The NHS 10-Year Plan makes it clear: AI, data-driven care, and digital-first services will play a central role in the future of healthcare delivery. But while the technology is advancing fast, there’s a bigger question at stake:

Are we equipping NHS leaders with the right skills, mindset, and support to make this transformation safe, ethical, and scalable?

This isn’t just about technology adoption. It’s about leadership, cultural change, and how we prepare people across the NHS to shape the future- not just react to it.

The Leadership Challenge of Digital and AI Transformation

Many CIOs, CCIOs, and digital leaders are already guiding their organisations through complex transformation journeys. But the next phase will be even more demanding.

AI and automation are not just another tech upgrade, they represent a fundamental shift in how we deliver, manage, and experience care.

Leaders will need to:

• Understand the clinical, technical, and governance dimensions of AI solutions.
• Support teams through new ways of working, underpinned by data and digital workflows.
• Build and nurture the digital capabilities of the workforce.
• Tackle the challenge of cultural adoption, ensuring technology is seen as an enabler, not a threat.
• These aren’t skills that develop by accident. They need structured investment.

A Widening Skills Gap

One of the emerging risks is a growing skills gap in AI and digital transformation.

We are asking clinicians, operational leaders, and digital teams to design, implement, and scale new technologies – but often without giving them the training or tools to do it safely and confidently.

This raises some critical questions:

• In five years, will we still separate ‘digital leaders’ from clinical and operational leaders – or will all leadership in healthcare need to be digital by default?
• How do we equip NHS leaders with the technical and ethical confidence to evaluate AI solutions – not just deploy them?
• What frameworks do we need to balance innovation with safety, ethics, and inclusion, while still driving rapid change?
• How do we avoid repeating the past mistakes of tech rollouts that leave frontline staff feeling like change is ‘done to them’, rather than with them?

Despite these challenges, there are already signs of what’s possible when the right support is in place. In early pilots of CLEARnotes, our ambient voice technology, we’ve seen productivity gains of 14–25% – a tangible example of how AI, when well-designed and clinically assured, can reduce burden, enhance workflow, and support frontline teams to deliver better care.

The Human Side of Digital Transformation

It’s easy to focus on infrastructure, interoperability, or procurement when talking about digital health. But the reality is:

The hardest part of transformation is the ensuring the digital transformation is done by and with staff and patients.

We need to support NHS leaders to:

• Foster trust and confidence in AI and data-driven decision-making.
• Lead cultural change – helping teams move from paper-first or analogue processes to digital-first mindsets.
• Engage in multi-disciplinary leadership, breaking down silos between clinical, operational, and technical teams.
• Recognise that diverse leadership voices are essential to ensuring AI solutions serve all patients fairly and avoid reinforcing bias or inequality.

If we’re serious about safe and ethical AI adoption, we need leadership that reflects the diversity of our workforce and the communities we serve.

Time to Build a New Digital Leadership Model?

Perhaps it’s time to rethink how we approach digital leadership development in the NHS.

What would a model look like that:

• Gives CIOs, CCIOs, clinicians, and operational leaders enhanced support to build digital, technical, and change management expertise for themselves and their organisations?
• Balances technical literacy with ethical governance, inclusion, and patient safety?
• Focuses not just on implementing tech, but on transforming care pathways and patient experience?

This isn’t just a training question – it’s about building a long-term digital leadership pipeline to underpin the NHS’ transformation ambitions.

Opening the Conversation

These ideas are not set in stone – they’re part of an evolving conversation about how we best prepare for the next decade of healthcare transformation.

I’d love to hear your thoughts:

• Where do you see the biggest leadership capability gaps today?
• What support would make the biggest difference to NHS digital leaders and their teams?
• How do we balance innovation with safety, ethics, and public trust?
• What can we do now to ensure AI serves everyone fairly and equitably, not just those who shout the loudest?

Let’s work together to shape the future of safe, effective, and human-centred digital care.