With the NHS pursuing an AI-driven future, the challenge is no longer imagining what’s possible but delivering what’s needed today. This article outlines how Trusts can make meaningful progress now through focused, scalable AI adoption
The challenge
NHS England operates on an unimaginable scale that defies one-size- fits-all solutions with a £192 billion annual budget, circa 1.5 million staff. With The King’s Fund reporting approximately 600 million patient contacts annually across GP, community, hospital, NHS 111 and ambulance services, productivity remains stubbornly below pre- pandemic levels despite an 18% workforce increase. The numbers tell a stark story: in October 2025, 54,300 patients waited over 12 hours for emergency admission.
Sir Jim Mackey’s appointment as transition chief executive in April 2025, with a mandate to “radically reshape” NHS England, underscores the urgency. The government has set demanding targets: 2% annual productivity growth — equivalent to £17 billion in savings over 3 years — The Spending Review 2025 (June 2025) commits £10 billion for NHS technology and digital transformation by 2028-29. This isn’t just an operational challenge, this is a transformation of unprecedented scale, and the stakes could not be higher.
NHS commitment to reform
The 10 Year Health Plan articulates an ambitious vision of fully AI-enabled hospitals within the decade, the NHS App as the full front door to the entire NHS, and unified Single Patient Records by 2028. However, these are decade-long aspirations when the NHS needs relief now. The plan’s implementation chapter is yet to be published, requiring clarification on precisely how and when the NHS will achieve these worthy objectives and has already met with some resistance from clinicians.
AI solutions are not magic bullets, and like any technology implementation, can only drive change if they are properly implemented and adopted by clinicians and Trust Managers. However, the plan offers little on practical steps to advance towards these intended AI-enabled outcomes.
More practically, this vision-first approach leaves untouched the complex technical integration challenges posed by historical applications and technologies, compounded by local variation between and, in many cases, within NHS Trusts. Individual Trusts have spent years navigating procurement, governance, and integration challenges independently.
How do you eat the AI Transformation Elephant – Think Big, Start Small, Scale Fast
The 10 Year Plan has a very long roadmap before it reaches its target state. But NHS Trusts need immediate reform to maintain patient care standards and reduce operational burdens. So where do you start? Aivantor advocates a Think Big, Start Small, Scale Fast approach.
Think Big means identifying fundamental constraints to patient care, then aligning AI adoption to remove them.
What’s actually blocking better patient outcomes? Constraints typically fall into clear categories: access (patients can’t get appointments when needed), capacity (critical resources operate below their potential), coordination (staff time is consumed managing complexity), and workforce (burnout and resource gaps reduce clinical capacity).
Start Small means overcoming change inertia by avoiding the urge to solve all problems at once; instead, focus on identifying one or two high-impact operational challenges directly causing your priority constraint.
Once you’ve identified the dominant challenge, align a targeted AI-enabled intervention directly to removing it. Enquiry management, which consumes hours of time for patient care, becomes a target for intelligent communication automation. Theatre scheduling and utilisation improvements become the target for resource coordination.
Learn by doing and prove how a targeted AI deployment removes that constraint in your operational reality. Then use these proof points to build the business case for scaling.
Innovation Pathway – People Services HR AI Assistant
Aivantor and their strategic partner Applaud HR successfully completed a pilot of a People Services HR AI Assistant deployed simultaneously across 10 NHS Trusts. The solution addresses a common challenge across healthcare organisations: routine staff enquiries about policies, procedures, and employment information consume 30-40% of HR advisors’ time that could otherwise be directed toward complex casework requiring professional judgment.
The pilot demonstrated how AI innovation may be deployed securely and at scale to deliver tangible value. Natural language AI assistants provide immediate self-service access to HR policy information, targeting 60-70% enquiry deflection whilst dramatically improving employee experience. Staff gain instant answers when they need support, 24/7, in any language they choose – all within a framework designed to meet NHS data protection and security requirements. The option to refer to a HR specialist is embedded within the support model.
We are now in mature dialogue to agree an adoption roadmap that will be accessible NHS-wide. This pathway offers a proven model for scaling AI capabilities across complex, federated organisations whilst maintaining rigorous governance and local autonomy. Future phases will integrate common services such as booking annual leave through multilingual AI assistants, empowering HR teams to recover capacity and target policy priority areas including staff wellbeing and retention. Our approach supports Trusts to deploy flexibly at a pace that recognises their operational readiness and AI maturity.
Scale Fast means deploying AI capabilities that demonstrate measurable constraint reduction within weeks, not months. Aivantor deploys pre-configured AI capabilities designed for healthcare operational coordination: intelligent communications management, staff scheduling optimisation, resource coordination and long-running process orchestration.
Communications management deploys in two weeks, processes real enquiries under supervision, and demonstrates measurable constraint reduction within four weeks. Scheduling optimisation deploys in three weeks, demonstrating improved capacity within six. Resource coordination deploys in four weeks, demonstrating measurable utilisation improvement within eight.
Your Trust is under immense pressure to deliver 2% productivity growth whilst waiting lists, emergency admission delays, and workforce burnout worsen. The 10 Year Health Plan offers vision. The £10 billion investment provides the budget. But neither tells you what to do on Monday morning.
We’re offering a limited number of half-day AI readiness assessments for Trust leadership teams in 2026. These sessions identify your dominant operational constraint, map it to deployable AI capability, and produce a 12-week delivery roadmap. Contact David Cameron directly to secure your assessment slot before capacity fills.
This work is licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International.
