By Editorial Staff
The digital transformation of the National Health Service (NHS) stands at a precarious crossroads. While the allure of artificial intelligence and cutting-edge software dominates boardroom agendas, the reality on the ground tells a different story. According to James Freed, Deputy Director of the NHS Digital Academy, the service is currently suffering from a dangerous mismatch between high-level ambition and the practical capacity to deliver.
Ahead of his keynote appearance at the Digital Health Summer Schools 2026, Freed has issued a sobering challenge to NHS leaders: stop "throwing money" at technology while cutting corners on the people and processes that actually make digital systems work.
The Myth of the "Tech-First" Approach
For years, the narrative surrounding NHS digital transformation has focused on procuring the latest Electronic Patient Record (EPR) systems or investing in high-profile AI pilot programs. However, Freed argues that this approach is fundamentally flawed. When budgets are tight, organizations inevitably prioritize the purchase of expensive software over the "boring" but vital components of implementation: change management, staff education, and technical resilience.
"You can’t cut corners on the amount of money that you give to vendors like Cerner or Epic," Freed notes. "But you can cut corners on change management, education, and leadership—the stuff that matters more to successful implementation than the technology itself."
The result is a cycle of under-investment in the human element, leading to digital tools that are poorly integrated, difficult to use, and ultimately frustrating for clinical staff.
Chronology of a Digital Skills Crisis
The current malaise within the NHS digital landscape did not happen overnight. To understand the gravity of the situation, one must look at the timeline of the last two years:
- 2024: Digital maturity assessments began expanding into primary care, revealing that while infrastructure was improving in some areas, a significant divide remained between tech-savvy trusts and those struggling with legacy hardware.
- 2025: A growing crisis of staff retention hit the headlines. Data revealed that an alarming number of clinicians were citing digital technology—specifically, the burden of using complex, unintuitive systems—as a primary reason for leaving the NHS. Research indicated that up to 75% of the workforce faced a digital skills gap.
- 2026: The current focus has shifted toward the sustainability of these systems. With the cost of repairing EPR data errors projected to hit at least £13.5 million this year, the focus is moving from "implementation at any cost" to "optimization and data integrity."
The Evidence: Why Infrastructure and Literacy Outperform "Innovation"
Freed’s argument is backed by hard data. When analyzing productivity metrics, he suggests that the most significant drivers of success are rarely the features of the software itself. Instead, they are found in the foundational environment in which that software operates.
The Power of Device Refresh
Perhaps the most striking finding is the correlation between organizational productivity and the physical state of the equipment used by staff. Organizations that maintain a robust policy of regular "device refresh"—ensuring that every clinician has access to modern, fast, and reliable technology—are, on average, 37% more productive than those that do not.
Digital Literacy as a Catalyst
Second only to hardware quality is the digital literacy of the staff. Organizations with high levels of digital proficiency among their workforce see a 33% boost in productivity. Crucially, Freed emphasizes that this is the "easiest single thing to address."
Data from EPR usability studies confirms that the software’s design, interface, and functionality only account for approximately 30% of user satisfaction. The remaining 70% is driven by factors such as network speed, Wi-Fi reliability, and, most importantly, user training.
"Small amounts of training can make a big difference," Freed says. "Just one hour’s training a year on average can improve staff satisfaction by 17 points. Twenty hours or more makes some increased difference, but nowhere near as much as that first hour."
Implications: The Dangers of the "Kitchen Sink" Strategy
The prevailing belief that the NHS should "throw the kitchen sink" at every available digital solution is a recipe for failure. By attempting to deploy too many technologies simultaneously, organizations inevitably under-fund the implementation of each one.
This leads to a fragmented landscape where clinicians are expected to master dozens of disparate tools, none of which are fully optimized for their specific workflow.
The Data Quality Hurdle
Freed offers a stark warning regarding the current craze for Artificial Intelligence. AI, by definition, requires high-quality, structured data to provide meaningful insights. Without a foundational, well-implemented EPR system that captures accurate, clean data, any investment in AI is essentially a wasted effort.
"Before going anywhere near AI, I’d make sure the data quality was good," Freed asserts. "I would prioritize an EPR over anything on top of an EPR."
Professionalizing the Digital Workforce
A significant hurdle in the NHS’s digital journey is the lack of standardized language and roles within the digital, data, and technology (DDAT) workforce. With only about 3% of the total NHS workforce classified as digital professionals, these teams are managing approximately 100,000 products. That equates to roughly three products per digital professional—an unsustainable ratio.
To combat this, the NHS is moving toward professionalization. The recent mandate for DDAT staff to join professional bodies and register with the Federation for Informatics Professionals (FEDIP) is a critical step. By defining 14 distinct job families and 79 specific roles, the NHS is creating a framework that will allow for better recruitment, clearer career paths, and, ultimately, a more capable workforce.
Looking Ahead: The Summer Schools 2026 Agenda
As the industry prepares to gather at the Digital Health Summer Schools 2026 in Nottingham this July, the agenda will likely be dominated by discussions of AI and emerging tech. However, Freed hopes the conversation shifts back to the basics.
"They’ll be talking about AI—and I’d rather they talked about workforce," he says. "It is something that will make a huge amount of difference and it is within their gift. It doesn’t require hundreds of millions of pounds of investment. People can make a difference now within their existing resources."
A Call to Action for Leaders
The path forward for the NHS is not necessarily found in the next major procurement contract, but in the deliberate, incremental improvement of the working environment for the frontline clinician.
- Standardize Measurement: The NHS lacks a consistent way to measure the actual benefits brought about by digital tools. The industry must move away from the "if it worked there, it will work here" mentality and adopt standardized, rigorous impact assessments.
- Prioritize Fundamentals: If an organization’s Wi-Fi is slow, its devices are outdated, or its staff lacks basic digital literacy, the focus must remain there. These are the "force multipliers" of digital success.
- Invest in People: True digital transformation is a human endeavor. Professionalizing roles, providing consistent training, and fostering a culture that values digital competence are the most effective ways to ensure the longevity of the NHS.
As the health service looks toward an increasingly digitized future, the message from the NHS Digital Academy is clear: stop chasing the shiny objects. Build the foundation, invest in the people, and the benefits will follow.
James Freed will be a featured speaker at Digital Health Summer Schools 2026, held at the University of Nottingham, 16-17 July. For more information on the event and to register, visit the official Digital Health website.
