Digital transformation sits at the heart of the NHS Long Term Plan, promising a more connected, efficient, and patient-centred health service. Yet as the NHS accelerates towards this digital future, a critical question must be asked: how do we ensure no one is left behind?
For all its potential to streamline care, improve safety, and reduce costs, digital transformation risks widening inequalities if digital inclusion is not treated as a core priority. Ensuring equitable access to digital healthcare is not only a moral imperative — it is essential to the success of the NHS Long Term Plan itself.
The scale of the communication challenge
Every day, the NHS manages around 1.7 million patient interactions — over 600 million each year (The King’s Fund, 2024). At this scale, communication is more than an administrative task; it is a clinical function that directly impacts patient outcomes.
Poor communication remains a significant and costly challenge. Missed appointments, or DNAs, cost the NHS an estimated £1 billion in wasted resources over four years. Each missed outpatient appointment represents not only a financial loss but also a lost opportunity for care, potentially delaying diagnosis or treatment and worsening health outcomes.
Many of these missed appointments stem from avoidable communication barriers. Appointment reminders can be unclear, letters may lack essential details, or patients may struggle with literacy or language differences. For others, disability, sensory impairment, or lack of digital access creates further exclusion.
The promise and pitfalls of a digital-first NHS
The NHS Long Term Plan envisions a future where digital tools empower patients to take control of their care. From the NHS App providing access to prescriptions and test results, to electronic patient records ensuring information follows patients across services, the benefits are clear: greater efficiency, improved safety, and enhanced patient experience.
Digital systems also enable better data sharing and decision-making. Artificial intelligence and automation are already supporting clinicians in diagnosis and reducing administrative burden, freeing up time for direct patient care.
However, the transition to digital-first communication is not without its challenges. The Good Things Foundation (2024) reported that:
- 3.7 million families in the UK live below the minimum digital living standard.
- 1.6 million people have no access to a smartphone, tablet, or laptop.
- 7.9 million adults lack basic digital skills.
- 69% of those with no basic digital skills have a disability or impairment.
These figures make one thing clear: digital transformation cannot succeed if digital exclusion persists.
Understanding digital inclusion in the NHS context
Digital inclusion means ensuring everyone — regardless of age, ability, income, or background — can access and use digital healthcare services confidently. In healthcare, this extends beyond access to technology. It includes digital confidence, accessibility, affordability, and personal choice.
For patients who prefer digital channels, apps and portals offer convenience and control. But for those who rely on printed letters or alternative formats — such as Braille, large print, or easy read — the NHS must continue to provide inclusive communication pathways.
The Accessible Information Standard (AIS), introduced in 2016, plays a crucial role here. It requires NHS organisations to identify, record, and meet the information and communication needs of patients with disabilities, sensory loss, or other specific needs. Compliance with AIS is not simply a regulatory obligation — it is central to ensuring the NHS’s digital evolution remains equitable.
Interoperability: The missing link
Even with clear inclusion standards, another fundamental challenge persists — interoperability.
The Healthcare Information and Management Systems Society (HIMSS) defines interoperability as the ability of different information systems and applications to “access, exchange, integrate and cooperatively use data in a coordinated manner.” In simpler terms, it’s what allows NHS systems to talk to one another.
When systems are disconnected, the consequences are immediate and human. Consider a patient who is partially sighted and has requested all letters in large print on yellow paper. If one hospital department uses a compliant system but another does not, the patient receives inconsistent communications — one accessible, the other not. The result is confusion, frustration, and potentially missed appointments.
Achieving interoperability means ensuring that patient preferences, accessibility requirements, and clinical data follow the patient across every touchpoint. Yet NHS Trusts still face barriers:
- Legacy IT systems that cannot communicate effectively.
- Data incompatibility, where even minor variations (such as patient ID formats) disrupt integration.
- Financial constraints limiting system upgrades and staff training.
- Cultural resistance, where change is seen as disruptive to already pressured teams.
Building a digitally inclusive future
While these challenges are complex, they are not insurmountable. The NHS can take meaningful steps towards a more inclusive, interoperable digital ecosystem:
- Adopt open standards.
- Frameworks such as HL7 and FHIR enable systems to ‘speak the same language’, supporting smoother data exchange and interoperability across providers
- Invest in inclusive digital platforms.
- Platforms that support both physical and digital communications — and integrate patient preferences automatically — can ensure consistent, accessible interactions for all patients
- Capture communication preferences accurately.
- Patient communication preferences must be recorded centrally and updated dynamically to ensure they are applied consistently across all services
- Collaborate across the system.
- NHS organisations, suppliers, and technology partners must work together, prioritising shared benefit over commercial isolation. Partnerships built on interoperability and inclusion deliver better outcomes for everyone
- Support digital confidence.
- Beyond systems, digital inclusion depends on people. NHS staff need the confidence and skills to embed digital tools in daily practice, while patients need reassurance that digital does not mean impersonal
The role of technology partners
As digital transformation accelerates, trusted technology partners play an essential role in bridging gaps and simplifying complexity. At Synertec, our mission is to help healthcare organisations produce secure, accessible, and patient-centred communications in whatever format each patient requires.
Our Prism platform enables Trusts to standardise outputs from multiple systems, ensuring every communication whether printed, emailed, or uploaded to a portal — is accurate, compliant, and aligned with each patient’s recorded preferences. By capturing, transforming, and delivering communications securely and consistently, Prism helps the NHS progress its digital ambitions without compromising inclusion.
Inclusion as a measure of success
True digital transformation is not just about adopting new systems or achieving cost savings. It’s about building a health service that is more responsive, inclusive, and sustainable.
The NHS Long Term Plan envisions a future where technology enhances care, clinicians are empowered by data, and patients are active participants in their health journey. But that future will only be realised if digital inclusion remains a guiding principle at every stage.
A digitally mature NHS must also be a digitally fair NHS. One that recognises the diversity of its patients, adapts to their needs, and ensures that communication is always clear, accessible, and compassionate.
