The year opened with the NHS facing unremitting pressure that never really let up. A government that had promised not to reorganise the NHS announced a reorganisation of the NHS. Ministers also launched the 10 Year Health Plan, but delivery had to wait for the Medium Term Planning Framework in the autumn. Big electronic patient record, imaging and pathology roll-outs continued, but national attention focused on the Federated Data Platform, a single patient record, and the NHS App. Plus, there was big news from Highland itself. Catch up on another eventful 12 months in digital health.
January
As the year opened, hospitals across England declared critical incidents, as flu added to unremitting demand. But NHS England indicated that its priority would be waiting lists, as it issued an update to its elective recovery plan, with an expanded role for ‘advice and guidance’. Hopes for rapid action on social care were dashed when the government asked Baroness Louise Casey to lead a two-year commission into the issues instead (10 January). The New Hospital Programme was also delayed, as the government announced that just 16 of its 40 projects would start this decade.
In health tech news, John Quinn stepped down as NHS England’s interim chief information officer. Prime minister Sir Keir Starmer accepted the recommendations of an AI Opportunities Action Plan drawn up by entrepreneur Max Clifford (17 January). University Hospitals Plymouth and Torbay and South Devon NHS foundation trusts announced they had chosen the Epic electronic patient record for a One Devon project (24 January). And the National Audit Office warned that government progress on cyber security was too slow, as the Home Office opened a consultation on proposals to tackle ransomware.
February
As January ended, there were signs that the government was losing temper with NHS England. MPs on two Commons committees rowed with its leadership in evidence sessions on finances and reform. After which, the organisation announced another reduction in its headcount (31 January). And chief executive Amanda Pritchard announced she would stand down at the end of the month. Health and social care secretary Wes Streeting marked her departure by saying that Sir James Mackey, a veteran regulator and trust chief executive, would “provide new leadership for a new era for the NHS” (28 February).
March
Two weeks later, the Health Service Journal reported that the Department of Health and Social Care and NHS England were looking at even more swinging job losses, with up to 50% of their complement at risk. But two days after that, Sir Keir Starmer used a speech about the reform of the state to announce the abolition of NHS England (14 March). Amid shock at the way the changes were being handled, Amanda Pritchard said she was going back to her old job as chief executive of Guy’s and St Thomas’ NHS Foundation Trust.
In health tech news, Digitalhealth.net reported that the NHS was not ready for the end of Microsoft Windows 10 support in October. The government agreed a new contract with GPs, which included a requirement to leave their online triage and booking systems on during the day. University Hospitals of Derby and Burton and Chesterfield Royal Hospital NHS trusts went live with the Nervecentre EPR. And the Tony Blair Institute for Global Change called for an ‘AI navigation assistant’ for every citizen, to streamline access to the NHS (21 March).
At its March meeting, the Highland advisory board considered the potential impact of AI on the NHS, and some of the pitfalls of the government’s approach (AI in healthcare: how do we get from hype to usefulness?)
April
The Scottish Government issued an operational improvement plan, with a role for digital. However, the long-promised app for health and social care was delayed again. Meanwhile, public satisfaction with the NHS in England felt to an all-time low. Ming Tang became interim chief digital information officer, following the departure of John Quinn (4 April). The Health Foundation called for a new EPR strategy, to get more out of the systems in place (11 April). And the roll-out of the Federated Data Platform was criticised by chief information officers, who were unhappy with its functionality (24 April).
May
NHS England published a ‘model’ integrated care board blueprint for ICBs to follow as they cut costs by 50%. It said the future of ICBs lies in “strategic commissioning”, with their other roles split between regions, trusts, and neighbourhood teams. The government published a pre-market engagement notice on proposals to create a single patient record, another idea promoted by the Tony Blair Institute for Global Change (9 May). KPMG won a £13.3 million contract to provide ‘tiger teams’ to support EPR implementations at the handful of trusts still lacking basic IT functionality (16 May).
June
As summer started, Chancellor Rachel Reeves unveiled the outcome of the Treasury’s spending review and set out the funding that will be available to government departments, public sector bodies, and specific projects by the end of this Parliament. In headline terms, the NHS will receive a real-terms increase of 3% a year. But think-tanks warned its starting position is tight, and the NHS faces significant cost pressures, which will impact the money available for care, waiting lists, and reform. The Treasury said there would be a “total investment of up to £10 billion” in NHS technology.
Meanwhile, the NHS Confederation held its annual conference in Manchester. Wes Streeting used the event to claim the NHS was “in jeopardy” with “right wing vultures” ready to capitalise on low public satisfaction, and to trail a new operating model, with a big role for the NHS App. In other health tech news, Northern Ireland completed the nation-wide roll-out of the Clinisys WinPath laboratory information system (13 June). Two trusts went live with MEDITECH. And University Hospitals of Leicester NHS Trust launched a ‘first of type’ patient administration system from Nervecentre (27 June).
July
As the NHS prepared to mark its 77th anniversary, the government published its 10 Year Health Plan, ‘Fit for the Future’. The plan said the NHS must “reform or die” and, as expected, called for three shifts to put it on a sustainable footing: from treatment to prevention, hospital to community, and analogue to digital. The plan confirmed that a single patient record will be developed, and highlighted investment in the NHS App and an NHS Online virtual hospital. The plan also made “bets” on five “transformative technologies”: data, AI, genomics, wearables, and robotics (3 July).
The Highland Advisory board held a special meeting to discuss the 10 Year Health Plan and argued that what it really needed was a funded, delivery strategy (Great plan: now we need to get real about digital delivery).
August
There was less good news for the government over the summer, as resident doctors struck again in support of pay restoration and better training opportunities. The British Medical Association warned that 52% of the resident doctors who have completed foundation training have not been able to get jobs this year (1 August). The Tony Blair Institute turned its attention to the NHS App and argued the approach to development outlined in the 10 Year Health Plan ran the risk of “fossilising old models of care.” The TBI said the app should be used to drive new, patient-focused care models and prevention (8 August).
The Health Foundation turned its attention to the impact of policies already in place. It found that while the NHS has delivered millions of extra appointments, as promised in the Labour Party manifesto, they have had a “modest impact” on waiting lists because it is taking more steps to complete a patient pathway. The Health Foundation and the Nuffield Trust also showed that most of the recent reduction in waiting lists has been down to cleaning and validation (15 August). It emerged that the Federated Data Platform will cost more than £1 billion. OneAdvanced bought the Vision GP system from INPS (21 August).
September
As the summer holidays came to an end, prime minister Sir Keir Starmer launched a shake-up of Downing Street to further strengthen Number 10’s grip on government policy. But the Liberal Democrats warned that the NHS had entered a state of “permacrisis” and there was no slack in the system for winter (5 September). The government also released a model regional blueprint, announced the first 43 neighbourhood health services in areas with “the lowest life expectancy and longest waits”, and published new league tables for trusts (12 September). And then it touted compulsory ID for all adults (23 September). In further health tech news, two trusts in Devon and Cornwall went live with Sectra’s digital pathology module.
With no delivery plan in sight, the Highland advisory board felt there was a growing gap between the rhetoric of reform in the 10 Year Health Plan and the reality of reorganisation and financial pain on the ground (Health tech’s lost summer).
October
Highland had its own news to announce. After more than two decades as Highland Marketing, we revealed an updated identity as Highland, to reflect a sharper focus on helping health tech companies to find market opportunities, convince their target audiences, and drive growth. Our chief executive, Mark Venables, said it was clear that in an exciting but challenging policy and market environment, traditional marketing is no longer enough, and described our new identity as a “growth partner” as “a great leap forward” in helping health tech and med tech companies to accelerate success (10 October).
Our chief executive Mark Venables set out the thinking behind Highland’s new approach and in a dedicated blog (Marketing alone isn’t enough for health tech growth: why Highland is driving a new approach in 2025).
Elsewhere, attention was turning to the November Budget. NHS Providers and PA Consulting called for more, and more creative capital investment in the NHS, while the NHS Confederation argued that a new route for private sector involvement is needed. Funding is just one issue for big IT procurements, and the approval process got another step when HSJ reported that Sir James Mackey wants to to sign off on go-lives personally (17 October). The DHSC claimed unprecedented savings has been achieved in an NHS pilot of Microsoft Copilot. And Medway NHS Foundation Trust put together a business case for a virtual hospital with 260 beds (24 October).
Then, at the end of the month, NHS England published a document that may be at least as important as the 10 Year Health Plan initially. The Medium Term Planning Framework set out a ‘to do list’ for the three years covered by the spending review. It aimed to balance the imperative to control finances and tackle waiting lists with “laying the foundations” for the shifts in the 10 year Plan, and included a chapter on “doing digital differently” that focused on using national offers, rolling out productivity tools, and developing the NHS App and NHS Online virtual hospital (31 October).
We analysed the Medium Term Planning Framework and what digital health companies should take away from it (Medium Term Planning Framework: what health tech companies need to know).
November
The first warning that the UK could be in for a tough flu season came in from Australia and Japan (7 November). After months of argument, the government reached agreement with the Treasury on funding the huge waves of redundancies at NHS England and ICBs. The DHSC also unveiled details of its “revitalised” advanced foundation trust programme, with eight trusts in the running (14 November). But the Public Accounts Committee and the Institute for Government warned that for all the noise in the system, the government lacked a coherent plan for tackling waits or for reform (21 November).
When chancellor Rachel Reeves finally stood up in the Commons, she confirmed the revenue and capital budgets for the NHS set out in the spending review but announced even tougher savings targets. Reeves also announced £300 million of capital funding for “digital tools”, without further details. Think tanks warned this left the NHS in a tough position, with potentially unfunded pay, strike and drug costs coming down the line (28 November). Eighteen years after the first London trust went live with Cerner Millennium as part of the National Programme for IT, Barking, Havering and Redbridge, became the last capital trust to digitise.
December
As if to underline the precarious nature of NHS finances, the government did a deal with the US that will see the NHS pay around 25% more for new, branded medicines by the end of the next decade. And the British Medical Association announced that resident doctors would strike again in the run up to Christmas (5 December). The autumn’s concerns about flu looked set to be realised, as cases rose in hospitals and the head of NHS Providers suggested that people should wear masks in public. An alarming number of acute and ambulance trusts also declared critical incidents, in the face of yet more unremitting pressure (11 December).
