The NHS modernisation agenda is moving the health and care system towards more connected, preventative and neighbourhood-based models of care. By giving patients greater choice and control, improving access to information and bringing care closer to communities, it has the potential to make a real difference to how people access and experience care.
But for the next phase of reform to be truly successful and make a tangible difference, It has to be designed around the real lives of patients and carers, and the clinical and operational realities faced by frontline staff.
Digital healthcare is becoming part of everyday care
Taking a step back, it's clear the challenge is no longer whether digital tools have a role in healthcare, because a quick assessment of the industry shows they already do. In fact, the NHS App activity demonstrates how rapidly digital interactions with the NHS are growing. In April 2026, there were 74.8m logins, compared with 51.2m in April 2025. Repeat prescription orders through the app also increased over the same period, rising from 5.5m to 7.0m.
The question is no longer whether digital tools have a role in healthcare. They are already embedded in how many patients access services and manage aspects of their care.
Designed well and integrated into existing workflows, digital services can reduce avoidable administrative demand, release staff time and give patients greater control, but it also brings about new risks. As more services become digital by default, poor connectivity, limited access to devices or low digital confidence can become practical barriers to care.
This is particularly important for people who may already experience inequalities in accessing care, including those with long-term conditions or disabilities, people facing language or literacy barriers, carers managing care on someone else's behalf, and households without reliable connectivity, suitable devices or affordable data. A system that feels simple to one patient can feel inaccessible to another.
Designed for real-world conditions, built for resilience
For digital reform to succeed, services must work in the real conditions in which patients and staff use them, not only under ideal circumstances. That means designing around how people actually access care, whether checking results at home, updating information between appointments or when seeking support, and recognising that many people still lack confidence using digital services.
For health and care leaders, connectivity and digital inclusion are not secondary considerations; they are fundamental to whether a service works. Neighbourhood health, remote monitoring, shared records and care closer to home all depend on secure, reliable access to information at the point of need. When access is slow, unreliable or difficult to use, staff lose time and patients lose confidence.
Digital services must be secure and resilient, remaining accessible when systems are under pressure. Health data is highly sensitive and public confidence depends on patients knowing that their information is protected and that the services they rely on will be available when needed.
That means designing digital routes with assisted access, clear support and alternative options for people who cannot use online services easily. It also means testing services in the environments where they will actually be used, rather than assuming every patient or clinician is operating in perfect conditions.
A practical test for digital reform
The next stage of NHS digital reform will require more than new platforms. It will require co-ordinated delivery across policy, operations, technology and infrastructure.
For healthcare leaders, that means asking practical questions early. Can patients complete a task without needing to switch to another channel? Can staff update or retrieve information while working away from a fixed site? What happens if a service is slow, unavailable or difficult to use? What support exists for patients who need help with digital access? How does the service continue during disruption?
These questions should sit alongside the usual measures of functionality, cost and efficiency. A digital service should not be judged only by whether it exists or how many people use it, but by whether it improves access, reduces unnecessary friction and works effectively for both patients and frontline staff. It should be judged by whether it improves access in practice; removing unnecessary friction, earning the trust of employees that are tasked with using it, and allowing those with limited connectivity to access the care and support they need.
If digital reform reflects how people actually access care, it can make the system easier to use and relieve pressure on frontline teams. If it assumes every patient has the same connectivity, confidence and support, it risks creating new barriers and widening existing inequalities.
