Navigating the Future of NHS Technology: A View from gravity9

As the NHS undergoes significant structural reform, what does this mean for the future of healthcare technology?

At gravity9, we’ve spent years working alongside NHS teams to modernise legacy platforms, improve service delivery, and build resilient digital foundations. As the latest reforms begin to take shape—most notably the shift in power from Integrated Care Boards (ICBs) to localised neighbourhood teams—we’re reflecting on the implications for those of us designing and delivering technology within the healthcare system.

From Regional Oversight to Local Leadership

One of the most striking changes is the decentralisation of operational leadership. ICBs are being scaled back, with some expecting up to a 50% reduction in size. While they will retain their commissioning responsibilities, much of the decision-making is being handed over to place-based teams, modelled on UK-style Accountable Care Organisations (ACOs).

This marks a significant departure from previous efforts to consolidate decision-making at the regional level—a strategy often aimed at addressing the NHS’s historically fragmented structure. The move raises valid questions: How do we maintain coherence across such a distributed system? And how can local flexibility be preserved without sacrificing national consistency?

Data as the Common Thread

For decentralisation to succeed, data must act as the connective tissue. Local innovation is most effective when insights can scale, and strategic decisions are most impactful when grounded in on-the-ground realities. That requires infrastructure capable of collecting, sharing, and interpreting data across organisational boundaries.

Without this, decentralisation risks deepening existing silos. The opportunity lies in creating a feedback loop between frontline innovation and central policy—supported by unified, interoperable digital systems.

A New Procurement Dynamic

This local shift could also transform procurement. Suppliers have long found NHS procurement processes difficult to navigate, often hampered by complexity and a lack of transparency. The emergence of new, more locally embedded buying organisations could open new pathways for engagement.

That said, decentralisation may not inherently simplify the landscape—it may just change the terrain. Suppliers, especially those used to working through central frameworks, may need to rethink how they approach the NHS, adapt their engagement strategies, and invest in understanding new procurement structures.

AI Adoption: Managing Hype and Hesitation

The government’s ambition to increase AI adoption in the NHS presents both promise and challenge. While use cases—from diagnostic support to workforce planning—are compelling, there remains hesitation at the point of care. The gap between AI’s technical capability and real-world adoption is often driven by uncertainty, lack of understanding, or inconsistent implementation.

What’s needed is a measured, practical approach that builds confidence while delivering value. This includes developing strong business cases, clear accountability, and supporting clinical teams through change—not just introducing new tools but embedding new ways of working.

Financing Fit for the Future

Perhaps the most systemic challenge is financing. The NHS is often expected to implement 21st-century digital solutions within a 20th-century funding model. Short-term budget cycles make long-term planning difficult and often discourage investments in interoperability or transformation.

There’s growing awareness that this needs to change. A financing and procurement model that prioritises strategic value, flexibility, and system-wide outcomes could unlock the full potential of emerging technologies—especially as the needs of local systems continue to evolve.

Looking Ahead

These changes mark a major inflection point for the NHS—and for those working to support its digital future. As we await the full release of the NHS Long Term Plan, the path forward will hopefully become clearer. What’s already evident is that the relationship between national strategy and local innovation is central to what comes next.

At gravity9, we’ll continue to support our partners across the NHS as they navigate this transition—bringing technical expertise grounded in practical experience and a clear-eyed view of what meaningful, sustainable transformation requires.