the NHS, rather than overload them with targets which have failed to deliver better outcomes for patients.
“This new approach will see the NHS focus on what matters most to patients – cutting waiting list, getting seen promptly at A&E, and being able to get a GP appointment”.
Responding to the NHS priorities, Sarah Woolnough, chief executive of The King’s Fund, said: “Tackling the backlog of people needing planned care is important but should not be taken as the sole measure of what a health and care system is meant to deliver.
“Achieving the target of patients being seen for planned hospital care within 18 weeks will seem like a small and isolated victory in four years’ time if it meant the government took its eye off the ball in reforming adult social care, helping the NHS to turn into a prevention-focused service that helps keep people well, and reducing health inequalities between different parts of the country.”
Matthew Taylor, chief executive of the NHS Confederation, said: “We should be under no illusion – this is going to be one of the most challenging financial settlements of recent years and these ambitions will be unbelievably stretching for the NHS.”
Digital health suppliers’ reactions
There was a mixed reaction to the guidance from digital health suppliers, with some welcoming the emphasis on digital solutions and cutting waiting lists, while others argued that the narrow focus ignores vital areas such as improving adult social care and women’s health, which could further exacerbate health inequalities. Here’s what they had to say:
Nick Wilson, chief executive, System C:
“The understandable focus on waiting list targets misses the bigger picture. Yes, we need to reduce delays – but not at the expense of quality care. No amount of front-door efficiency matters if we can’t get patients safely discharged.
“Without proper social care funding, we’re simply creating a bottleneck at the back door”.
Julian Coe, managing director, X-on Health:
“Today’s announcement is a blow for the NHS overall, with both budget and staffing challenges on the horizon. Without consistent support the NHS will flounder, with levels of patient care ultimately likely to suffer as a result.
“While the emphasis on reducing GP appointment waiting times is a positive step, addressing this issue doesn’t require massive investment.
“Instead, it demands practical, hands-on support for every GP practice manager to maximise the potential of existing tools. There’s no national solution or quick fix, it requires tailored efforts at each practice.
“This means reducing technological complexity by offering fewer, better-integrated tools and providing ongoing, practical support to refine workflows. Success lies in focused, detailed work on the ground.”
Alison Gardiner, chief executive and founder, Sleepstation:
“While frontline digitisation and scaling the NHS App are important digital shifts, which can help reduce waiting times and improve patient flow if implemented well – there are some obvious ‘digital wins’ to tackle productivity and move towards a Neighbourhood Health Service that have been overlooked in the guidance.
“In the bid to deliver the government’s ambitions for a ‘more devolved system’ when budgets are constrained, more needs to be done to champion scalable community-based digital services that are already helping primary care providers tackle service demands and elective waiting lists.”
Rachael Grimaldi, chief executive and cofounder, CardMedic:
“It’s shocking that vital interventions, such as annual health checks for people with learning disabilities and women’s health hubs, are being scrapped, which will only exacerbate health inequalities in the long run.
“While reducing NHS waiting lists is crucial, the proposed £22bn won’t meet targets if critical factors are ignored.
“Over 21,053 operations were cancelled at the last minute for non-clinical reasons as of March 2024 which demonstrates the severe impact on external factors, such as interpreter access. This could increase morbidity and mortality, further exacerbating health inequalities and lengthening wait times.
“Robust interpreting services and continued preventative care are essential for patient safety, efficiency and health equity.”
Chris Davies, chief executive, The Institute of Clinical Science and Technology:
“Wes Streeting’s focus on reducing NHS targets and prioritising waiting times aligns with the urgent need to shift healthcare resources towards proactive, community-based care.
“The ‘left shift’ in the NHS, as outlined in the 10 year plan, aims to prevent people from requiring more intensive care by focusing on early interventions and preventive measures.”
Phil Bottle, managing director, SARD:
“I think most trust leaders will welcome the rationalisation of targets, but another widespread update to the NHS operating model, will hinder, not help local leaders meet challenging mandates around budget and productivity.
“The mandate reiterates that the public remain sceptical about NHS budgets being well spent.
“It’s well-known that there are huge amounts of waste in the system, but sweeping cuts in headcount – whether that’s substantive workforce or agency staff – are unsafe, and unethical.
“Trusts need more help in understanding how to utilise their workforce budgets appropriately and to do this, they need to gather forensic-level management information to inform strategic decisions around capacity and demand.”
Rachael Fox, executive vice president, UK & EMEA at Altera Digital Health:
“I support the recently published NHSE operational planning guidance and its streamlined approach to prioritise cutting waiting lists to avoid adverse/improve outcomes.
“It will clear the path to enable innovation and focus on what matters most to patients.
“It’s going to be a challenging year for the NHS. However, we are fully committed to supporting trusts through it with robust electronic patient record (EPR), patient flow and interoperable solutions.”
Paul Wye, head of AI, Answer Digital:
“Labour’s first NHS mandate, and subsequent NHSE operational planning guidance makes it clear that every penny invested into the health service will now be more vital than ever.
“Despite the cost base reductions for all NHS organisations, the government’s commitment to investing in data and digital technology is a vital step towards building a modern, productive NHS.
“Data integration is pivotal in driving enhanced efficiency and productivity, enabling better coordinated care and improved outcomes for patients.
“In a move from analogue to digital, enhanced government support for programmes such as the NHS App, full roll-out of EPRs and countrywide integration with the e-referral service are key elements of digitally pushing the NHS forward.
“The push to enhance the offering and capacity of our community diagnostic centres will help tackle growing waiting lists, whilst a strategy for a safe and secure adoption of AI could support our diagnostic services even further”
Darren Ransley, managing director UK & Ireland at Better:
“Although it’s clear from the planning guidance that 2025/26 is going to be a demanding year, I’m pleased to see that the government is simplifying its mandate.
“Reducing and cancelling other targets to get control of the elective backlog and its adverse effects is crucial.
“The NHS urgently needs innovation to drive this reform and sustainability, now more than ever, and it’s good to see that they are backing it with investment in data and digital.
“An integrated, digital NHS should be underpinned by both a platform and an open clinical data-driven approach, that supports innovative tactical solutions for local and regional problems and patient expectations, so that they don’t have to keep re-inventing technical architectures and processes.
“We have seen the impact this can have in many European hospitals, regions, and countries, as well as in the benefits being delivered by the OneLondon Universal Care Plan.”
Steve Wightman, managing director – healthcare, The Access Group:
“Technology has a pivotal role in supporting the healthcare sector as part of the government’s ‘Road to recovery mandate’, particularly in strengthening integration and coordination between health and social care services.’
“We need to embrace innovative digital tools that have the ability to allow clinicians and carers to communicate and share information across the whole care continuum to drive efficiencies and reduce pressure on frontline services.
“However, technology alone is not a complete solution. Challenges around budgets, the need to empower social care with a stronger voice, and enhancing community healthcare initiatives also require attention.
“While technology is a significant enabler, a holistic approach across health and social care will be essential to truly transform the NHS.”