For years, the promise of digital transformation in healthcare has been a constant refrain. The vision is clear: a connected, data-driven system that empowers clinicians, improves patient outcomes, and makes services more sustainable. Yet new data shows that, despite this ambition – and widespread recognition at the policy level, including through the government’s 10 Year Health Plan for England – progress on the ground has been uneven. Many organisations remain stuck in ‘automation purgatory’, where innovation outpaces integration and promising pilot projects fail to scale.
OneAdvanced’s 10th Annual Trends Report, informed by the experiences of 4,500 leaders across multiple sectors, shows that this gap between ambition and execution is not unique to healthcare. However, the data also suggests it is particularly acute in the health sector. While investment in technology, particularly AI, is now front and centre, significant hurdles remain. These challenges are not unique to one organisation or region but reflect the entire sector’s journey – one shaped by both the incremental steps described in the 10 Year Health Plan and the acute pressures facing frontline teams. Understanding where things are stalling, and why, is the first step towards realising digital transformation’s full value.
Integration remains the biggest barrier to scale
Integration emerges as the single biggest barrier in OneAdvanced’s Annual Trends Report, with 66% of healthcare organisations reporting a platform integration crisis. Decades of underinvestment have created a landscape of disjointed, legacy systems that do not communicate effectively. As a result, data remains fragmented, blocking the seamless data flow that clinicians and patients expect and pushing the vision of a single patient record further into the future.
The government’s 10 Year Health Plan sets out a clear ambition to shift the NHS from analogue to digital through the implementation of a single patient record, accessible across all care settings. OneAdvanced’s data suggests this ambition is well understood, but the practical challenges of delivery are already evident. Establishing the necessary infrastructure will take time, requiring sustained investment, alignment between clinical and digital stakeholders, and careful management of risks such as data governance and vendor lock-in.
In practice, a patient’s journey – from GP surgery to hospital or community care – still often involves systems that don’t share information, forcing clinicians to navigate manual, fragmented processes. Even as efforts continue to modernise and prioritise digital upgrades, the data shows that information siloes remain a daily reality for healthcare teams.
The urgency is clear. AI and wider digital tools can only succeed if they draw upon accurate, up-to-date, and accessible data. Integration, therefore, is not just about modernising for the sake of technology, but about providing the reliable foundations needed to transform clinical pathways and improve patient outcomes.
Ambition is not yet translating into widespread use
OneAdvanced’s data shows a clear gap between ambition and everyday use of digital tools in healthcare. While digital transformation and AI rank as top priorities for healthcare leaders, this ambition is not yet translating into routine practice. While more than half of healthcare leaders list AI as their key investment area, the same proportion say that AI is embedded in less than a quarter of their day-to-day operations.
A similar gap emerges in the government’s planning. While the single patient record is acknowledged as a game changer for joined-up care, the government’s own impact assessment is candid that establishing such infrastructure will take several years. Challenges remain around interlinking legacy IT, aligning clinical workflows with digital requirements, and building confidence among patients and professionals in new systems.
The result is a repeating pattern: pilot projects and digital tools that never break out of isolated use. The underlying challenge is both technical and operational. Technologies need to integrate with day-to-day workflows and support – not disrupt – how already stretched teams deliver care. National initiatives may set direction, but progress depends on how effectively they translate into operational reality. This means prioritising solutions that can be embedded into day-to-day clinical workflows and operate across the fragmented landscape, connecting primary and secondary care, community and hospital services. For clinicians and patients to experience tangible benefits, digital initiatives must be designed to function across organisational boundaries rather than as isolated systems.
Workforce readiness is lagging behind technology adoption
The findings of the Trends Report also point to a growing digital skills divide; a challenge echoed in the 10 Year Health Plan. There is investment in AI and new systems, yet less than 11% of healthcare transformation budgets is going towards workforce development. This is a fundamental issue: no amount of digital investment can deliver value if people do not feel confident and equipped to use these tools.
The report underlines that digital transformation will require not just technology upgrades: it needs substantial investment in people as well. It highlights that frontline teams – especially GPs, nurses and community staff – need training, clear guidance, and protected time to adapt to new systems, and warns of the risk of digital exclusion, for staff who may not have high confidence in technology or who are already under pressure.
Technology partners therefore carry a responsibility: making products intuitive, clinically relevant, and co-designed with the people who use them. But broader system investment is vital too. Prioritising practical training, creating champions in multidisciplinary teams, and supporting staff through the transition are all recurring themes. As the 10 Year Health Plan notes, staff buy-in and digital literacy do not come automatically. They must be built, supported and valued.
Closing the perception gap to unlock value
Another crucial challenge, echoed in both the national plans and the OneAdvanced research, is the perception gap between the C-suite and frontline managers about the benefits and ease of technology adoption. Senior executives may see the strategic rationale for digital investment, but it is the clinical and operational staff who are more likely to experience friction – from multiple logins to workarounds and digital tools that don’t reflect the realities of delivering care.
The 10 Year Health Plan responds by calling for extensive co-design, local flexibility, and clear expectations around patient and staff engagement in transformation. The research findings reinforce that consistent adoption is far more likely when digital change reflects real operational needs and builds trust among those expected to use new systems.
The research shows that collaboration is critical. Co-creating AI-powered triage tools with GPs, for example, has enabled more effective management of appointments and urgent cases, precisely because the solutions were defined by those who use them daily. For example, another report published by OneAdvanced showed that adoption of AI tools in GP workflow could unlock 150,000 appointments per week.
From pilots to progress: a practical path forward
Altogether, the findings point to a clear set of priorities for healthcare organisations seeking to move from pilots to consistent use. Progress is less about accelerating innovation and more about strengthening the foundations that allow digital tools to deliver value at scale.
Prioritise genuine integration. Invest in shared infrastructure and interoperability, recognising that the journey towards a single patient record and joined-up data will be incremental. Progress requires partners who understand existing complexity and can navigate gradual migration from legacy to modern systems.
Embed technology in clinical practice. Move beyond isolated pilots by choosing AI and digital tools that are woven into real workflows. This demands technology partners who listen and adapt to clinical feedback, ensuring that tools support staff and reduce – not add to – workload. Doing so can reduce GP workload by 43%, as shown in this report by OneAdvanced and Patchs.
Invest in people and culture as much as systems. Provide the practical training, headspace, and incentives that enable everyone to participate in change. Adoption depends as much on confidence and engagement as on the technology itself.
Embrace a ‘test and learn’ approach. Transformation should be iterative, with pilots being evaluated, refined and scaled based on robust feedback – not just top-down expectation.
Put user experience and transparency at the heart of digital change. Transparency, engagement, and the empowerment of both patients and clinicians should guide every digital project, from data governance to app development.
Digital transformation in healthcare is at an inflection point. The policies exist, the investment has been committed, and the technology is advancing rapidly, but progress will depend on the ability to overcome entrenched integration barriers, support people, and deliver the trusted, joined-up system envisioned for the NHS. But the tools are here to help close the gap – moving digital potential into routine practice and, most importantly, improving the experience and outcomes for everyone who depends on our health system.
Ric Thompson
Ric Thompson is SVP for Health at OneAdvanced, where he drives strategy, product innovation, and growth across one of the UK’s largest health technology organisations. With over 25 years’ experience in healthcare and technology, Ric has been a key leader in NHS digital transformation, from pioneering clinical document management solutions with Docman to developing integrated care platforms and AI-driven innovations aligned with the NHS 10-year plan.
