The NHS generates vast quantities of data every day. Much of the debate around health data focuses on clinical information, but operational data covering workforce, finance and procurement already flows across the system at scale. This data can reveal where capacity will tighten long before waiting lists grow, where staff are at risk of leaving, and where inefficient spending hides in plain sight. Too often, these insights remain trapped in disconnected systems, where they can’t necessarily be used to best effect in decision-making.
The 10 Year Health Plan for England commits up to £600 million to a Health Data Research Service and promises to make the NHS “the most AI-enabled health system in the world.” But delivering on that ambition will require more than investment in technology. It will require a shift in how the health service thinks about operational data as national infrastructure rather than an administrative by-product.
This was the focus of the third event in our Futureproofing the NHS webinar series. The discussion brought together Cassie Smith of Health Data Research UK, Jake Arnold-Forster of Carradale Futures, Robert Walker from techUK and Raine Pell of NHS SBS (who chaired the panel). They explored what it would take for operational data to function as a dependable national infrastructure. Their perspectives converged on a shared view that the barriers to better data use are more about trust, consistency, and the courage to do things differently than about technology.
Theme one – trust through transparency, building public confidence in data use
At the heart of the discussion was a fundamental challenge that, without trust, even the most sophisticated data infrastructure will fail. The panel was clear that transparency alone is not enough. This is as true for operational data as it is for the clinical data that’s more frequently the focus. Information on the efficiencies and benefits delivered in workforce management, finance, and procurement can be strong indicators of overall performance. The NHS needs genuine dialogue with staff and patients so they can understand and engage with the Service’s development and improvement.
Cassie Smith set out the potential and the risk: “There is an enormous opportunity to harness the power of data to support delivery of the 10 Year Plan, to help streamline clinical workflows, reduce administrative burden, improve coordination, enhance decision making and also vital research to improve population health. But because there can be real mistrust around the use of data, the key challenge is really around trust. It’s really important to have transparency and openness about how data is being used”.
Cassie pointed to a cautionary tale. When concerns were raised around the GP Data for Planning and Research (GPDPR) programme, opt-out rates spiked sharply. “People will vote with their feet if there are things that are causing concern, and that has a huge detrimental impact on the use of data,” she said. “It’s easier to opt out of data sharing for research than it is from customer loyalty schemes”.
Rob Walker agreed, saying that data gets a bad name when applied to the healthcare sector. People are often willing to share their data with social media platforms and customer loyalty schemes, yet “healthcare data is perceived differently.” His conclusion was that trust must be built in from the start, with clarity about what data is being collected and why, and visible benefits for both patients and staff.
For Jake Arnold-Forster, the route to trust lies in publishing more, not less information: “Publish, publish, publish and keep publishing until you start moving people to deliver better outcomes.” He argued that operational data about NHS performance should be far more visible than it currently is: “A lot of the answers, or at least a lot of the questions that we need to ask, are hidden in data sets about operational performance which need to get out there.”
Cassie Smith offered a note of optimism, pointing to the pandemic as proof that public engagement with data is possible: “We did see during the pandemic that people will engage with data. People were engaging with data worldwide in a way that we’ve never seen before. Let’s think about how we can harness that for lots of other areas” [edited for clarity]. She argued that the pandemic offers a blueprint for data engagement, one that could be applied to improving pathways for cancer, cardiovascular disease and “the other great pandemics really affecting society at the moment.
Key takeaways
- Transparency is necessary but not enough on its own – the NHS needs genuine two-way dialogue with the public about the data infrastructure that affects them.
- Publish operational data – greater visibility of NHS performance data can drive improvement and build confidence, even when the picture is uncomfortable.
Theme two – people at the centre, patient and workforce control
A recurring theme was the question of who data is really for. “Of all the data that we have about ourselves, surely health data is your own,” said Jake Arnold-Forster, “At the moment, I don’t think there’s enough clarity about that in the 10 Year Plan or generally in the public debate” [edited for clarity]. He returned to this point several times, arguing that giving patients greater rights over their own information would not only build trust but improve the quality of care: “Give patients more rights to information and to be actively involved in their care….don’t protect people from knowledge of risk. That’s a risky thing to do”.
Jake also suggested there’s room for fresh thinking about the data that’s collected, where the focus can be on gathering information about inputs and outputs: “We often look at the output data and input data and try to draw conclusions from that. But the thing that is being missed is, what are the processes? How, what, when, who does the task? How long does it take them to do it? You really need to understand the processes that deliver the outcomes”.
Rob Walker called for digital upskilling: “The majority of health and social care workers simply don’t have the capacity, training or indeed protected time to really deeply engage with those digital tools”.
Rob went on to argue for digital champions at board level in each organisation’s leadership group. At the same time, Jake diagnosed the underlying challenge as cultural: “The issue is the inability to sort tasks into three boxes – what do we have to do, what should we do, and what are the things that someone told us at some point to do that we shouldn’t do at all?”. He added that “it requires courage by providers to say ‘no, we’re not going to do that…and we’re going to automate that because we can, and pay attention to the things that matter and correlate them to the outcomes that matter to patients’”.
Key takeaways
- Health data belongs to patients – the NHS should give individuals greater agency over their own information.
- Equip the workforce – staff need time, training and support to make good use of digital tools and data infrastructure.
Theme three – modernising purchasing, unifying services
Some on the panel agreed that, if data is to serve as national infrastructure, the way the NHS procures technology and services will need to evolve.
As an outsider looking in, Rob Walker (representing techUK, the country’s leading technology trade association) had a particular view of current systems: “The current procurement models incentivise the lowest cost and not the long-term value. It comes down to price rather than whether it delivers what I want, and whether the long-term outcomes are beneficial to staff and patients. That fundamental question gets lost within the current procurement model”.
Rob argued that “the way that we procure technology projects is based on outdated procurement models. Has the actual procurement model changed throughout the history of the NHS? I would argue it hasn’t.” He called for flexible, modular contracts that allow for innovation over the lifetime of a framework.
Rob also pointed to a skills gap in some places where there can be “a limited commercial and digital skill set within procurement teams. Whilst our frontline or clinical team may say ‘we need this tool to solve a problem’, the actual procurement team doesn’t quite understand the tool that their colleagues need to implement and buy”.
Jake Arnold-Forster suggested that modernising purchasing also means diversifying the commercial ecosystem around the NHS. Rather than relying solely on large contracted suppliers, the health service should release non-identifiable operational data to a wider range of organisations (SMEs, civil society and researchers), he said, who can analyse it and use it to drive improvement. “Get individuals and companies to get hold of all of the data that is not in any way patient identifiable, to make use of that, to understand it, to publish it, to create tools with it” [edited for clarity]. His point was that outsiders often see patterns that insiders miss: “The information is actually in better hands with those people who want to create insights to drive change than it is within the service”.
Key takeaways
- Procure for value, not price – contracts should focus on long-term outcomes and allow for flexibility and innovation.
- Diversify the ecosystem – releasing non-identifiable operational data allows a wider range of organisations to build tools and drive improvement.
Theme four – supportive solutions, doing corporate services properly
While much of the debate around NHS data focuses on clinical information, the panel emphasised that corporate and operational data (covering workforce, finance and procurement) is just as vital. The group agreed that getting the infrastructure right for these functions could unlock significant improvements across the system, but also that it would require a shift from short-term firefighting to long-term strategic thinking.
Rob Walker was clear about the challenge: “The NHS as a system is often still operating in crisis mode, really focusing on the immediate pressures – waiting lists, workforce shortages – rather than that long-term strategic direction of digital transformation”. He argued that the focus on the here and now crowds out the deeper work needed to embed digital tools properly.
For Rob, the answer lies in treating change management as seriously as the technology itself: “Any digital project is only as successful as its change management project and programme. Don’t just procure the tool, procure the fundamental training and skills to upskill your staff. Make sure that the digital tools you are buying are not just being bought for the sake of buying, and that they are being optimised and utilised in the best way and most effective way possible”.
He summed up the broader point: “Solving this issue isn’t just about deploying new tech. It’s about rethinking how we build, fund and really embed digital software and tools at the very heart of the NHS.”
Panel chair Raine Pell reinforced the importance of change management and suggested that a better user experience could make the process easier: “I would very much like to see an alignment of the user experience that you get outside, with your bank or your insurance company or your flights, echoed across the health service. When we’re working in the public sector and the health service, time is a valuable commodity. If we can really start to see some of that UX brought in, that whole change management might look a little easier for people”.
Raine also shared an example of what becomes possible when operational data is used well. She described NHS SBS consultancy work with one organisation that used workforce data to predict (with 95% accuracy) the staff who were at risk of leaving: “The organisation was able to put preventative steps in to ensure they were supporting their workforce. That data was used really as an early warning system, to help with the retention issue before it started to impact clinic and wait times, which was really powerful”.
Cassie Smith suggested that the NHS should apply the same urgency to operational challenges as it did to the pandemic: “We saw during COVID how quickly we were able to deliver real insights from data when all our resources and efforts were focused on it – not quite in real time, but near real time. There is an opportunity to replicate some of that urgency for equally urgent challenges around critical hospital wait times, around the burden on NHS staff. We can learn a lot from that approach”.
However, replicating that success depends on having the right people with the right focus. Cassie made a strong case for treating data governance as a profession in its own right: “We need career paths for information governance professionals that equip them to make risk-balanced judgments about data. It’s not a pure administrative function. If you have the right people with the right skills and the right training, and you’re really treating and valuing that as its own skill set, it really helps”.
She argued that when data governance is undervalued, the result is risk aversion and delay: “Sometimes you can have a default to risk aversion and caution and worrying about data protection laws, which are hugely important to comply with. But sometimes the perception of what those laws require you to do and the actual reality – there can be a mismatch”.
The scale of fragmentation in governance is striking. Cassie cited research showing that accessing linked health data for research can require completing 600 pages of paperwork across multiple organisations: “Every custodian or controller of data is setting up that process from scratch. If you want to link together different data sets, you’re replicating that process five, ten times”. She noted that there are now over 200 secure research environments for health and administrative data. “Do we need more, or should we really be consolidating?” she said.
Her message was that the building blocks of good data governance are well understood. What’s missing is consistency. “We know what good governance is. But we need to do it once.”
Jake Arnold-Forster reinforced the point, arguing that standardisation is the precondition for improvement: “If you want to transform things, you first have to make them consistent, because if you make things consistent and transparent, then you can improve them. I think it is the biggest single failing of the NHS not to exploit its unique ability to standardise governance. Unwarranted variation is the biggest cause of avoidable harm and waste in healthcare, by far”.
Key takeaways
- Change management matters as much as technology – training and skills should be procured alongside tools, and user experience should match what staff expect from their digital lives outside work.
- Use operational data as an early warning system – workforce, finance and procurement data can predict pressures before they affect patients.
- Professionalise data governance – treat it as a skilled specialism with career paths, not as an administrative add-on.
- Standardise governance – the NHS’s unique position as a single national system should be an advantage, not a source of fragmentation.
Conclusion
Overall, the discussion revealed both the scale of the opportunity and the depth of the challenge. Operational data could help the NHS anticipate pressures, improve efficiency and build a more responsive service, but realising that possibility will require more than technology investment.. It will mean forging a new relationship with the public, built on transparency and genuine dialogue. It will mean giving patients and staff real agency over the data that concerns them. It will require procurement reform that values outcomes over sticker price, alongside a willingness to diversify the ecosystem around the NHS and let others help turn data into insight. And it will involve treating change management, training, and user experience as seriously as the technology itself, while professionalising and standardising data governance so that linking datasets does not mean navigating hundreds of separate processes.
If the health service can rise to that challenge – treating data as the infrastructure it truly is – then the 10 Year Plan’s ambitions could well come to fruition.
