Building a better NHS through system change

The NHS is in serious trouble. Those are the words of Lord Darzi, whose independent report into the state of the health service in England made for troubling reading.

This won't be overly surprising for many of us who either work in or have used services recently. The report has highlighted a range of problems the NHS faces and the prime minister has promised to act on the findings, calling for major reform of the health service to address these challenges. 

But what should this reform look like and what can be done now to start making the changes needed? We can’t afford to get this wrong, so making an accurate and immediate impact is vital if we’re going to get the NHS back on track.  

Whole-system change, not piecemeal reform

A key takeaway from the Darzi report—and from years of attempted reform—is that piecemeal changes won’t work. The NHS needs a whole-system transformation. This means moving beyond changes to individual organisations or services and looking at how the entire healthcare system can function better as a network.

There are already examples of this happening. We’ve been working with an Integrated Care System (ICS) to create a healthcare hub dashboard that connects different healthcare providers, including general practitioners, pharmacies, and community organisations. This allows them to track patient journeys more effectively and prevent unnecessary hospital admissions, as well as giving patients a full view of their care records. By centralising information and coordinating care across different services, the hub ensures that patients receive the right care at the right time, reducing strain on urgent and emergency care.

The NHS needs to embrace more of this kind of thinking, interlinking reporting and utilising people and services across the sector to clearly understand how they can better connect. It must look at healthcare not just as a series of isolated units but as an interconnected system where collaboration can yield better results.

Focussed digital transformation

One of the most pressing needs is digital transformation. Over the past 15 years, many sectors of the economy have been radically reshaped by new technologies, but the NHS is in the foothills. As the report points out, it’s barely scratching the surface of what digital solutions can do to improve healthcare delivery.

To get this right the question can’t just be around how to implement technology, but how to do it effectively. The government, Trusts and services know digital solutions alone won't fix everything. They need to build a shared understanding of where the challenges lie and what types of digital solutions can have the biggest impact.

Should the focus be on automation, artificial intelligence, or more personalised, data-driven care? These are some of the questions the NHS needs to find answers to if they want technology to improve outcomes. If those in charge need support, they should look to work with digital partners who can help them understand what the challenges are and use their expertise to advise on what actions and solutions could help address them.

Building user centred services

'Patients’ voices are not loud enough' was another criticism levelled by the report. The NHS needs to be listening to people, particularly service users. If their voices go unheard, it just leads to the creation of systems that have no buy-in or that users don’t know how to operate, leading to confusion, backlogs and wasted investment. 

The NHS, particularly at a service level, has to engage with people through discoveries, interviews, community meet-ups etc. to understand their needs, test systems and address concerns. Through this, platforms and services can be tailored to meet the requirements of patient groups and communities because their needs are being taken on board and addressed. This will ensure that patients are being listened to and we are building systems that will work better for everyone.

Bringing systems together

Lord Darzi also highlights how too much money is spent in hospitals, not communities. This is correct, but it’s also true that we’re not making the most of the services already available.

The third sector plays a critical role in providing care to those in our communities, particularly the most marginalised and vulnerable. The support charities give, including peer to peer support, health information and specialist nurses, are all vital to helping people stay well, self manage conditions and access help when they need it. They are key if we want to move to a more preventative model of care while reducing pressure on services and health inequalities.

The NHS needs to work with these organisations to create a system where patients can seamlessly move from services to support in their communities. By providing information and bringing in charities and volunteer groups at the earliest point, patients can gain fast and easy access to local care, reducing the risk of them falling ill or returning to the health service for support. 

We’ve been working with leaders from charities and the NHS to bridge this divide. We hope that through these efforts we can create a more efficient system which produces positive health outcomes.

The Darzi report paints a stark picture, but also provides a clear direction: the NHS needs bold, immediate, and system-wide reform. We can't afford to waste time with half-hearted measures or isolated changes. To rebuild trust, improve patient outcomes, and future-proof the health service, we must focus on the bigger picture—connecting systems, embracing digital transformation, and centring our approach on patients and communities. Through this, we can create a transformed NHS that’s fit for the future.