The UK Government has made its ambition clear: digital and AI will play a central role in the future of public services, with healthcare at the forefront. For the NHS, this presents a pivotal opportunity to transform patient care, improve efficiency and alleviate pressure on frontline services.
Yet our new research suggests that, while progress is being made, confidence in that digital future is beginning to falter, both inside the system and among the citizens it serves.
A system improving today, but uncertain about tomorrow
Across the public sector, satisfaction with digital services is actually rising. More than half of public sector workers (56%) now say they are happy with current digital provision, reflecting years of investment and incremental progress.
However, this progress is not translating into confidence about what comes next. Fewer than half of workers (47%) believe their organisation is prepared to meet the digital demands of the future, with confidence declining significantly compared to the previous year (61%). This trend is particularly acute within the NHS, where the complexity of frontline delivery, legacy systems and workforce pressures combine to create a more challenging environment for transformation. The result is a growing gap between what has been achieved and what is believed to be possible.
From a citizen perspective, a similar pattern is emerging. While many report positive experiences with digital services today, 42% are not confident that public services will meet their expectations over the next two to three years. In healthcare, that lack of confidence matters more. It is the public service citizens most want to see improved, with around one in three (32%) identifying it as the top priority for better digital delivery. The NHS is therefore under a unique form of pressure: expectations are highest, but confidence in future delivery is fragile.
The AI paradox: progress without trust
Much of the Government's digital strategy hinges on AI and data-driven innovation. Within public sector organisations, including the NHS, AI is already becoming embedded, with the majority of workers (57%) reporting some level of adoption. But this progress is largely invisible to the public. Over two-thirds (69%) of citizens say they are unaware of any public services using AI and almost half (49%) do not trust or feel comfortable with its use.
This disconnect represents a significant risk. While AI has the potential to enhance diagnostics, streamline processes and personalise care, it could just as easily become a flashpoint for concern if introduced without transparency or clear communication.
Citizens are also sending a clear signal about priorities. Only 17% believe AI itself should be a focus for improving services, with greater emphasis placed on customer experience, staff training and accessibility. For the NHS, this highlights a critical misalignment. While policymakers and system leaders look to AI as a catalyst, patients are focused on outcomes. From how easy services are to use, how accessible they feel, to how well they meet real needs. Without bridging that gap, technological progress risks outpacing public confidence.
Accessibility and inclusion: the persistent gap
Accessibility remains one of the most pressing and under-addressed challenges in healthcare digital transformation. While the majority of public sector workers believe their services are accessible (58%), confidence is notably lower within the NHS, where fewer than half (46%) feel digital services fully meet accessibility needs.
Citizens' experiences reinforce this concern. Nearly a third (29%) report difficulty accessing digital public services in the past year, pointing to a clear separation between internal perception and reality on the ground. In healthcare, where services must cater to diverse populations, including older adults and those with complex needs, this gap carries significant implications. Digital exclusion is not just an inconvenience; it risks exacerbating health inequalities and limiting access to care.
Closing this divide requires more than technical fixes. It demands a sustained focus on user-centred design, inclusive services and ongoing engagement with patients to ensure digital solutions reflect how people actually access healthcare.
The human factor: leadership, skills and delivery
If technology is not the primary barrier, what is? Our research points consistently to people and organisational factors. Skills gaps, particularly around AI literacy and insufficient training are cited as the biggest constraints on progress.
At the same time, challenges in leadership alignment and communication continue to hinder transformation efforts. Significant proportions of workers point to a lack of clear vision and poor collaboration across teams as barriers to delivering digital change effectively.
In the NHS, where services span multiple organisations and disciplines, these issues are amplified. Delivering meaningful transformation requires not only a clear strategy but the ability to translate that strategy into coordinated, frontline action. Ultimately, the challenge is not whether the NHS adopts new technologies, but whether it can operationalise them in a way that is coherent, scalable and trusted.
Rebuilding confidence: a patient-centred path forward
The findings point to a clear conclusion: the next phase of NHS digital transformation will be defined less by technology and more by trust. The NHS stands at a crossroads. The foundations for digital transformation are in place and the potential benefits of AI and data-driven services are significant.
But without a parallel effort to build understanding, improve accessibility and align with citizen priorities, that transformation risks losing the confidence of the very people it is designed to serve. In healthcare, more than any other sector, trust is everything. The success of the NHS's digital future will depend not just on what it delivers, but on whether patients believe in it.
