HTN was joined by a panel of digital leaders to discuss the NHS 10 Year Health Plan, looking at building the right digital foundations to deliver on ambitions, local approaches to national objectives, system transformation, challenges, progress and the road ahead.
Our panel included Ravinder Kaur Sahota, group CIO at The Dudley Group and Sandwell and West Birmingham; Kelvyn Hipperson, executive CIO, Cornwall and Isles of Scilly ICB, Royal Cornwall Hospitals, and Cornwall Partnership; and Graham Brown, Marketing Director at Redcentric.
Sharing their role and organisation in turn, our panellists started out with introductions, with Ravi outlining her remit across digital, data, technology, and digital transformation at the Dudley and Sandwell and West Birmingham group. “We have six main hospital sites and a variety of community sites, and we also have a GP footprint,” she noted.
Graham talked about having been involved in the health tech space for around twelve years, focusing on tech-enabled care, and moving to Redcentric around 18 months ago. “Redcentric is a managed service provider that’s spent almost 30 years supporting the public sector and particularly health and care,” he said. “We’re probably best known for our work on the HSCN Network, but we offer a broad suite of managed service capabilities across infrastructure, cloud, communications, and security.”
“My remit is delivering technology services across the whole healthcare system in Cornwall, which is a really fun part of the job,” Kelvyn shared. “Cornwall is often described as a simple system because we’ve just got one acute and one community mental health provider, but if that’s simple, I’d hate to think what complicated is! I’ve worked in wider government and I can assure you this is just as complicated as anything I’ve ever done.”
Opening thoughts on the 10 Year Health Plan
Sharing her thoughts on the 10 Year Health Plan, Ravi said: “I don’t think it’s a plan. For me, a plan describes how you’re going to get from A to B, and it doesn’t do that. It does set out some ambitions, but it’s more like a framework, and it lends itself to a lot of variation.” Whilst it does recognise that there is a need for a huge structural shift in the way NHS organisations work, there is “very little national standardisation”, she continued, “and I feel like ultimately we’re just going to compound the variation that already exists across the system based on how digitally mature organisations are”.
“I agree with the fact it’s not a plan, but as a set of ambitions it’s something I feel very supportive of,” Kelvyn nodded. “You can’t argue with the desire to put patients in control of the services they use, and I find it a very useful framework.” Aligning local work with national ambitions can work “really well” in securing buy-in at a local level for things you’re doing to try and meet local needs, he said, and then building cases for the important aspect of getting national support. “Probably the one element I think is missing is I don’t think it says enough about the business of doing IT alongside the whole transformation agenda and meeting the needs of patients – we need to look at what our fundamental network infrastructure is going to need to look like, how we can continue to develop our whole service management infrastructure to support services effectively – that’s as important as all the ambitions in the plan.”
Graham reiterated Ravi and Kelvyn’s point about there being ambition, but not enough clear structure about what has to be in place to allow change to happen. “I think a lot of that from a digital perspective comes back to baseline infrastructure and capabilities – we’re at risk of chasing the shiny new innovations and forgetting to pay attention to those fundamentals,” he commented. “The challenge and the opportunity haven’t changed, but it’s demand versus capacity. The tech landscape and the goalposts for what good looks like are changing rapidly, but we’re not keeping pace with that transformation within the NHS.”
After taking the decision to form a group in April 2025, the focus has been on understanding what the impact of the 10 Year Health Plan is in terms of maturity as a digital organisation, Ravi shared. That includes the “less sexy” work of optimising digital, EPR, and improving data. “Once we’ve got the enabling infrastructure in place to support that, we can scale it up to support future ambitions,” she said. “Then we have been looking at what we can actually deliver in 12 months, 24 months, and so on, so we’re not setting ourselves up to fail. We’ve also been looking to close our skills gaps, at prioritisation of investments, and that planning has really helped us, so we’re not reliant on the national team; we have a plan and we know it aligns with our ambitions and what we’ve been asked to do nationally.”
Alignment of digital strategy with the broader organisation strategy is key, Kelvyn considered. “We’ve got an EPR deployment happening, and that doesn’t exist in isolation; all of those things are interrelated. We’ve also got a cyber security operations centre, which runs 24/7, and I’m pleased that seems to have landed with colleagues now – they get why we need that sort of thing.” Whilst some things can be a challenge when it comes to engagement, there is excitement around tech such as ambient voice technology, he noted. “I could roll that out everywhere tomorrow, because I’ve never known anything like it in terms of clinical engagement.”
It’s important to start to look at infrastructure as something more than just a utility, Graham told us, as it’s central to enabling innovation and being able to roll new things out, as well as keeping on top of things like security posture. “We can’t have a digital conversation without talking about AI,” he said. “Redcentric isn’t an AI house, but what we do want to do is make sure you have the confidence to put in these tools that will have access to your data and so on. I think the role of infrastructure and platforms has shifted over the last five years – it used to be you’d make an investment decision around infrastructure and look at it again in ten years, but now it’s more embedded in transformation.”
One area in which the 10 Year Health Plan has been successful has been in galvanising wider organisation enablement and cross-functional working, according to Graham. “If you want to succeed with that shift out into community, everybody has to be working from the same baseline and standard operational capabilities, and we’re seeing a lot more conversations with local authorities about the digital aspects of the plan.”
Progress to date
Thinking about progress to date, Ravi elaborated on some of the planning work undertaken across her group, including the community and GP footprint. “We’ve gone out to all of our services and been very clear about the elements we can do and when,” she said. “Then it’s looking at the why, and how you tell that story across your organisation to get them on board. There’s also the need to clarify what are absolute ‘must-do’ items and where there can be more flexibility.” The group started looking at AI in 2024, and then AVT, she went on, running a procurement for the technology on behalf of the Midlands region which has now enabled 1,149 organisations to benefit. “That has avoided a lot of duplication, and we’ve shared everything we’ve been doing, including DPIAs, specifications, DTAC assurance, clinical safety, and so on.”
“We’ve been on a slightly different journey with AI, which started back in the world of diagnostic imaging, which was a proving ground in terms of safety cases, IG documentation, etcetera.” Kelvyn highlighted. “Although we’ve not run a single procurement, we’ve got trials running across the system, and GPs have been the cheerleaders – they have been using the free-to-use versions, and that inspired us to say we need to support.” Interestingly, feedback from teams has been that the tech is evolving so fast that it’s worth revisiting a product trialled six months ago to look at added functionality, he said, “so we’re trying to build the flexibility to allow ourselves not to be tied in to something for an extended period until it stabilises”.
Neighbourhood care is a “really big thing” in Cornwall, Kelvyn noted. “We’ve committed to it, and we’re working with a range of partners to look at how we reimagine the way we share information across the system. We’re now doing a piece of work looking at system architecture from neighbourhoods outwards, considering what neighbourhood teams need.”
It’s about getting everyone on the same platform, across not only care settings, but also local authority settings, Graham told us. “The basic sharing of information becomes so much simpler when they’re operating off the same platform or if network capabilities are aligned. It’s also the bit around multidisciplinary working, so different teams with distinctly different needs and requirements, who are able to get online on all the right systems, access all the right capabilities.”
Ravi reflected on progress around neighbourhood health to date, and some of the infrastructure considerations involved. “I don’t think we’re convinced that convergence is the way to go – lots of organisations have decided that’s what they’re going to do, but we think it would take too long and there’s no appetite for that,” she said. “We’re looking at how we enforce common data standards and how we flow data through, and interoperability, etcetera. An example of that is that we don’t have a community EPR, so we built our own, which is a web-based portal that is device agnostic, and we brokered agreements with primary care EHR providers to pull data from EMIS into the community portal. We have the ability to pull data from our secondary care system into this portal, and when our community teams are entering data, we can push that back into those EPRs.”
In making progress, it’s important to also ensure staff digital literacy and confidence to allow them to get the best out of the digital tools and systems they’re using, Ravi continued. “We’ve also had conversations with our third party suppliers to let them know it’s not acceptable to not be able to flow data across systems, and we’re actively working with them to be able to do that.” With the wealth of information that is now available, conversations are starting to happen about the potential to use AI to summarise patient history, she noted, “but we definitely shouldn’t be siloing it out, and often when suppliers are bringing products to the market they’re not thinking about working at scale across the system”.
“This conversation highlights the range of timeframes these things operate over, because in Cornwall our shared service has been around for 25 years,” Kelvyn observed. “We’ve been systematically working our way through, and moved from three primary care systems to two, and in community mental health we did have multiple instances of EPR serving different parts of community but they’ve been consolidated into one.” The focus now is on acute EPR rollout, he mentioned, “but now the whole world is being turned upside down effectively in the sense of neighbourhood care, because the community mental health trust right in the centre of this is now simultaneously looking into primary care, and also the acute embedded settings across the border into our partner mental health trust”.
There are some big strategic decisions that will need to be made over the coming years, and the Shared Care Record is a central part of that, Kelvyn went on. “We developed it as a common solution across Cornwall and Devon, and the opportunity for that to join up both systems and everything else from a neighbourhood perspective is a really interesting prize, particularly when you think of the ambitions for the Single Patient Record.” The challenge moving forward will be getting those things done quickly enough, he considered.
“There isn’t going to be a single blueprint that works everywhere, because systems distinctly look different,” Graham shared. “But the big thing is taking into account the full set of partners, including community pharmacy and out to third sector organisations shifting things out to the community. There’s a huge barrier to overcome to get a single blueprint that works across all of those, particularly with disparities in funding models, and so on.” Decisions will need to be made at ICB level to distribute funding to the right places, he noted, “and we know from working with third sector organisations that they’re having to play catch-up on a lot of this, as they might not have the same funding or digital leadership, and it’s how we get a better economy of wealth and scale across the full system”.
Digital leadership
Considering how the role of a digital leader might change to reflect the needs and ambitions set out in the 10 Year Health Plan, Kelvyn told us that fundamentally, many parts of the role are likely to stay the same. “The thing I do think is changing, which I welcome, is that due to the system-wide focus on neighbourhood, for the first time there are opportunities for clinical and operational leaders to genuinely think about the whole system.” Part of that is having greater confidence that the solutions being provided meet the overall need, he said, “and a whole system that wants to drive neighbourhood care is an opportunity that’s too good to miss”.
Ravi observed that a lot of organisations still have a separate digital strategy, rather than an organisational strategy with a digital plan outlining how to get there. The focus tends to be too heavily on the technology, rather than understanding the outcomes, she shared. “It’s interesting in the NHS, because the benchmark for ‘good’ seems to be that nothing bad goes wrong, and that’s disheartening, because in any other sector it would be looking at what you’re transforming, what you’re changing; I don’t think we have enough of that happening, but we are starting to have those conversations.” When you don’t consider holistically what you are doing for your system and patients at scale, the people who suffer are patients, she explained, “and that’s not acceptable as a leader – we need to think about how we support everybody’s journey, how we support everyone on our patch to get to that level”.
Graham agreed that a focus on outcomes is “absolutely vital”, and provides the best opportunities to add value for organisations like Redcentric. “We’re really having conversations about outcomes and working back from there, rather than getting a shopping list of requirements,” he told us, “which is good, because otherwise you’re not getting the best out of those partners and the expertise across all the layers that they have to offer. Having that clarity there, not just in your own organisations, but all those that are supporting you, can be pivotal in driving some of that change through.”
For Kelvyn, an important part of the 10 Year Health Plan is the need to find a way to reach patients with services and have ways to support them as end users of tech that is introduced. “Increasingly, we need to provide for digital exclusion,” he said, “and we need to think about that as much as we do pure digital, so we can be that inclusion vehicle for people who can’t necessarily interact directly with digital.” For most people using health services, the amount of time actually spent with a clinician represents a “tiny fraction” of their experience, he went on.
“I call it the citizen lens,” Graham noted, “and it’s all those public services touchpoints across an entire geography that are going to feed into the ultimate outcomes of the 10 Year Health Plan – the real value is in people never actually going into the NHS.” There is a lot of potential to “make the easy things easier”, he suggested, by automating where it is safe to, and to do some of the fundamental things that will free-up capacity and promote the right interactions between citizens and clinical staff when needed. “For me, it’s all about access and breaking down siloes across the entire care continuum, that’s the real game changing shift.”
AI has the potential to turn the whole service model on its head, according to Kelvyn, with one of the major parts to change being the waiting and seeing various people until you get in front of the right one. “The whole way we deliver services and the whole workforce model is going to have to react to that, so we’re giving people the best of what they need, wherever they need it in their healthcare journey.”
Ravi spoke about a shift happening in terms of patients turning up to appointments having done their own research using ChatGPT, or coming in with health data from wearables. “It’s happening in front of our eyes, and if we’re not keeping up with it ourselves, it will be difficult to continue to educate patients – we have to share with them about bias and what to expect from those kinds of things.”
Looking ahead
To conclude the session, each of our panellists detailed what they were most excited about for the next ten years, with Kelvyn talking about the promise of AI to support care delivery that is “actually in the hands of the people who need it”. He added: “As I said, we’re in the middle of a big EPR delivery, but in future I wouldn’t be surprised if we no longer need EPRs as having that capability will bring together all the information people need to both support themselves and work in a true partnership with the clinicians. Clinicians will absolutely continue to be vital to healthcare delivery and working with patients, but all of this is the only way the NHS is sustainable in the longer term.”
For Ravi, the opportunities for at-scale working are most exciting, she offered. “The work that’s happening now has paved the way, and it feels like things we have been talking about for years are actually being heard now, like making things seamless and getting access out to patients, moving into that prevention agenda. What I’m really excited about is the ability to be able to utilise everything we have in order to drive down health inequalities and personalise care, as it feels like we have the power to do that now.”
“From a Redcentric perspective, listening to Ravi and Kelvyn today and their real focus on the fundamentals and infrastructure of platforms, is massively reassuring,” Graham reflected. “That’s exciting for what Redcentric can offer and how we can support in that. The technology shift is happening at such a rapid pace, and we’re at a real turning point there, but we’ve got fantastic people working to make sure it’s done in the right way, that doesn’t detract from clinical interaction, but lets us meet demand that is going to continually increase.”
We’d like to thank our panel for taking the time to share these insights with us.
