The report, based on a high-level roundtable with senior NHS, local government, academic and industry stakeholders, highlights the pressing need to move beyond traditional bed management strategies to operationalise whole-system flow through digital intelligence.

Dr Victoria Betton, director for data, digital and AI at Health Innovation Kent Surrey Sussex, said: ‘One of the most compelling sentiments shared by participants is that patient flow is fundamentally a governance challenge. Technology alone cannot solve systemic issues. It must be embedded within redesigned workflows and governance structures that clarify accountability and enable teams to apply actionable intelligence. Without this alignment, even the most advanced digital tools risk becoming underutilised or misapplied.'

The report recommends:

• NHS organisations should ensure that flexible governance structures empower local integrated neighbourhood teams with decision-making authority, clarifying accountability for cohorts at every step of their care journey
• commissioners and procurement teams must ensure tenders for any electronic patient record or other digital tool include explicit, testable interoperability use cases, aligned to national standards (eg UK Core FHIR), with pre-defined acceptance criteria, open APIs, and financial/contractual penalties for failure to deliver functional interoperability in real-world workflows
• ensure that NHS England funding earmarked for digital transformation in community settings is properly allocated to equip neighbourhoods with digital tools that support cohort segmentation, risk stratification and preventative management, enabling healthcare teams to anticipate demand and proactively advance population health improvements
• any NHS digital transformation project must be overseen by a multidisciplinary change management team. This team must ensure that tool implementation is driven by continuous engagement with clinicians, technical staff and patients to align digital solutions with real-world workflows, localised workforce strategies, and targeted training through a sustained user-feedback loop.