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This article is part of our Opinions section, where we invite industry professionals to share their views on the most pressing technology questions of our time.
The NHS is entering the next pivotal stage in its digital transformation journey. Over the past decade, the focus has largely been on digitisation itself – reducing reliance on paper, implementing electronic patient records, and improving access to information across care settings. More recently, attention has shifted towards extracting value from data, as the sector seeks to unlock insights, support clinical decision-making, and enable more proactive models of care.
Now, as digital capabilities continue to mature, a more fundamental challenge is coming to the fore. The next phase of transformation will not be defined solely by what systems can do, but by whether they can be trusted – by the sector in its entirety, yes, but more specifically by the clinicians using these tools every day, and by the patients who should benefit immeasurably.
Cybersecurity has been a central theme in recent years, with several high-profile incidents underscoring the vulnerability of healthcare systems and the potential impact of disruption. In response, organisations have strengthened defences, invested in resilience, and embedded more robust security practices.
Yet, while these efforts are essential, digital trust extends far beyond protection against external threats. It encompasses the integrity, transparency, and reliability of data and systems at every level. In the healthcare environment (where decisions carry significant clinical and ethical weight), trust is not an optional attribute. It is a prerequisite for safe and effective care, and, crucially, it must be continuously earned.
As trusts continue to digitise legacy records and integrate multiple systems, ensuring the accuracy and completeness of information becomes increasingly complex. Data can be drawn from disparate sources, captured in different formats, and subject to varying levels of quality and consistency. This consideration should be at the forefront of all decision-makers’ minds.
Even seemingly small discrepancies can have far-reaching consequences. Missing documents or incomplete patient histories, for example, can risk introducing friction into clinical workflows and, over time, inevitably erode confidence in digital systems. If and when clinicians feel the need to question the reliability of information in front of them, the benefits of digitisation are very quickly undermined.
Establishing trust, therefore, requires a rigorous and ongoing approach to data management, and accurate digitisation is only the starting point. From here, continuous validation, standardisation, and governance are essential to ensuring information remains dependable as it moves across systems and care settings, while reliably informing clinicians so they feel equipped and confident to make important decisions about care pathways.
Accessibility alone is no longer enough – data must be credible and empowering, acting as an intelligent assistant that interacts with clinicians more meaningfully.
As digital tools become more sophisticated, particularly with the growing use of algorithmic and AI-driven capabilities, transparency is increasingly important. Systems are no longer simply storing and retrieving information. They are analysing data, identifying patterns, and surfacing insights that influence clinical decisions.
While these capabilities offer significant potential, they also introduce new challenges – and a very real requirement for thorough due diligence. If the reasoning behind a recommendation is unclear, for example, or if the inputs and assumptions are not wholly visible, clinicians may be hesitant to rely on the output. As such, a lack of transparency risks creating a disconnect between technological capability and clinical confidence. This makes explainability a critical component of digital trust.
Systems must be able to demonstrate what they are doing and why. Intuitively designed interfaces, with clear and interpretable outputs, allow clinicians to access data within the context of their professional judgment. Explainability, in this sense, acts as a trust mechanism and reinforces the role of technology as a support to clinical expertise rather than a replacement for it. It helps ensure innovation is adopted in a way that, rather than simply aligning with established clinical practice, is designed and built around it.
Alongside transparency, accountability plays its role in building and maintaining trust. In complex digital environments in the NHS, in which data often flows across multiple systems and boundaries, it can be difficult to ascertain how information has been accessed and used.
This challenge is particularly apparent when working with unstructured clinical content – documents, correspondence, and scanned records – where visibility and traceability have historically been limited. As trusts continue to digitise these records and bring them into wider digital workflows, clearer oversight becomes imperative.
Robust audit trails can be invaluable in addressing this challenge. By providing a clear and chronological record of interactions with data, they allow teams to trace changes, investigate anomalies, and demonstrate compliance with regulatory requirements. They also create assurance that systems are functioning as intended and that any issues can be identified and resolved.
Strong governance frameworks are equally important. Clear ownership of data, well-defined responsibilities, and consistent policies all contribute to an environment in which trust can be sustained over time.
Without these structures in place, even the most advanced systems risk introducing ambiguity, undermining confidence rather than reinforcing it.
There are clear similarities here with financial services, where digital systems underpin transactions that demand absolute confidence. From payments to fraud detection, trust is reinforced through transparency, regulation, and accountability.
Customers expect visibility, regulators require compliance, and institutions invest in concepts and frameworks that prove reliability at every stage.
Healthcare operates differently, but the principle remains. Trust is not static or a ‘one-off’. It is built through consistent and reliable performance and maintained through accountability. Every interaction with a digital system either strengthens or weakens this hard-earned trust. As the NHS expands its use of data-driven technologies, this continuous approach becomes even more critical.
Where trust is lacking, hesitation will undoubtedly follow – with a risk of frontline teams reverting to manual processes and patients becoming cautious about how their data is being used. Conversely, when trust is established, it becomes empowering, supporting engagement, strengthening long-term confidence, and going some way toward realising the full value of digital investment. As the digital landscape evolves and new risks emerge, maintaining this trust requires continuous oversight and a commitment to improvement.
Training, communication, and leadership all shape how digitisation is perceived and handled. So, a holistic approach – one that combines data integrity, transparency, and governance – is essential.
As the NHS advances, the focus must continue to shift beyond digitisation alone if systems, tools, suppliers, and partners are to be trusted at every level. Without trust, healthcare’s digitisation progress will stall. But once it is earned and established, technology will continue to innovate, clinical workflows will streamline, and patients will benefit from more tailored, effective care.
