The Future of Patient Portals as 'Engines and Infrastructure supporting the NHS App'

Nelson Advisors
4 hours ago
18 min read

Strategic Context: The Death of the Destination Portal

The digital architecture of the United Kingdom's National Health Service (NHS) is currently executing a fundamental pivot, a transformation that marks the end of the "destination portal" era and the rise of the "aggregation engine."

For the past decade, the prevailing model for digital patient engagement was characterised by fragmentation and sovereign operational silos. Individual NHS Trusts, operating as semi-autonomous fiefdoms, procured standalone Patient Engagement Platforms (PEPs), proprietary "front doors" that required patients to register, retain credentials and navigate distinct user interfaces for every provider they encountered.

A patient with complex needs might manage a login for myhospital.com for their oncology care, a separate account for their General Practitioner (GP) and yet another for mental health services. This fragmented landscape, while functionally operative, created profound friction, limiting adoption and stifling the potential for a unified longitudinal health record.

The current strategic trajectory, crystallised by the NHS England "Wayfinder" program and the statutory weight of the Data Saves Lives strategy, mandates a reversal of this fragmentation.

The NHS App is no longer merely a utility for ordering repeat prescriptions or displaying COVID-19 vaccination status; it has been designated as the "single front door" for the health service.

This designation is not simply a branding exercise but a rigid architectural mandate that redefines the commercial and technical reality for third-party suppliers.

In this new ecosystem, patient portals are ceasing to be standalone destinations. Instead, they are evolving into "engines", sophisticated backend infrastructure layers that handle complex business logic (scheduling, triage, clinical correspondence, rule-based routing) but surface their functionality through the national infrastructure of the NHS App.

The Policy Imperative and the "Wayfinder" Mandate

The catalyst for this shift lies in the aggressive policy frameworks established post-pandemic. The unprecedented adoption of the NHS App, driven by the necessity of the NHS COVID Pass, saw registered users swell to over 28 Million by July 2022, representing approximately 63% of the adult population in England. By late 2024, this figure had surpassed 32 Million users. This critical mass fundamentally altered the strategic calculus for NHS England. The cost of customer acquisition for a standalone hospital app marketing to patients, guiding them through registration, verifying identity, became unjustifiable when compared to the existing, verified user base of the NHS App.

Consequently, the "Wayfinder" program (technically the Secondary Care Integration Programme) was launched with a clear objective: to integrate secondary care appointment data directly into the NHS App.

The mandate, reinforced by the Wayfinder Services Directions 2023, compelled acute trusts to expose their appointment data to the national aggregator. The directive was unambiguous: by March 2024, all non-specialist acute trusts were required to be integrated. This effectively closed the market for standalone portals that could not, or would not, integrate. The value proposition for Trusts shifted overnight. Procurement decisions were no longer based solely on the quality of a vendor's user interface, but on their ability to act as a compliant "engine" that could feed the national "front door".

This policy is rooted in three strategic pillars:

Friction Reduction: Eliminating the cognitive load on patients who previously had to navigate multiple digital identities. The "single sign-on" (SSO) capability via NHS Login is the cornerstone of this friction reduction, allowing seamless passage from the national app to the provider's specific domain.
Standardisation of Experience: Ensuring that a referral letter looks and behaves consistently whether it originates from a Cerner Millennium system in London or a System C instance in Manchester. The "Wayfinder" architecture imposes a baseline of standardized metadata on these interactions.
Market Shaping: By controlling the primary access point, NHS England forces interoperability on a supplier market that has historically profited from vendor lock-in. To participate in the national app ecosystem, vendors must adopt open standards (FHIR), breaking the "walled garden" business models of legacy EPR providers.

The "Engine" Defined: From SaaS to BaaS

In this emerging paradigm, successful digital health vendors are transitioning from providing Software-as-a-Service (SaaS) destination sites to providing Backend-as-a-Service (BaaS) or "headless" engines. An "engine" in this context is a specialised software platform that manages the complexity of healthcare workflows, writing back to the Patient Administration System (PAS), managing clinical safety rules for appointment cancellation, generating accessible letter formats, without necessarily owning the primary pixel-level interaction with the patient.

This mirrors the broader trend in enterprise technology toward "headless" Content Management Systems (CMS), where the repository of content is decoupled from its presentation. In healthcare, the "content" is the patient's care pathway.

Vendors like DrDoctor, Patients Know Best (PKB), and Induction Zesty are positioning themselves as these invisible engines. Their value is no longer judged by the beauty of their proprietary app icon on a patient's home screen, but by the reliability of their API endpoints and their ability to handle high-volume transactions through the NHS App "shell".

The Strategic Shift – Destination Portal vs. Aggregation Engine

Operational Dimension	The Legacy Model (Standalone Portal)	The Future Model (NHS App Engine)
Primary Access Point	Proprietary URL (e.g., mytrust.nhs.uk) or Vendor App	NHS App (National Infrastructure)
Identity & Auth	Local credentials or Vendor-specific account	NHS Login (National Biometric SSO)
User Acquisition	Trust-led marketing (Posters, leaflets)	Organic (32M+ pre-verified users)
Notification Channel	SMS / Letter (High operational cost)	App Push Notifications (Near-zero cost)
Data Architecture	Siloed Data Lake per Trust	Federated Aggregation via FHIR APIs
Vendor Value Prop	"We own the patient relationship."	"We power the national infrastructure."
Clinical Governance	Local Trust Governance	Distributed Chain of Custody (DCB0129)

The operational and commercial implications of this shift are profound. For vendors, the "engine" model offers immediate scale but threatens commoditisation. If the user experience is standardised by the NHS App, vendors must compete on backend performance, integration depth, and ancillary features (like AI triage) rather than UI design.

For the NHS, the model promises a unified patient experience but introduces significant systemic risks regarding single points of failure and data governance, which will be explored in depth in subsequent sections.

2. Technical Architecture: The Mechanism of Aggregation

The realisation of the "single front door" vision relies on a complex technical architecture known as the Patient Care Aggregator (PCA). Understanding the mechanics of the PCA is essential to grasping how "engines" interact with the national infrastructure and where the limitations of this model lie.

The Patient Care Aggregator (PCA) and Wayfinder

The PCA acts as a national routing layer, a federated broker that sits between the NHS App (the front end) and the myriad local systems (the back ends). Crucially, the PCA is designed to be stateless regarding clinical data; it does not create a massive central database of all patient appointments. Instead, it operates on a query-response model.

When a patient opens the "Appointments" tab in the NHS App, the following sequence occurs:

Identity Assertion: The user is authenticated via NHS Login, leveraging OpenID Connect (OIDC) standards to assert identity (LOA P2 - high level of assurance).
Endpoint Resolution: The PCA queries a central registry to identify which Trusts or PEPs hold a relationship with the patient's NHS Number.
Broadcasting: The PCA broadcasts a request to the registered "engines" (e.g., DrDoctor, Zesty, Netcall). The request effectively asks: "Do you have any active bookings for NHS Number X?"
Aggregation: The engines query their local databases (or the Trust's PAS) and return a standardised JSON bundle containing metadata: Appointment Date, Time, Specialty, Location, and Status.
Rendering: The NHS App aggregates these responses and renders a unified list. To the patient, appointments from three different hospitals appear in a single, consistent view.

Deep Linking vs. Native Experience

A critical architectural distinction exists between native rendering and deep linking, which defines the user experience and the technical burden on the engine.

Native Experience (Read-Only): The listing of appointments is "native." The NHS App reads the standardized data returned by the engine and displays it using its own UI components. This ensures accessibility compliance and visual consistency. The patient stays strictly within the NHS App environment.

Deep Linking (Transactional Handoff): When a patient wishes to act on an appointment, for example, to cancel, reschedule, or complete a pre-operative questionnaire, the PCA cannot handle the complex business logic required. (e.g., "This appointment cannot be cancelled within 24 hours," or "This MRI requires a safety checklist first"). Instead, the PCA generates a Deep Link.

The user clicks "Manage Appointment."
The NHS App uses a secure token handoff (OAuth 2.0) to seamlessly log the user into the PEP's specific web portal.
A "WebView" (an in-app browser window) opens, loading the vendor's interface (e.g., DrDoctor or PKB) inside the NHS App frame.
The user performs the action on the vendor's infrastructure.
Upon completion, the user is returned to the native app view.

Critique of the Deep Linking Model:

While theoretically seamless, research indicates significant friction in this handoff. Users report disorientation when the design language shifts from the NHS standard to a third-party interface.

Furthermore, technical failures in the token exchange can lead to "login loops," where a patient is asked to re-enter credentials for a system they do not recognise, undermining the "single sign-on" promise. The reliance on Deep Linking means the "engine" must still maintain a robust, user-facing web front end; it cannot be purely an API service. The engine must effectively run a high-performance web app that can load instantly within the constraints of a mobile WebView.

The "Headless" Healthcare CMS

The move to an engine model aligns with the broader "Headless" trend in software architecture. Just as a Headless CMS decouples content from display, a Headless PEP decouples the clinical pathway from the patient interface.

Research suggests that forward-thinking vendors are re-architecting their platforms to treat the NHS App as just one of many "heads." A single appointment slot in the database might be surfaced via:

The NHS App (via PCA API).
A bedside tablet in the hospital (via a local web app).
A kiosk in the waiting room.
A text message chatbot.

This "Omnichannel" capability is the defining characteristic of the next generation of patient portals. It allows data consistency across all touchpoints. If a patient updates their demographics in the NHS App, the Headless architecture ensures this change propagates instantly to the kiosk and the PAS, without manual reconciliation. Vendors adopting this architecture (e.g., using technologies like GraphQL or rigorous RESTful APIs) gain a significant competitive advantage over legacy monolithic portals that are difficult to integrate.

Integration Standards: FHIR and BaRS

The lingua franca of this ecosystem is FHIR (Fast Healthcare Interoperability Resources). To function as an engine, a vendor must expose APIs that strictly conform to NHS England’s FHIR profiles.The Booking and Referral Standard (BaRS) is the specific implementation guide that dictates how booking data must be structured.

This standardisation drives commoditisation. In a world where every vendor must output the exact same FHIR resource for an "Appointment," proprietary data structures lose their value. The value shifts to the reliability of the integration. Vendors are now competing on their ability to handle the "messy" reality of legacy hospital systems (HL7 v2 messages, CSV files, on-premise servers) and translate them into pristine FHIR resources for the PCA. The "engine" is effectively a translation layer that sanitises the chaotic data of the NHS back-office for consumption by the modern NHS App front end.

Commercial Landscape: The Battle of the Engines

The transition to the engine model has triggered a restructuring of the UK digital health market. The need for scale, compliance, and deep integration capabilities is driving consolidation, separating the market into "Infrastructure Titans" and "Niche Innovators."

DrDoctor: The Transactional Engine

DrDoctor has emerged as the premier "transactional engine" for secondary care. Their strategy is explicitly aligned with the "Wayfinder" vision, positioning their platform, HybridOS, as the operating system for the hybrid NHS.

Integration Agnosticism: DrDoctor’s core value proposition is its ability to connect with over 20 different PAS/EPR systems, including major players like Oracle Cerner, Epic, System C, and Lorenzo.They market themselves to Trusts as the "universal adaptor" that bridges the gap between legacy on-premise infrastructure and the cloud-native NHS App.
Strategic Milestone: DrDoctor facilitated the first-ever integration of an Epic EPR Trust (Birmingham Women's and Children's) into the NHS App. Epic’s native "MyChart" portal is notoriously self-contained, often functioning as a walled garden. DrDoctor’s ability to extract data from Epic and feed the PCA proved that the engine model can permeate even the most closed ecosystems. This success cemented DrDoctor’s status as a critical infrastructure partner rather than just an app developer.
Operational Focus: Their "engine" focuses on high-volume, high-value transactions: appointment rescheduling, digital letters, and DNA reduction. By embedding these flows into the NHS App, they deliver the efficiency savings (paperless switching) that Trusts require to meet their "Greener NHS" targets.

Patients Know Best (PKB): The Longitudinal Data Engine

While DrDoctor focuses on the transaction (the appointment), Patients Know Best (PKB) focuses on the record (the data). PKB claims the title of the "first PHR to integrate with the NHS App" and positions itself as a "storage engine" for the patient's lifelong health data.

The "Unparalleled" Integration: PKB’s integration goes deeper than the PCA’s transient appointment view. It leverages the NHS App’s SSO to provide persistent access to test results, care plans, and discharge summaries. PKB acts as the "long-term memory" of the NHS App ecosystem, holding data that persists across different care settings (GP, Hospital, Mental Health).
Strategic Partnerships: Recognising the distinct requirements of "booking" vs. "records," PKB has entered into strategic partnerships with DrDoctor and Induction Zesty. This is a crucial market evolution: PKB provides the record engine (test results), while DrDoctor provides the booking engine. These partnerships allow Trusts to deploy a "best-of-breed" stack where two different engines power different tabs of the NHS App, invisible to the user. This interoperability between competitors is a direct result of the "engine" architectural model.
Regional Scale: PKB’s commercial model often targets entire Integrated Care Systems (ICSs) rather than individual hospitals. In Nottingham and Nottinghamshire ICS, PKB serves as the underlying data layer for millions of citizens, surfacing data through the NHS App "front door".

Induction Zesty: The Integrated Write-Back Engine

Induction Healthcare (via its acquisition of Zesty) represents the consolidation trend. Their "Health Stream" engine is designed to manage the complex rules of writing data back into hospital systems.

Write-Back Capability: A key differentiator for an engine is not just reading data (showing an appointment) but writing data (booking a slot). Zesty emphasises its ability to write directly into the PAS/EPR, automating the administrative workflow.
Oracle Health Partnership: Induction Zesty has secured a strategic position as a preferred partner for Oracle Health (Cerner) Millennium sites. This creates a defensive moat, as integrating with Cerner’s complex scheduling modules is technically demanding. By validating their "engine" with the primary EPR vendor, Zesty ensures longevity in the market.

Emerging Entrants and Market Consolidation

The rigorous requirements for becoming a "Wayfinder" engine, including DCB0129 clinical safety standards, Data Security and Protection Toolkit (DSPT) compliance, and FHIR conformance, create high barriers to entry.This is driving market consolidation.

M&A Activity: Larger players are acquiring niche functionality to expand their engine's capabilities. Induction’s acquisition of Zesty is a prime example.
New Entrants (Primary Care Triage): A new class of engines is emerging in primary care. Vendors like Anima Health, Hero Health, and Klinik are integrating "medical query" and "admin query" workflows into the NHS App. These engines use AI to triage patient symptoms entered via the app and route them to the appropriate GP pathway. They represent the expansion of the engine model from secondary care appointments to primary care clinical triage.

Comparative Analysis of Major "Engines"

Vendor	Primary Focus	Key "Engine" Capability	Strategic Integration
DrDoctor	Transactional (Booking)	HybridOS: Universal connectivity to 20+ PAS/EPRs.	Epic (First UK integration).
Patients Know Best (PKB)	Longitudinal (Records)	Data Aggregation: Persistent storage of test results & care plans.	Nottingham ICS(Regional scale).
Induction Zesty	Scheduling (Write-back)	Health Stream: Deep two-way integration with EPRs.	Oracle Health (Cerner partnership).
Anima / Klinik	Triage (Primary Care)	AI Logic: Automated symptom analysis and routing.	GP Systems(EMIS/SystmOne).

Operational Impact and Clinical Workflows

The transition to the engine model is not purely technical; it delivers tangible operational benefits that align with the NHS's productivity and sustainability goals.

The "Greener NHS" and Sustainability

The "engine" model is a critical enabler of the NHS's Net Zero ambitions. The digitisation of appointment letters and correspondence via the PCA has yielded measurable environmental dividends.

Carbon Reduction: By defaulting to digital letters surfaced in the NHS App (powered by engines like Servita or DrDoctor), the NHS avoids the production and transport of millions of physical letters. Servita’s implementation alone is credited with avoiding 8.5kt CO2e emissions annually and saving 30 million sheets of paper.
Mechanism: The "engine" checks the patient's preference in the NHS App. If "Paperless" is selected, the engine suppresses the print file at the hospital mailing house and instead pushes a notification to the app. This logic is handled entirely by the backend, requiring no manual intervention by hospital staff.

DNA Reduction and Efficiency

The "Did Not Attend" (DNA) rate is a multi-billion pound drain on NHS resources. Standalone portals struggled to impact this because patients often deleted the apps or ignored email reminders. The NHS App, residing on the devices of 32 Million users, changes this dynamic.

Push Notifications: Engines can trigger native push notifications on the user's device. These are more visible than emails and cheaper than SMS.
Actionability: The ability to cancel or reschedule an appointment with two taps in the app (via the deep link) lowers the friction for patients to free up slots they cannot use. DrDoctor reports that their integration helps reduce DNAs by up to 30%, directly returning capacity to the system.
Waitlist Validation: Engines are also used for "Waitlist Validation" questionnaires. A Trust can send a bulk message via the engine to thousands of patients on a waiting list, asking via the NHS App: "Do you still need this appointment?" Early pilots have removed thousands of unnecessary appointments, cleaning the backlog.

Primary Care Triage and Automation

The integration of primary care engines (Anima, Klinik) introduces AI-driven automation into the workflow.

Scenario: A patient logs into the NHS App and selects "Ask my GP for medical advice."
Engine Action: The Anima engine presents a dynamic, AI-driven questionnaire to gather clinical history. It processes this data, assigns a urgency score, and pushes the structured request directly into the GP's workflow (EMIS/SystmOne).
Impact: This bypasses the "8am telephone rush," smoothing demand and ensuring that clinicians receive high-quality, structured data rather than vague free-text notes.

The Patient Experience: The "Super App" Vision vs. Reality

The ultimate ambition for the NHS App is to function as a "Super App", a concept borrowed from Asian markets (eg. WeChat) where a single application hosts an ecosystem of "mini-programs" covering all aspects of daily life.

The Super App Trajectory

Financial analysts and government advisors have explicitly drawn parallels between the NHS App and the Super App model. The app's evolution from a simple symptom checker to a platform for identity (NHS Login), prescriptions, appointments and now "life admin" (managing dependents, organ donation) mirrors the trajectory of financial super apps.

Ecosystem of Services: By aggregating distinct services, secondary care booking (DrDoctor), records (PKB), repeat prescriptions (NHS Digital), and vaccinations (NIMS), the app is becoming the operating system for the citizen's health.
Mini-Programs: The "deep linked" PEPs function analogously to WeChat "mini-programs." They are lightweight, specific applications that run within the container of the host super app. This model allows the NHS App to offer infinite functionality without bloating its core codebase.

User Experience Fragmentation

Despite the "single front door" branding, the user experience remains fragmented and inconsistent, a phenomenon research describes as a "postcode lottery" of digital access.

Inconsistency: Because the app relies on the underlying engines, the user experience is defined by local procurement decisions. A patient might see full read/write functionality for their cardiology appointment (because that Trust procured Zesty) but have zero visibility of their dermatology appointment (because that Trust uses a legacy system not connected to Wayfinder).
The "Black Box" Effect: Patients do not understand the federated architecture. When an appointment is missing or a button doesn't work, they blame the NHS App, not the local Trust or the third-party engine. This disconnect creates trust issues. Research highlights that while the app is valued, significant frustration exists regarding the "variability" of information.
Deep Link Friction: The transition from the native app to the web-based engine is often jarring. Users report confusion when the UI changes, and "login loops" (where sessions time out) are a persistent technical grievance.

Digital Exclusion and the Inverse Care Law

A critical critique of the engine model is its potential to exacerbate health inequalities. The "Digital First" strategy optimises the system for the "digitally able", those with modern smartphones, data plans, and high digital literacy.

The Inverse Care Law: Research suggests that digital adoption is often lowest among the demographics with the highest health needs (the elderly, those with multiple comorbidities, and those in deprived areas).
Two-Tier System: There is a risk of creating a two-tier health system. "Engine-enabled" patients can snap up cancelled slots instantly via app notifications, while digitally excluded patients remain stuck in telephone queues. While the 10 Year Health Plan emphasises maintaining non-digital channels, the system's design clearly privileges the digital path.
Accessibility: While the NHS App itself is rigorously tested for accessibility (WCAG 2.1 AA), the third-party engines it links to may vary in quality. A deep-linked portal that is not optimized for screen readers creates a barrier that the "front door" cannot fix.

Systemic Risks: Governance, Security and Safety

The centralisation of access through the NHS App "hub" creates systemic risks that are fundamentally different from the distributed risks of the standalone era.

The "Single Point of Failure" (SPOF)

The NHS App ecosystem operates on a "hub and spoke" model.

Hub Fragility: If the NHS Login authentication service experiences an outage, all connected services become inaccessible simultaneously. Unlike the standalone era, where a failure at one hospital affected only local patients, a failure of the national aggregator can blind millions of patients to their appointments and records nationwide. The resilience of the entire national patient engagement layer depends on this single digital key.
Cascading Failure: The Change Healthcare cyberattack in the US demonstrated how a compromise in a widely used clearinghouse (an engine) can paralyse the entire sector. If a major engine like DrDoctor or PKB were compromised, the "blast radius" would extend to every Trust connected to them. Attackers could theoretically use the trusted channel of the NHS App to push malicious notifications or phishing links to millions of users.

Data Privacy and the "Fourth Party"

The integration of third-party commercial engines raises complex data privacy questions.

Data Controllership: The chain of custody for patient data becomes opaque. The Trust is the Data Controller, but the Engine (DrDoctor/PKB) is the Data Processor. However, these engines often use sub-processors (cloud hosting, SMS gateways), the "fourth parties." Research indicates that healthcare organisations often lack visibility into these downstream risks.
Commercial Use: There is lingering public anxiety regarding the use of health data by commercial entities. While engines assert that data is used solely for care delivery, the potential for "anonymised" data to be used for model training or secondary commercialisation remains a sensitive topic. The complex terms of service in a federated ecosystem make informed consent difficult for the average user to navigate.

Clinical Safety Governance (DCB0129/0160)

The NHS imposes rigorous clinical safety standards: DCB0129 (for the manufacturer) and DCB0160 (for the deploying organization). The engine model complicates this governance.

Accountability Gap: If a patient misses a critical cancer referral because the PCA failed to relay a notification from the Zesty engine to the NHS App, where does the liability lie? The Trust? The Engine Vendor? NHS England? The "chain of custody" for clinical alerts is fragmented across multiple technical boundaries.
Quality Assurance: MPs have raised concerns about the lack of systematic quality assessment for third-party apps integrating into the ecosystem. Unlike medicines, which undergo rigorous centralised testing, digital engines are often assured via self-declaration and local procurement, leading to variability in clinical safety.

Future Horizons: The Roadmap to 2030

The trajectory for the next five years points toward the total dominance of the engine model and the expansion of the NHS App into a proactive health partner.

Beyond Appointments: Personalised Prevention

The 10 Year Health Plan signals a "shift from sickness to prevention." The NHS App engines will evolve from administrative tools to clinical monitoring platforms.

Wearable Integration: We anticipate the rise of "Wellness Engines" that ingest data from consumer wearables (Apple Watch, Fitbit) and surface validated insights in the NHS App.
Proactive Nudges: Instead of waiting for a patient to book, AI-driven engines will analyse the longitudinal record (held by engines like PKB) to trigger proactive interventions. e.g., "Your prescription history suggests you are due for a blood pressure check." This shifts the app from a reactive utility to a proactive health coach.

The Extinction of the Standalone Portal

The market dynamics suggest that the standalone patient portal will become commercially extinct by 2030.

Procurement Pressure: Trusts will increasingly mandate "Wayfinder compliance" in all tenders. Vendors who cannot offer a headless, integrated engine will be locked out of the market.
Consolidation: The market will likely consolidate around 3-4 major "Infrastructure Titans" (likely DrDoctor, PKB, Induction, and potentially a new entrant like Apple or a US tech giant) who can afford the immense compliance and integration costs. Smaller innovators will exist only as "micro-services" plugging into these larger engines.

Convergence with Social Care

The final frontier is the integration of social care data. The NHS App roadmap includes the ambition to surface social care records, creating a truly unified "life record". PKB is already technically positioned for this, with existing integrations into social care systems.

This expansion will further entrench the engine model, as no single monolithic software could ever span the diverse technical landscape of health and social care; only a federated network of engines, aggregated by a national front door, can achieve this vision.

Conclusion

The transformation of patient portals into "engines" surfacing through the NHS App represents the industrialisation of the UK's digital health infrastructure. It marks the end of the "cottage industry" era of bespoke hospital apps and the beginning of a standardised, national-scale utility.

For vendors like DrDoctor, Patients Know Best, and Induction Zesty, this shift is existential. They have successfully pivoted from being consumer-facing brands to becoming the critical, invisible infrastructure of the NHS. Their future value lies not in their user interfaces, but in the robustness of their APIs, the depth of their integration with legacy record systems, and their ability to reliably power the national "front door."

However, this centralisation carries a heavy burden. The "single front door" must not become a "single point of failure." As the NHS App becomes the de facto operating system for patient health, the resilience, security, and inclusivity of the engines that power it will define the success, or failure, of the NHS's digital future.

The challenge for the next decade is to ensure that this engine of efficiency does not leave the most vulnerable passengers behind.

Nelson Advisors > MedTech and HealthTech M&A

Nelson Advisors specialise in mergers, acquisitions and partnerships for Digital Health, HealthTech, Health IT, Consumer HealthTech, Healthcare Cybersecurity, Healthcare AI companies based in the UK, Europe and North America. www.nelsonadvisors.co.uk

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