The UK is on the brink of a profound demographic transformation. By 2072, more than a quarter of the population – around 22.1 million people – will be aged 65 or over. Yet, the homes being built today are failing to meet the needs of this ageing society.
Mike Lord
Research commissioned by Stiltz Homelifts in 2024 revealed that 70 per cent of adults over 50 want to stay in their current homes over the next decade, with half saying they have no intention of ever moving. However, nearly a quarter fear declining mobility will eventually force them to relocate. This mismatch between aspiration and reality highlights a growing crisis in housing design – one that not only limits independence but also risks placing greater strain on the NHS and social care systems.
By 2040, one in four people in the UK will be over 65. While most older adults wish to “age in place,” remaining in the homes and communities they love, the trend towards multi-storey, space-saving developments makes this increasingly difficult. Steep stairs, narrow hallways, and limited adaptability are becoming the norm – features that actively discourage healthy ageing.
The problem is not just physical accessibility but also the absence of foresight in planning. For decades, government housing policy has focused on numbers – homes built – rather than on quality and longevity. As David Sinclair, Chief Executive of the International Longevity Centre UK, warned in response to the 2024 Older People’s Housing Taskforce report, “It is not enough to build more houses for first-time buyers; we must also design age-friendly and inclusive homes that better suit people’s long lives.”
The Cost of Inaction
Unsuitable housing is a silent driver of poor health outcomes. Falls alone cost the NHS an estimated £2.3 billion annually, while cold, damp, and poorly designed homes exacerbate chronic illness and accelerate dependency. Every £1 spent on home adaptations – such as handrails, ramps, or walk-in showers – saves £1.62 in reduced health and care costs.
Beyond the economic calculus lies an emotional toll. Stiltz’s research found that 13 per cent of older adults believe being forced to move from their homes would negatively affect their mental health. For many, leaving familiar surroundings represents a loss of independence, identity, and community ties. Designing homes that evolve with their occupants is not only a practical solution but a moral imperative – one that supports mental well-being and social continuity.
The UK’s obsession with vertical expansion – three-storey townhouses and high-density developments – has created housing that is effectively “future-blind.” While it may satisfy short-term targets, it ignores the long-term realities of an ageing population.
Bungalows and single-storey properties, once considered essential for older people, have become rare and expensive. As a result, those with declining mobility often face an impossible choice: adapt their existing homes at great cost or move into residential care prematurely.
Stiltz’s research also shows that 23 per cent of adults over 50 already face mobility challenges, a figure that rises to 43 per cent among those over 70. If the built environment continues on its current trajectory, millions will find their homes uninhabitable long before their lives are over.
A Blueprint for Change
The government’s 2024 Older People’s Housing Taskforce and the British Property Federation have both issued clear calls for reform. They urge the creation of a national housing strategy for an ageing population, planning reform through a new “CR2” use class for senior housing, and the integration of older people’s needs into local plans. These are sensible measures – but they must be accompanied by practical, design-led solutions.
Accessible housing should not be viewed as a niche requirement but as a universal standard. The Housing Made for Everyone (HoME) coalition recommends that all new homes meet at least the M4(2) accessibility standard, ensuring basic adaptability for people of all ages and abilities. This is not a luxury – it’s a necessity. Currently, only nine per cent of UK homes meet these basic standards.
Designing for Real Life
True inclusivity in housing means thinking beyond ramps and grab rails. It means creating homes with level access at entrances, wide hallways, flexible kitchens and bathrooms, and crucially – vertical mobility options.
Domestic homelifts are an increasingly viable solution. Modern units are compact, energy-efficient, and easy to install in both new builds and retrofits. Yet public awareness remains low – just one in five homeowners knows how straightforward these installations can be. Integrating “lift-ready” frameworks at the design stage would allow homeowners to adapt seamlessly as their needs change, without the upheaval of moving or extensive renovation.
From Policy to Practice
To make this shift a reality, Stiltz recommends three key policy actions:
1. Update Building Regulations – Amend Part M to mandate “lift-ready” or “mobility-adaptable” designs as standard, ensuring homes can support lifetime living.
2. Incentivise Developers – Offer grants, tax relief, or planning advantages for inclusive design and early adoption of homelifts or adaptable layouts.
3. Lead a Cultural Shift – Launch public awareness campaigns and showcase exemplar developments that prove accessible homes are desirable, modern, and cost-effective.
These measures would align housing policy with health, social care, and equality objectives – turning inclusive housing from aspiration into expectation.
Homes That Last a Lifetime
If the UK is to meet the challenge of an ageing population, it must start by rethinking what makes a home “fit for purpose.” Inclusive, adaptable design is not a concession to ageing – it’s an investment in the nation’s future.
The construction industry, policymakers, and local authorities all have a role to play. By designing homes that people can live in for life, we can reduce hospital admissions, ease pressure on social care, and build stronger, more resilient communities.
The choice is clear – continue building upwards without looking ahead – or elevate housing design to meet the realities of how we live, age, and thrive.
The global medical tourism market has grown exponentially over the past two decades – and nowhere is this trend more visible than in aesthetic medicine. Every year, more UK patients travel abroad for low-cost cosmetic procedures, drawn by persuasive marketing, short waiting times, and the promise of “holiday surgery” for a fraction of the UK price.
Kagan Seymenoglu
But behind the glossy imagery lies a troubling truth. Many patients are being exposed to unregulated, unsafe clinics – and when complications occur, as they frequently do, it is the NHS and reputable UK aesthetics professionals who are left to pick up the pieces.
As CEO of Longevita, I have witnessed both the benefits and the risks of this growing industry. That’s why I have authored a new White Paper, “Cutting it fine – Regulating Medical Tourism for UK Patients”, which calls for a comprehensive regulatory framework to govern outbound medical tourism from the UK – one that safeguards patients, protects public resources, and preserves the hard-earned reputation of the UK’s aesthetics industry.
To accompany the White Paper, I have launched a public petition urging the Government to act. The petition is now live and open for signatures.
According to the Office for National Statistics, more than half a million British patients left the UK for healthcare overseas in 2024, a 50 per cent increase in two years. A significant proportion of these journeys involve elective cosmetic procedures such as breast augmentations, rhinoplasties, veneers, and hair transplants.
International healthcare has an important role in a globalised world. However, when patients undergo surgery in clinics that lack enforceable safety standards, proper insurance, or aftercare pathways, the risks extend far beyond the individual. Complications often result in additional NHS treatment or revision procedures by qualified UK professionals – diverting clinical time and resources away from domestic patients.
Currently, no UK-specific body exists to regulate or accredit international clinics targeting British patients. This vacuum has enabled poor-quality operators to flourish – both overseas and increasingly within the UK – undercutting legitimate clinics by reducing prices and standards alike.
To address this, my White Paper proposes the creation of an independent UK Medical Tourism Accreditation Association (UKMTAA). This national body would be responsible for accrediting overseas clinics that market directly to UK consumers, ensuring that participating providers meet UK-equivalent standards in safety, transparency, and clinical governance.
Such a system would empower patients to make informed choices and give reputable overseas clinics a benchmark to demonstrate credibility.
The framework also recommends introducing mandatory medical tourism insurance to cover complications, emergency repatriation, and follow-up care. Too many patients currently travel uninsured, leaving them financially and medically vulnerable – while the NHS absorbs the cost of complications.
In parallel, we propose an integrated aftercare pathway to facilitate the seamless transfer of medical information between overseas clinics and UK providers. This would improve patient recovery and clarify clinical responsibilities when complications arise.
Another critical element is tighter regulation of medical tourism advertising. Many social media promotions and influencer endorsements omit crucial information about risks, qualifications, or aftercare. Working with the Advertising Standards Authority (ASA) and Care Quality Commission (CQC), we recommend establishing clear, enforceable rules requiring overseas clinics marketing to UK consumers to meet the same transparency standards as domestic providers.
This is not an attack on international healthcare – it is a call for accountability and alignment. Without regulation, we risk undermining both patient safety and public trust.
Every botched procedure that returns to the UK adds to NHS workloads, strains public finances, and damages the reputation of our aesthetics sector. Regulation is not a burden – it is an investment in public confidence and professional integrity.
A Call to Action
The UK aesthetics industry has long been admired for its professionalism, innovation, and commitment to patient welfare. But without decisive action, that reputation could be compromised by the actions of unregulated overseas providers.
By supporting the proposals outlined in this White Paper – and by signing petition – policymakers, clinicians, and patients can help establish a safer, fairer system that upholds the UK’s world-class standards.
It is time to act – to protect patients, preserve NHS resources, and safeguard the future of a sector that represents the very best of British medical excellence.
It’s that time of year again – Halloween – when the ghosts and witches are expected to come out to cause havoc. When it comes to phishing attacks, it’s a game of trick rather than of treat. Check Point writes in its blog, ‘Halloween Frights of the Digital Age: Cyber Threats Haunting Us in 2024’ that in the third quarter of last year, there was a 75% increase in cyber-attacks worldwide. In another blog, the company says that this equates to an “average of 1,876 cyber-attacks per organisation, marking a 75% increase compared to the same period in 2023 and a 15% rise from the previous quarter.”
In its blog, ‘A Closer Look at Q3 2024: 75% Surge in Cyber Attacks Worldwide,’ the company provides an industry-wide breakdown: “The Education/Research sector was the most targeted with 3,828 weekly attacks, followed by the Government/Military and Healthcare sectors, with 2,553 and 2,434 attacks, respectively.” The cyber-security firm adds that Africa faced the highest average of attacks at 3,370 per week (+90% YoY), “while Europe and Latin America also saw significant increases.”
Ransomware: Persistent threat
Ransomware sits out as one of the most persistent threats. This time last year, 1,230 incidents were reported. North America was most affected with 57% of the attacks occurring there. Not far behind are the cyber-attacks on Europe, which had to deal with 24% of the ransomware attacks. Coupled with phishing attacks, this is perhaps the most serious form of attacks for public sector organisations, as a ransomware attack could cripple their ability to provide public services, and to operate more generally.
Cyber-security firm, Guardz, warns: “Employees overloaded with emails might miss the common tactics used by attackers, such as domain spoofing, look-alike URLs and manipulated sender headers that make a message appear to come from a trusted source. This was the case in a recent Microsoft 365 phishing campaign exploit earlier this year, where attackers were even able to evade SPF, DKIM and DMARC security measures.”
The firm reveals that new recruits are the most likely to unwittingly start a phishing attack – citing an article by Help Net Security, with the headline: ‘71% of new hires click on phishing emails within 3 months.’ Anamarija Pogorelec, Managing Editor of Help Net Security, writes: “Based on data from 237 companies across various industries, the 2025 New Hires Phishing Susceptibility Report found that new hires are 44% more likely to fall for phishing and social engineering scams than longer-term employees.”
Business Email Compromise
Guardz also warns that Business Email Compromise (BEC) attacks are another one to watch out for during the Halloween period. So, you thought a phishing scam was spooky, but in the first quarter of 2025, BEC attacks accounted for 37% of all email scam attacks. The firm says 73% of them impersonate someone senior – usually a company’s CEO or another C-suite executive. Invoice fraud is next on the list, as it ranks high in its use for BEC attacks, targeting HR and payroll teams by “impersonating legitimate vendors, company executives or internal finance contacts to extract sensitive data or credentials.”
Malware poses a significant threat, too. Jordan Snapper, writing for Guardz, continues: Halloween wouldn’t be complete without a cunning cyber threat actor that usually comes in the form of a sneaky file attachment. That ghostly threat, better known as malware, can silently infiltrate systems, exfiltrate sensitive dataor create backdoors for further attacks.”
Then there is fileless malware, which he explains “operates entirely in memory, leveraging legitimate system tools, such as PowerShell, WMI or macro-enabled Office documents to execute harmful code or run malicious commands when opened, all without leaving traditional files on disk.”
He adds: “Talk about an unpleasant Halloween surprise; fileless malware makes it virtually impossible for traditional antivirus tools to detect. MSPs that manage remote teams and contractors face a greater risk, as attackers often exploit unsecured endpoints and unmanaged devices to inject malicious scripts directly into memory. Without proper endpoint coverage and visibility, a threat actor can take control of a remote Windows session, execute commands, and deploy payloads while appearing as a legitimate user.”
In this case, the goal could be to slowly crash systems or to gain long-term undetected access to critical infrastructure. It also doesn’t matter whether your teams are working in an office, or remotely. They are all potentially vulnerable to attack unless the right training and precautions are put in place to forestall any kind of attack – including ones that aim to cause a data breach that could lead to a breach of GDPR and significant fines, lawsuits, and damaged reputations.
Danger: Windows 10’s demise
With support for Windows 10 now ending this month, October 2025, there is also concern about whether Microsoft could be leaving millions of users in the lurch – vulnerable to cyber-attack as many of them won’t be receiving any security updates in the push by Microsoft to get its customers to migrate to Windows 11. This is as true of public sector organisations, as it is of companies in the private sector, and of individuals.
British newspaper, The Guardian, headlines this as: ‘Millions in UK at risk of cyber-attacks as Windows 10 ends updates, Which? finds.’ Written by Robert Booth, the newspaper’s UK technology editor, its standfirst claims: “Survey shows one in four users intend to keep using system as it is phased out, despite increased virus and malware risk.” That’s at least 21 million people who use a device that runs Windows 10 software intend to keep using the operating system after updates cease, leaving them at risk of online security breaches – including malware and viruses, according to a survey by the consumer watchdog Which?
As for the public sector, Google AI says: “There is no exact number for how many Windows 10 machines in the public sector will be replaced by Windows 11, as this is a complex, ongoing transition. However, it’s clear a significant number of public sector machines will be replaced because many older computers are not compatible with Windows 11, which requires specific hardware. Organisations are facing increased budget pressure to fund these replacements to ensure security, with some already budgeting for new devices or extended support.”
Back up, back up!
With increasing volumes of data also being stored in the cloud, public sector organisations should actively and regularly back up their data. However, these systems aren’t immune from attack, and so there is a need to back up and restore data rapidly. One of the traditional responses to this issue has been WAN Optimisation, but it can’t send and receive encrypted data. Increasingly popular in the public sector are SD-WANs, but they also need a boost in their performance with a WAN Acceleration overlay.
To have the ability avoid any disruption caused by a cyber-attack, or to restore operations quickly, and to keep data safe – away from the threat actors, it’s firstly important to have data stored in 3 disparate disaster recovery, situated miles from each other. Next to ensure that your data backup and restore activities also obfuscate cyber-criminals, it’s vital to deploy a technology that uses artificial intelligence, machine learning, and data parallelisation – and that unique technology is WAN Acceleration.
With this, you can dramatically improve data throughput up to 98% of bandwidth – regardless of distance. It’s a technology that is being used by CVS Caremark in the U.S, and by the National Institutes of Health. The latter has global data transfer requirements as it is also the world’s biomedical research agency. As for CVS, it connected two virtual tape libraries over 2,860 miles at full WAN bandwidth. This achieved a performance gain of 95 times the unaccelerated performance.
Still, while this technology goes a long way forward to protect data and systems that store and use it, organisations also need to ensure that they put other cyber-security technologies, training, policies and procedures in place. Whether at Halloween, or at any other time of the year, public sector organisations need to be forearmed to prevent and forestall cyber-attacks – no matter what kind of cyber-attack is launched against them. It’s cheaper because it saves time, money, and reputations. By putting prevention before a cure ahead of any reactive response, the cyber-criminal ghouls will be kept away.
A new UK-based consultancy, MPP Culture, has launched to support health and social care organisations in addressing organisational culture as a root cause of care quality issues, workforce challenges, and compliance risks.
The consultancy offers structured cultural assessments and advisory support to providers, boards, commissioners, and investors. Its goal is to help organisations identify and manage cultural risks that influence care outcomes, regulatory performance, and organisational sustainability.
A system-wide concern
The role of organisational culture in care delivery has been widely acknowledged. The Care Quality Commission (CQC), NHS England, and various public inquiries have repeatedly linked poor culture to service failure, unsafe care, and staff attrition.
Conversely, strong organisational cultures are associated with improved clinical outcomes, higher staff morale, and positive inspection results.
A toolkit for cultural assessment
At the centre of MPP Culture’s approach is its proprietary Culture Assessment Toolkit (CAT) – a structured diagnostic framework providing a 360-degree assessment of leadership, communication, values in practice, staff engagement, and regulatory preparedness. The process is delivered by assessors with experience in care governance, operations, and compliance and generates a report outlining key cultural dynamics with practical, actionable recommendations for improvement.
Chair Richard McKenzie, a former CEO and Chair in the care sector, stresses that culture is not a secondary concern: “It’s not abstract. Culture directly affects safety, compliance, and the long-term sustainability of services.”
Relevance to public sector oversight
MPP Culture’s services are relevant not only to care providers but also to local authorities, integrated care systems (ICSs), boards, insurers, and investors.
Current services offered include:
· Organisational culture assessments using the CAT
· CQC inspection readiness reviews
· Board and executive team diagnostics
· Cultural due diligence for investment and acquisition
These services are designed to help organisations proactively identify cultural risks, align leadership behaviours with quality goals, and strengthen system resilience.
Responding to sector pressures
The launch of MPP Culture comes at a time of significant pressure on the care system. Workforce shortages, rising demand, regulatory scrutiny, and financial constraints continue to impact the sector’s ability to deliver safe, sustainable care.
In response, national regulators have placed increased emphasis on leadership and organisational culture. The CQC now expects providers to demonstrate a positive,
inclusive, and learning-oriented culture as part of its inspection and assessment framework.
Supporting workforce and service stability
Workforce retention remains a critical challenge in health and social care. While pay and workload are important, the working culture within an organisation is often the decisive factor in whether staff stay or leave.
MPP Culture’s assessments explore how leadership, communication, and team dynamics shape the staff experience. This enables organisations to take targeted action to improve morale, reduce turnover, and create more supportive working environments.
For local authorities and ICSs, this insight can inform workforce planning and help stabilise fragile markets by reducing provider failure due to leadership or culture-related issues.
A governance and risk management tool
Boards are expected to provide oversight of organisational culture, particularly where quality or compliance concerns exist.
MPP Culture’s assessments offer objective data on cultural strengths and risks. This supports better decision-making and more effective governance, particularly in organisations undergoing change or improvement.
Cultural reviews can also be used as part of due diligence in acquisitions or investment processes. They can reveal hidden risks, such as incompatible leadership styles or unresolved workforce issues, that may affect integration or future performance.
For commissioners and public sector partners, the ability to assess cultural risk in provider organisations offers a way to intervene early and reduce the likelihood of crisis-driven responses.
Practical applications across the system
The consultancy’s model has wide application across the health and social care system. Providers preparing for inspection can use cultural assessments to test readiness and identify areas for improvement. Organisations with regulatory concerns can use findings to support action plans and demonstrate progress.
In multi-provider environments, such as supported living or community-based care, cultural alignment between partners is essential to delivering consistent, person-centred care. MPP Culture’s approach can help improve collaboration, and support shared standards.
For system leaders, these insights can be used to design targeted support, strengthen market oversight, and encourage quality improvement at scale.
Conclusion
The launch of MPP Culture reflects a growing shift in the sector: recognising that culture is not an intangible concept, but a measurable, strategic factor that shapes outcomes at every level.
For public sector leaders, commissioners, and system stakeholders, MPP Culture offers a way to bring cultural insight into strategic planning, oversight, and intervention – supporting better care, better governance, and more sustainable services.
MPP Culture MPP Culture is a UK-based consultancy focused on organisational culture in health and social care. It provides structured cultural assessments and advisory services to care providers, boards, investors, and public sector bodies.
Healthcare Excellence Through Technology took place at London ExCeL at the start of October. Over two days, speakers, exhibitors and visitors expressed a desire for policy, commitment, and innovation to bring about transformative change.
In a special address to the HETT audience, newly appointed Parliamentary Under-Secretary of State of the Department of Health and Social Care, Dr Zubir Ahmed MP told visitors that he was “restless for change.”
Dr Ahmed, who is a surgeon by background, highlighted in his speech his particular interest in robotic surgery, emphasising technologies that can support patients both before and after operations, helping them prepare for treatment and facilitating their recovery.
The transplant and vascular surgeon, who became a Health Minister this Summer, said he could see huge potential for digital. “Our challenge now is delivery,” he said, “and to get this technology into the hands of the many, not the few.”
National Plans, National Foundations
A succession of key digital voices from NHS England told HETT that the groundwork has been laid with the 10 Year Plan and its three shifts from hospital to community, treatment to prevention, and analogue to digital.
Of these shifts, they argued, digital is the most critical component, as it enables these the shifts to take place. Alec Price Forbes, the National Chief Clinical Information Officer, said the NHS should be “digital by default.” It will not be enough to extend digital tools into existing workflows, he stressed: “We need to see digital used to transform services.”
Ming Tang, Interim Chief Digital and Information Officer at NHS England, said three big national projects will underpin change across the system. The first is the NHS App, during Tang’s Afternoon Keynote in the Infrastructure, Data and Cyber Security theatre, she described the NHS App as the “trojan door” for changing people’s journey through health and care services.
The second is the single patient record, which Tang said will collate information and make it available to clinicians and patients for specific use cases, starting with maternity. Finally, the third is the Federated Data Platform, which will not only enable the NHS to make better use of its data, but also enable it to become “a growth platform for the UK” through supporting research and innovation.
“It is all coming together and now we need to make sure we work together to ensure we can do all the things we want,” Tang said. “Ten years is a long time. We need to focus on the next two to three years to deliver things [that will] change the environment, create tools people want, and make an impact on some of the big challenges we face.”
Ayub Bhayat, Director of Data Services and Deputy Chief Data and Analytics Officer at NHS England, joined a panel at the Digital Maturity Forum discussing the Single Patient Record. He explained that three prototypes are being developed: one following a “hub and spoke model,” leveraging existing investments in shared care records; one built around a “central model”; and one based on a “data layer”.
Liz Clow, Director of Digital Products at NHS England, told a session on the future of the NHS App that three early priorities include developing “intelligent triage,” building the digital hospital and NHS Online, and, more immediately, “rolling out HPV self-service screening for women who may not access traditional screening services.”
Implementation and the Team
HETT didn’t just cover government policy or National Programmes, on Day Two, Sonia Patel
Chief Information Officer at NHS England, took part in a fireside chat about the future of NHS infrastructure and hospital trust IT deployments.
Patel outlined a streamlined relationship between the centre, regions, and the frontline, underpinned by a new ‘public digital infrastructure,’ and the creation of a flexible, standards-based blueprint for the deployment of technology to support new models of care.
Shortly afterwards, Will Monaghan, Group Chief Digital Information Officer at University Hospitals of Leicester and Nottingham University Hospitals NHS trusts, reflected on the progress it is making in deploying the Nervecentre electronic patient record across the East Midlands.
He said something to bear in mind “if you want to go fast, you go alone, but if you want to go far, you go with others.” In other words, the project sometimes had to slow down to get everybody on board, but now they are starting to reap benefits from having everybody working in the same way with the same system.
In a lively session with Dame Laura Kenny, HETT’s very first celebrity guest speaker, the spotlight was on the importance of setting common goals and discovering the best ways to communicate them to people with different perspectives. The five-time Olympic cycling champion reflected on her career and her experience of the NHS in conversation with Ayesha Rahim, Chief Medical Information Officer at Surrey and Borders Partnership NHS Foundation Trust.
To close her session, Dame Laura was asked for any “words of wisdom” for her audience, she said: “There is no journey that comes without hurdles… but every barrier can be broken down. And communication really [does] matter. Really understanding the team has been key to my success.”
Bringing AI to Life
There were also plenty of suppliers on the programme, talking about the potential of their solutions, services and products. Jane Stephenson, the Chief Executive of SPARK TSL, reflected on Dr Ahmed’s special address.
“I am happy to hear that he is restless for change, because I think we all need to be restless for change,” she said, before outlining how her company’s modern wi-fi, bedside devices, and SPARK Fusion platform, which can transform entertainment, information, and hospital processes for staff and patients.
Out on the exhibition floor, HETT had also created new features to bring visitors closer to suppliers and innovators. One of the busiest was the AI spotlight, which gave vendors and customers the chance to reflect on the implementation of what is still very new technology.
Eddie Gibson, Clinical Director of Radiology, at Northern Health and Social Care Trust in Northern Ireland, outlined their experience with BoneView, which it has deployed from the Sectra Amplifier, a marketplace, hosting and co-ordination service for imaging AIs.
Gibson said BoneView has improved the detection of fractures in the trust’s emergency departments, to the point where the performance of doctors in ED is almost as good as that of specialists in radiology. Results like this are impressive.
Outside of imaging, trusts can find it difficult to find the financial, infrastructure, and clinical resources to try out AI tools and services. This problem was addressed by Simon Windsor, Intel UK’s Healthcare and Life Sciences Manager, and Cory Neighbour, Insight Solution Leader for Public Sector.
“We have built a deployment model and toolkit,” Neighbour explained. “We understand the business challenge, and then we build a prototype that uses existing hardware and systems, so trusts can fail fast or scale up what works for them.”
HETT: A Platform for Inspiration
Windsor said HETT was the perfect show at which to present this kind of thinking. “It brings the whole ecosystem together, from decision makers to end-users,” he said. “That makes it a great environment to discuss these solutions.”
This was also the experience of exhibitors on busy stands. Dean Moody from Airwave Healthcare, the provider of digital signage, displays, and the mycareTV patient entertainment system, said: “We have been really busy, and we have had the right people coming to the stand: that means CIOs, CCIOs, digital teams. “We have just won some big contracts – the next new hospital to open, the National Rehabilitation Centre, is going to be using our intelligent bedside terminals – and this is the perfect place to tell people about them. People are genuinely interested in innovation.” Or, to coin a phrase, restless for change
In April 2026, the government will introduce Joint and Several Liability (JSL), a policy that will reshape how compliance is governed across the temporary labour market. For the first time, employment agencies and their end clients will be held jointly responsible for unpaid payroll taxes when working with non-compliant umbrella companies.
While the aims of the policy are clear and positive – protect workers, close the tax gap, and prevent fraudulent operators from undercutting legitimate businesses – the success of it will depend on more than legislation alone. Without modernised digital infrastructure, JSL risks creating unnecessary complexity and costs for the very businesses it seeks to protect.
Listening to the sector
Earlier this year, we surveyed recruitment agency finance professionals to gather their views of the reforms, and the results were revealing.
Nearly 80% of those agencies felt that HMRC needed to modernise and integrate its systems if JSL is to succeed. And three-quarters expect to rely heavily on new technology to manage compliance and conduct real-time audits.
This is not the sector’s resistance to reform, on the contrary, agencies recognise the need for change and are prepared to invest in compliance. But they are equally clear that current HMRC systems are not fit to support this scale of change.
The risk of standing still
We believe that without the right infrastructure in place, JSL risks creating unintended negative consequences. For example, agencies could face spiralling administrative costs as finance teams battle with fragmented processes, while workers could face delayed or incorrect pay as compliance checks slow down.
This is about more than efficiency; public trust in both the tax system and the temporary labour market depends on reforms being implemented fairly and effectively. With less than six months until the deadline, the time to modernise is now.
The technological gap and roadmap
The recruitment sector is already showing what is possible when compliance is embedded into everyday processes. Platforms like Finity are helping agencies, umbrella companies and payroll bureaus to automate auditing, integrate systems, and create transparent, auditable records.
Varun Monteiro
But for this to work at scale, HMRC must play its part. Without integrated, real-time systems, private sector innovation risks hitting a wall. And while in principle, technology can shoulder much of the compliance burden, this will only be achievable if government systems enable it.
The government has taken positive steps with the HMRC Transformation Roadmap, which aligns with the sector’s anticipated reliance on stronger digital infrastructure. However, the lack of efficient, real-time access to tax data is leaving businesses exposed to compliance failures and fraud.
Our proposed technological roadmap would help overcome these challenges. For example, leveraging AI, providing access to real-time tax data and developing a suite of publicly available APIs to enable recruitment businesses to remain compliant, reduce risk and meet their tax liabilities efficiently and confidently.
Right now, recruitment businesses have little visibility of tax liabilities across their supply chains. Without real-time access to this data, many are forced to depend on third-party advisors or manual checks that are slow, open to error and inevitably, increased costs and complexity which ripples through the entire chain.
The challenge is compounded by the fast-moving nature of recruitment, where thousands of transactions occur every week. Despite this, currently HMRC provides no inbound mechanism for businesses to access its wider dataset, leaving agencies unable to confirm compliance as transactions happen. This lack of transparency increases the risk of accidental non-compliance and major financial consequences.
Unless HMRC equips businesses with the right digital tools to make essential tax information instant and accessible, there will remain a stark mismatch between the tougher compliance now required and the limited capabilities currently available to deliver it.
The solution: modernise, integrate, simplify
The recruitment sector is clear about what it needs: digital compliance tools that are fast, reliable and built into existing systems. That means API-driven access to tax data, automated real-time auditing, and seamless integration with payroll and back-office platforms.
Modernisation on these terms would deliver faster checks, reduce fraud, and build stronger trust throughout the labour supply chain. At Finity, we are calling for HMRC to roll out three APIs:
Employer Liability Verification API – enabling secure, real-time verification of supplier tax liabilities (PAYE, CIS, VAT) without exposing sensitive data.
Payslip Verification API – confirming contractor payments match HMRC’s official Full Payment Submission (FPS) records, ensuring each worker is correctly reported and visible to HMRC.
Extension of HMRC’s existing RTI platform – enhancing current infrastructure with APIs rather than requiring a costly and disruptive full system overhaul.
Together, these would give businesses certainty that workers are properly reported, payslips are accurate, and liabilities are paid in full. Crucially, because most payroll platforms already connect with HMRC’s RTI, these enhancements would not require a costly rebuild. Instead, they would unlock the full potential of the systems we already have.
A shared responsibility
This reform isn’t just about liability; it is about shared responsibility. Agencies and the entire recruitment supply chain are being asked to step up, and our research shows they are ready and willing to do this. But government must mirror this commitment by delivering a digital infrastructure that is fit for purpose.
Conclusion
Joint and Several Liability is a welcome and much needed step towards tackling tax avoidance, however, legislation without infrastructure will cause frustration and disillusionment.
We therefore urge HMRC to modernise now to stand the best chance of delivering a compliance system that works for businesses, workers and public funds. With less than six months to go before the policy rolls out, we must not only have new rules, but the systems in place to make them work.
A pioneering fruit and veg prescription in Tower Hamlets has delivered powerful results, improving physical health for 8 in 10 participants and cutting self-reported GP visits by 15%.
Now, Alexandra Rose Charity is encouraging local authorities and healthcare leaders to take note of the scheme’s success and consider adopting similar models to support healthier, more resilient communities.
Alexandra Rose Charity is working in partnership with Tower Hamlets Council and the Bromley By Bow Centre to provide families on low incomes with access to fresh fruit and vegetables. The charity has been supporting communities to eat better since its 2014 ‘Rose Vouchers for Fruit & Veg’ project and, more recently, its two ‘Fruit & Veg on Prescription’ projects.
Based in London, one project operates in Lambeth, to the South, and another operates in Tower Hamlets, in the East End. The Tower Hamlets project is now set to enter its third year of funding from Tower Hamlets Council.
Alexandra Rose Charity, in partnership with the Bromley by Bow Centre, delivers the Fruit & Veg on Prescription scheme in Tower Hamlets as part of a broader social prescribing service. Health professionals and Social Prescribing Link Workers issue weekly Rose Vouchers to people on low incomes with diet-related health conditions. These vouchers are collected from the Bromley by Bow Centre and used to purchase fresh, healthy food at local markets.
Between October 2022 and July 2024, 140 people have been prescribed Rose Vouchers. The results of recent data analysis shows that access to weekly fruit and vegetables has improved the physical health of 8 out of 10 of these participants.
In addition, 54% of participants experienced improved mental health, attributed to their need to worry less about money for food – and feel more supported in their community.
Aggie, a participant from Tower Hamlets, said: “When I got the Rose Vouchers for fruit and veg, I thought, ‘Brilliant, I don’t have to worry about food – at least I can still eat’. It was lifesaving for me.
“The food choices I’m making now are forever. Before I started receiving Rose Vouchers, I was feeling awful – I’d found out I had Type 2 Diabetes and high cholesterol. It’s been a complete lifestyle change; I could never go back.”
Self-reported GP visits have reduced by 15%, with patients experiencing a better diet, thanks to greater access to fruit and vegetables. 78% of participants met their ‘5 a day’ target after nine months of ‘Fruit & Veg on Prescription’, compared to 32% at the start of the project.
Dr Jennifer Walmsley, practising GP at Kingthorne Group Practice said: “I’m a huge advocate for the work that Alexandra Rose Charity is doing. Diet is key and Rose Vouchers make eating healthier food much more accessible.
“As GPs, we spend a significant amount of time dealing with the effects of poor diet and nutrition – I’d say more than anything else, in fact – because the majority of chronic diseases stem from those issues.
“Any steps we can take to improve diets and reverse those consequences are hugely beneficial. Not only does it enhance individual health and wellbeing, but it also helps ease pressure on the NHS, allowing GPs to focus on areas of care that aren’t preventable.”
The ongoing project, delivered by Alexandra Rose Charity, in partnership with Bromley by Bow Centre and funded by Tower Hamlets Council, is part of a social prescribing service that provides bespoke support to people with health and wellbeing challenges by connecting them with a Social Prescribing Link Worker.
The National Academy for Social Prescribing defines social prescribing as ‘connecting people to activities, groups and support that improve health and wellbeing’.
Eleanor Curry, a Social Prescribing Link Worker at Bromley by Bow Centre, said: “Social prescribing can help in many ways – I find the work we do with Alexandra Rose Charity, who provide us with Rose Vouchers, deeply impactful. The difference we have seen with clients who have used these vouchers is quite special really. As well as their diet improving, their health is better, their mood is lifted and they’re connecting to people at the centre.”
Voucher scheme participant Aggie added: “A lot of the positive changes that have happened have come off the back of me having access to fruit and veg and the support I received from the centre.”
“Before I had the support of my Social Prescribing Link Worker, I was struggling to leave the house. But now, I’m part of a business enterprise group and I’ve set up a business selling banana bread in the community.”
In Tower Hamlets, only 27% of adults eat the government-recommended five portions of fruit and vegetables a day.
Alexandra Rose Charity also found that 80% of participants said they were skipping meals to make food last longer at the start of the project. Nine months on, this number has reduced to 30% and has had a big impact on physical health too.
Access to a healthy diet is a key determinant of health. Before joining the project, 80% of participants were suffering from at least four symptoms of poor nutrition, such as fatigue, trouble focusing on tasks, sleep issues, fainting spells, and gut and digestion problems.
“When someone’s struggling with low mood, one of the first things I like to address is their lifestyle and diet,” adds Social Prescribing Link Worker Eleanor. “I’ll ask how they eat every day, what they have for breakfast, lunch and dinner and identify some of their unhealthy habits. I encourage a lot of my patients to have more fruit and veg because nutrition plays a huge role in mood and mental health.”
87% of participants now report a range of health improvements. 60% of participants also reported an improvement in their energy levels whilst 59% reported better digestion.
More than 3,500 Social Prescribing Link Workers have been employed within primary care teams and GP practices across England, processing over 2.7 million referrals to date. The personalised approach taken by Link Workers ensures that each person’s unique needs are met, enhancing the role of community resources in supporting patient health.
Cllr Sabina Akhtar, Lead Member for Health, Adults and Social care at Tower Hamlets Council, said: “It’s been truly heartening to hear local people share how much this programme has made a real difference to their everyday lives. By partnering with Alexandra Rose Charity and the Bromley by Bow Centre, we’ve been able to keep building on a project that’s shaped by the community itself—tackling food and nutrition challenges whilst also giving local shops and businesses a well-deserved boost.”
Alexandra Rose Charity CEO Jonathan added: “Aggie’s story is one of many that shows how a small change, such as access to fruit and veg, can transform lives – improving health, reducing isolation, and building community.
Alexandra Rose Charity hopes to raise awareness of the scheme’s impact and is calling on other local authorities and healthcare partners to adopt similar approaches to improve health and reduce pressure on services.
Embarking on healthcare technology career after leaving his home as a refugee during his teenage years, Yousif is passionate about making a difference. He reflects on an apprenticeship in which he has worked alongside technology innovators and the hospital teams that put solutions into practice for patient care.
When Yousif saw an opportunity advertised to learn skills that would help him begin a technology career, his attention was caught.
Yousif
Yousif, who had studied computer installation and maintenance in high school, became a refugee when he was aged 17. It meant he had to leave his home in Iraq, and he could no longer continue his education. Yousif arrived in Belfast in 2022.
“I was looking to get into education again, and found this opportunity,” he says. “Already, I can say this has been the best position of my life.”
He refers to an employability programme launched by The King’s Trust, formerly The Prince’s Trust, and medical imaging and cybersecurity company Sectra in 2024.
Gaining significant interest, the programme in Northern Ireland aimed to equip young people from under-represented backgrounds with practical skills and insights to help them apply for positions, as well as providing a taste of what it is like to work in the healthcare technology sector.
As part of the programme Yousif was successful in being offered an apprenticeship with Sectra.
“Healthcare was completely new to me,” he explains. “But this is already way better than I could have imagined. It’s technology that makes a difference, that helps clinical teams as they save lives.”
Supporting technology that matters to people’s lives
Headquartered in Sweden, Sectra provides imaging and diagnostic solutions to hospitals around the world – allowing radiology, pathology and other diagnostic teams to access, review and report on patient scans and slides. This might mean an examination involving an x-ray, CT, PET, ultrasound or MRI scan, or digital images of patient tissue, which can inform vital patient diagnoses and allow healthcare professionals to monitor progression.
A substantial number of healthcare providers throughout the UK use Sectra’s technology, known as an enterprise imaging solution, including diagnostic teams throughout Health and Social Care Northern Ireland, in one of the largest initiatives of its kind called NIPACS+.
These are the customers Yousif has been supporting since just the first few weeks of his apprenticeship.
“We have the best customers: they are super nice, and they help me to learn,” he says. “Each time I’m on the phone with the customer we have a conversation that helps build a relationship, as well as responding to their needs.”
Yousif’s role has been to support customers as a first line engineer – where he has been trained to create environments to link hospital worklists to the Sectra software, so that diagnostic images can be appropriately stored. He is also a first point of contact for hospital teams requiring advice or encountering issues – where he helps to arrange appropriate engineer responses to ensure timely action and prevent disruption to hospital workflows.
Learning has been a mixture of formal training, mentoring, and doing. “I wouldn’t have felt so comfortable on calls and dealing with customers without the amazing training and hands-on experience I’ve had,” he says.
He adds: “The highlight for me at the beginning – a visit to a hospital.” This helped him to understand more deeply how customers use the technology that he helps to support.
‘So invested in my personal growth’
Yousif’s experience has helped him to develop significantly, even from a relatively early stage in the programme. “I’ve developed my skills so much – my technical skills, communication skills, and problem-solving skills,” he says. “I’m a much better team player.”
It’s the team, and the organisational culture, to which he attributes that development. “It’s incredible: You get to learn every day at Sectra,” he says. “You are surrounded by very knowledgeable people who are happy to lead you, support you and help you grow.”
“I’ve made friends for life,” he adds. “They are the nicest people to talk to. Everyone works with everyone. I’m surrounded by people who are really motivated, passionate and driven. People who want to make a difference. I wake up every day wanting to be part of this team.”
Yousif has also been able to expand his knowledge beyond the scope of the apprenticeship. “Sectra has been so invested in my personal growth,” he explains. “I explained my interest in AI. Although this isn’t part of my current job, the company offered to pay for me to do a coding course. It shows how much the company cares about my personal growth, and they want me to learn.”
A future in healthcare technology
Yousif has already been made to feel he can make a difference in his role. He gives an example of how he was encouraged by Sectra colleagues to share his ideas when he first started the apprenticeship. “Those ideas triggered a big conversation,” he says. “It was amazing realising I’m not just there to learn, but to participate.”
This experience has given Yousif a clear direction on where he wants his career to grow. “I am 100 per cent excited for a career in healthcare technology,” he concludes. “I want to do something that makes a difference, and this is something I love.”
The 10 Year Health Plan sees a big role for AI, but as things stand suppliers, trusts and clinicians are struggling to deploy, scale, and get the most out of the tools available.
Harry Lykostratis
Harry Lykostratis, chief executive of Open Medical, explains how its Keypoint project will address the challenges and create a framework for the adoption of agentic AI that can support more efficient and effective workflows.
The government’s 10 Year Health Plan makes a lot of the potential of AI-software to support clinical decision making, improve productivity, and guide patients around the NHS.
That optimism may be well founded: AI models are being developed and improved rapidly. However, what we are seeing right now is that health is struggling with applicability.
We have seen some success with ambient voice technology, but in many ways that is an evolution of existing ways of working. Scribes may capture more detail during a consultation and generate documents with less manual labour on the part of clinicians, but they are not going to unleash the revolution we have seen in other industries.
Scalability, applicability
So, what is holding health back when it comes to other applications of AI? From the conversations I have had with chief clinical information officers, it seems there is a lot of interest, but it is proving hard to experiment with these technologies.
Healthcare is reluctant to feed models large amounts of personal data, so they get trained on very sterile data that may come from just a few hundred cases. Integration with NHS systems is hard and expensive, so for most suppliers it is just not worth the effort to work at that level.
Also, models trained on just a few hundred cases are hard to scale, which makes it difficult to incorporate them into organisational workflows. We need to resolve these issues and start thinking about the near future, because over the next few years we are going to see a move from individual AIs to agentic AIs.
Today, we ask an AI a question, and it gives us an answer. Then we ask the AI another question, or we use another AI, to refine that output. In future, we’ll use an agent that can handle multiple outputs to achieve a specified end with much less – or no – intervention from us.
In some industries, it will be acceptable for these agentic AIs to operate as black boxes. We won’t really know how they achieve their goals, and they may evolve in ways that are hard to predict. I don’t think that will be acceptable in healthcare. Each step taken by an agentic AI will need to be transparent and we’ll want to be able to interrogate them to ensure patient safety.
Codename Keychain
Open Medical is addressing these challenges through a project that we have codenamed Keychain. Our cloud-based, pathway management platform, Pathpoint, already has many of the features required.
We are present in most trusts in England, so Pathpoint can already integrate with the major electronic patient record and enterprise IT systems in use in its hospitals. It can also handle the data cleansing and pseudonymisation needed to make large volumes of data available from these systems to AI models.
We want to create a single API, so that any AI tool integrated into the Keychain product can be securely and rapidly integrated with other systems, so trusts can both experiment with new models and rapidly scale those that work for them.
At the same time, we want to prepare for that coming era of agentic AI. So, our vision for Keychain is that it should be able to do four things. First, parallel processing.
Healthcare has a lot of data, in a lot of different formats, so we want a parallel model, in which it is possible to use all of them to generate an output. Second, sequential processing. We want to be able to take the output of one model and use it to prompt another model.
Thirdly, and critically, routing. We want to make sure those outputs are generated in the right order to act as agents that undertake specific tasks within a clinical workflow. Fourth, feedback. We want Keychain to enable AI models to re-use their own outputs, so they improve over time.
Four step framework applied
To see how this might work in practice, consider referral management, which is something we are already being asked to support at scale. In the traditional model of healthcare, a patient goes to see their GP and the GP refers them to a consultant, who advises them, or refers them on to another service, or puts them on a waiting list for treatment.
Referral management intervenes to triage the patient and decide whether a secondary care consultation is the really the most appropriate next step. At the moment, this triaging can also be undertaken by clinicians; but in the future it might be undertaken by an agent.
For this to happen, the agent would need to be able to handle the referral data. This might include a large PDF from the GP. There might be an additional input from the summary care record.
There might be a handwritten note from the patient, or a response from an online questionnaire. There might be an image from medical photography. So, we might send the electronic information to one AI model, and the questionnaire data to another AI model.
Then we might feed those outputs into another model that can decide whether to send the patient back to their GP, or suggest they visit a nurse or physiotherapist, or put them on an urgent care pathway, and generate a summary to write-back to the clinical record.
The outcome should be better use of resources and the removal of a significant bottleneck to timely care; but everything is done in a transparent manner, with guardrails so the patient can be picked up and referred back into the system, if necessary.
Making sure we are Fit for the Future
Open Medical is not looking to develop AI models. We are model agnostic: we think trusts and clinicians should be able to use any model they want. We are interested in agile models, that take outputs from one stage to the next.
Our ambition is to create a framework that will enable this to happen. Keychain will be able to integrate with the systems in use in an organisation, tap into and sanitise their data, route it to AI models, take their outputs, and present them back to the organisation in a useful way within the clinical workflow.
That will improve access for suppliers and enable trusts to move from having small pockets of AI within their organisations to using it to drive efficient, timely care. The government is right that there is huge potential in AI, but I think that now is the moment to address applicability.
We need to address the scale challenge and prepare for agentic AI. Otherwise, these potentially revolutionary technologies will have much less applicability in healthcare than ministers, trusts, clinicians and their patients hope.
Every winter, local authorities across the UK face the same challenge: how to keep civic buildings, council offices and public facilities safe and accessible while managing ever-tighter budgets. When facilities managers are asked to trim budgets, outdoor winter maintenance can often come under scrutiny. If the previous winter has been mild, then cuts here can seem like an easy saving on paper. However, gambling on the weather is a risk that almost always backfires.
The true cost of “doing nothing” extends far beyond the price of a gritting contract. A frozen footpath outside a civic centre is more than just an inconvenience; it can mean resident injuries, reputational fallout, costly legal claims and angry headlines in the local press. In the public sector, where scrutiny is constant and expectations are high, one bad winter can undo years of careful trust-building.
To see how expensive this gamble can be, let’s provide a practical example. NB – this is fictionalised version based on a several real case studies. Let’s imagine a hypothetical local authority, Eastborough Council.
Eastborough Council manages a civic centre, a large library, two public leisure centres and a portfolio of community buildings. For years, it had invested around £35,000 annually in proactive winter maintenance across these sites, including 24/7 weather monitoring, pre-treatment of entrances, and gritting of car parks and pedestrian areas. But in late 2024, faced with a funding shortfall, the council voted to cancel the proactive contract in favour of reactive gritting on an ad-hoc basis.
The decision looked like an efficient saving. The previous two winters had been relatively mild, and councillors argued that if severe weather arrived, contractors could simply be called in. But as with all gambles, luck eventually ran out.
In January, a sudden cold snap swept across the region. Overnight temperatures dropped sharply, and by morning the civic centre’s forecourt, library steps and leisure centre car parks were dangerously icy. With no proactive treatment in place, staff arriving early were the first to experience the consequences. Before 9 a.m., four residents had fallen outside the civic centre and library, two of them pensioners who required hospital treatment. The library was forced to close for the day, and the leisure centre cancelled morning classes after multiple complaints about unsafe conditions in its car park.
Local outrage grew quickly. Residents took to Facebook and X (Twitter) with photos of untreated pavements outside public buildings, using hashtags like #EastboroughIce. Within hours, the story was picked up by local newspapers under the headline: “Council Cuts Back on Gritting — Residents Pay the Price.” Opposition councillors seized on the issue, criticising the administration for putting cost savings ahead of public safety.
The fallout escalated further. Personal injury claims from the falls were later settled at around £25,000 each, including legal fees. Insurers increased premiums by 15% over the next three years, adding an extra £50,000 to costs. Local businesses around the civic centre reported reduced footfall, blaming unsafe conditions for lost trade, and submitted complaints to the council. Most damaging of all was the reputational impact: a public survey conducted weeks later found resident satisfaction with the council’s services had dropped by 18 points.
By spring, the £35,000 “saving” had unravelled into more than £250,000 in direct costs, not to mention political embarrassment and lasting reputational harm. For Eastborough Council, the gamble on the weather had failed spectacularly.
The Eastborough story may be fictional, but it highlights very real risks. Across the UK, local authorities are judged not just on financial stewardship but on how well they deliver visible, everyday services. Winter maintenance is one of the most visible of all. Residents notice immediately when footpaths, car parks and civic spaces are unsafe. A single incident can dominate local media, spark opposition criticism and erode community trust. In the world of local government, those consequences are measured not only in pounds and pence but in political capital.
The financial risks are equally stark. Slips and trips are the most common type of public liability claim against councils, costing millions every year. Cutting a modest winter gritting contract may save a few tens of thousands on paper, but one claim or closure can wipe out those savings instantly. And the hidden costs – reputational damage, lost community trust, reduced footfall in town centres – are harder to quantify but often more damaging in the long run.
So why do councils continue to cut winter maintenance? The answer lies in human psychology. We underestimate low-frequency, high-impact risks, convincing ourselves that “it probably won’t snow this year.” Councillors and officers under pressure to save money may gamble that luck will hold. But in a climate where weather patterns are increasingly volatile, with sudden freezes and icy rain becoming more common, relying on chance is not foresight. It’s negligence.
The smarter approach is to see winter maintenance as an investment in public safety, continuity and reputation. That starts with recognising that preventing accidents and disruption is always cheaper than responding to them. It means conducting thorough risk assessments, reviewing past claims and incidents, and modelling the return on investment for proactive gritting. It means ensuring providers offer guaranteed response times, accurate weather forecasting and auditable records that can be shared with insurers, auditors and residents alike.
At OUTCO, we see first-hand how proactive planning protects councils and communities. By combining live meteorological data with pre-agreed service schedules, we ensure civic centres, libraries, leisure sites and car parks are treated before ice can form. Our digital reporting systems provide councils with the evidence they need to demonstrate compliance, defend claims and reassure both insurers and residents. Most importantly, it gives councils confidence that they are doing everything possible to keep communities safe, rather than hoping luck will carry them through the winter.
The lesson from Eastborough Council is clear. The most expensive decision a local authority can make is to gamble on the weather. What looked like a £35,000 saving ended up costing over a quarter of a million pounds, alongside reputational damage and political fallout that will linger long after the ice has thawed. With budgets tight and winter approaching, councils face a choice: invest in proactive maintenance, or keep rolling the dice. But as every gambler eventually learns, the odds are never in your favour.
For more information on how OUTCO can bring an innovative approach to your winter gritting, contact 0800 0432 911 email enquiries@outco.co.uk or visit www.outco.co.uk
New data reveals 488 jobs were created and hundreds of people accessed apprenticeships and work placement opportunities within a year – thanks to national procurement experts Fusion21 helping companies smash their social value targets.
Working across housing, local authority, education, NHS, and blue light sectors, Fusion21 supports its members and suppliers to embed social value into projects.
The 488 jobs were created in 2024-2025 as a result of social value commitments delivered through Fusion21 frameworks – a 37% annual rise from the 356 jobs created in 2023-2024.
These opportunities were in sectors including construction, green skills, and housing and across a diverse range of roles, including water safety technician, senior site manager and graduate bid writer.
The data also shows that 96 jobs – around a fifth of all created – were for residents living in the areas where the work was being delivered.
Statistics also reveal that 39 of the jobs created were classed as ‘green sector’, defined as those with a decarbonisation or net zero focus. These positions included retrofit assessors, solar panel installers and low carbon heating technicians.
Overall, 2,497 jobs were created or sustained within a year, with the data showing that almost 10% of new jobs went to previously unemployed residents.
The combined number of apprenticeships sustained or created also shot up from 190 in 2023-2024 to 216 in 2024-2025.
There was also a 20% rise in the total number of people who remained in secure employment, increasing from 1,674 in 2023-2024 to 2,009 in 2024-2025.
Out of 107 new apprenticeships created in 2024-2025, 16 were in the green sector, and 25 apprentices were recruited locally.
Other statistics show:
· Out of 803 contracts, 66% saw those involved taking steps to reduce carbon emissions.
· In 41% steps were taken to reduce waste e.g. supporting community-level recycling, 17% saw measures implemented to reduce water consumption, 13% ran activities to engage local communities/schools/colleges to promote the benefits of renewable energy – and 51% of contracts delivered training initiatives to upskill existing members of staff around sustainability and green skills.
· Work experience placements including site visits rocketed from 296 to 478 – a 61% rise.
As part of their social value commitments, Fusion21 suppliers contributed materials and monetary donations worth £739,787. This ranged from gifting doorbell systems, to help domestic violence survivors feel safer at home, to charitable donations to a hospice and a guide dogs charity. Suppliers on Fusion21’s frameworks also embarked on 863 volunteering days for community projects, compared to 815 the previous year. This included a supplier assembling flat pack items for a resident with young children who after staying in a women’s refuge, moved into a new property.
Sarah Maguire, Head of Social Value at Fusion21 said: “This data again shows the hugely positive impact embedding social value into projects can have.
“By working with our members and carefully selected suppliers, we have created hundreds of new jobs and apprenticeships, including opportunities in the green sector and in the communities we serve. It is particularly pleasing to see roles created for people previously unemployed.
“We are committed to leading on sustainability and, as the data shows, it’s fantastic to collaborate with like-minded suppliers and members who share our ambition to change lives.”
Through impactful procurement, Fusion21 has delivered more than £300 million in social impact and created more than 16,600 employment outcomes. As a mission-driven business, social value remains at the heart of Fusion21, and it continues to make a tangible difference while delivering social value you can see.
First-of-its-kind technology installed in over 1000 social houses across the South West
Hewer, a leader in sustainable heating solutions, has launched Heat Saviour™, a groundbreaking technology that simplifies heat pump installations and maintenance, saving time, money and hassle.
As part of its Net Zero plan, the government aims to install 600,000 heat pumps annually by 2028, with gas boilers banned in new homes from 2027. Yet heat pump sales fell short last year, barely hitting 100,000 according to the Heat Pump Association. In response, the government has pledged to double the Boiler Upgrade Scheme (BUS) to £295m and launched a public awareness campaign to spotlight the £7,500 heat pump grant.
Heat Saviour™
Stuart Hesk, Director at Hewer, said: “Installing and retrofitting heat pumps can be complex, costly and disruptive. They are often designed with non-universal parts, requiring entire heating systems to be ripped out – systems that could have years of use left in them.
“Heat Saviour™ is a much smarter and cheaper way to install and use a heat pump, making property management easier and improving residential satisfaction. We saw the amounts of unnecessary waste, cost and downtime that installing and retrofitting heat pumps was causing. As a customer-first business, we set about inventing a solution to tackle these issues.”
Heat Saviour™ is a first-of-its-kind pre-assembled unit which conveniently sits underneath a standard hot water cylinder. Unlike traditional heat pump systems, which tie households into specific manufacturers’ components due to their singular loop design, Heat Saviour ™ enables the use of off-the-shelf components for quicker installation. Operating on a dual-circuit loop, the heat pump runs independently of the existing central heating, eliminating the need for system overhauls. This minimises disruption and downtime, cuts labour costs by up to 20%, and delivers homeowners savings of up to £2,000 per installation.
Heat Saviour™
With glycol only in the heat pump circuit (expensive antifreeze), it cuts glycol use by 80%, which is better for the environment, and allows radiator maintenance without the costly expense of having to drain and replace the glycol. The unit also has a built-in backup heating element, which can either be switched on manually or controlled remotely, avoiding downtime during maintenance or pump failure – crucial for vulnerable people – and reduces how often engineers need to enter the property.
Installed in 1,000 social houses
Over 1,000 social housing properties across the South West are already benefiting from Heat Saviour™, including those managed by social housing providers Two Rivers Housing Bromford, Green Square Accord, Rooftop Housing Group, Community Housing and Cottsway Housing Association.
Stuart continues: “There’s been no post-installation callbacks on the social housing installations since we implemented Heat Saviour™. One of the reasons for this is due to the central heating circuit being separate from the heat pump. This helps to prevent sludge from older systems – often still present even after cleaning – from reaching the heat pump filters, which can reduce performance and affect reliability.
“Our mission was to design a cost effective, durable and sustainable solution which makes the government heat pump grant go further. A design which simplifies installations from new builds to even older properties, which aren’t conducive to heat pump systems; meeting the needs of all homeowners, landlords and tenants, including social housing providers.
Sam Batt, Asset Investment Manager at Two Rivers Housing in Newent, Gloucestershire, said: “Heat Saviour has been a valuable part of our latest Social Housing Decarbonisation Fund project at Two Rivers Housing, installed successfully as part of the wider renewable technologies we have employed. Both these and the air source heating systems have proven reliable and have been an important step in our journey towards net zero. We have found them a reliable solution, smoothly installed by engineers who have been a pleasure to work with.”
Stuart added: “If the government succeeds in its goal of installing heat pumps in 600,000 UK homes a year, and each property is fitted with a Heat Saviour™, that’s an annual saving of £1.2 billion for the economy. Our unit empowers more communities to adopt greener heating methods, and most importantly, offers peace of mind – delivering reliability without the fear of premature failure.”
Founded in 1965, the company employs over 160 people, offering a wide range of heating, mechanical, electrical and renewable services for both domestic and commercial customers.
Thrive’s enhanced Impact Evaluation Standard ensures suppliers stay compliant with both the new PPN 002 Social Value Model and legacy PPN 06/20 rules.
Thousands of UK government suppliers risk falling foul of new procurement rules from last week — unless they can comply with both the old and new social value models.
Neil Macdonald
From last week, Procurement Policy Note 002 (PPN 002) becomes the mandatory standard for all new central government tenders — replacing previous rules and requiring a new approach to designing and assessing social value.
While thousands of existing contracts will continue under PPN 06/20, suppliers must now manage and report against two sets of requirements simultaneously — creating a compliance challenge across the market.
Thrive has now launched the only measurement framework and platform designed to meet this challenge from day one. Its enhanced Impact Evaluation Standard (IES) fully incorporates the requirements of both PPN 002 and PPN 06/20, enabling contractors and bid teams to switch seamlessly between models at the touch of a button.
Rob Wolfe, Managing Director, Chy Consultancy and Impact Evaluation Standard Steering Committee Member, explained: “PPN 002 sets a higher bar for social value in procurement. Suppliers will need measurement frameworks that not only incorporate the rules but drive better behaviour and make compliance practical. Thrive’s Impact Evaluation Standard is the first solution we’ve seen that addresses both the old and new requirements from day one.”
The Impact Evaluation Standard is widely regarded as the UK’s most credible and independent reporting standard for measuring social value because it is:
· Developed by an independent committee of experts, including one of the co-authors of HM Treasury’s Green Book and the Social Value Model.
· Built from the ground up to incorporate government procurement rules.
· Underpinned by the latest Office for National Statistics and government data sources, going well beyond the other frameworks which rely more heavily on the Unit Cost Database figures.
· Allows custom-built metrics to be combined with bespoke corporate reporting.
This marks the first time a UK measurement framework has been fully refreshed to incorporate both legacy and new government procurement rules. With annual public procurement expenditure in excess of £300billion, Thrive now offers suppliers and contractors a future-proof solution.
This October release introduces:
· 36 new metrics directly developed from PPN 002 requirements.
· A new framework structure aligned to the government Missions for clarity and usability.
· Platform enhancements allowing Thrives thousands of users to switch between PPN 002, PPN 06/20 and many other frameworks, instantly.
Neil Macdonald, CEO of Thrive, said: “From last week, suppliers must manage both PPN 002 and legacy PPN 06/20 contracts. Without the right measurement framework, that dual reporting burden risks delays or even lost bids. The updated Impact Evaluation Standard gives them a clear, compliant way to meet both requirements.” For more information, visit Thrive
Electric vehicle (EV) charge point operator (CPO) Believ has won the EV Debt Deal of the Year at the 2025 EVIE awards, recognising its role in helping to accelerate the rollout of public EV charging infrastructure across the UK.
Believ was nominated for its closing of £300 million of investment in June 2025, a landmark deal that will fund at least 30,000 charge points and positions Believ as one of the UK’s best-capitalised CPOs.The funding was led by Believ’s joint owners Liberty Global and Zouk Capital, Europe’s leading private equity investor in EV charging, alongside four retail and infrastructure financing banks – Santander, ABN Amro, NatWest and MUFG.
With this funding, Believ is able to deliver reliable, accessible, and scalable public charging infrastructure that will play a crucial role in supporting the UK to meet the government’s ambition to install 300,000 public charge points needed by 2030. The deal combines long-term financial security with flexible deployment capability and highlights the essential role of private capital in advancing the UK’s transition to net zero.
Believ’s expansion strategy focuses on both underserved urban areas where off-street parking is limited, and key transit corridors, ensuring equitable access to charging across the nation, and working towards Believ’s goal of cleaner air for all.
Guy Bartlett, Believ CEO, said: “We are delighted to have been awarded the EV Debt Deal of the Year Award, which recognises our efforts to ensure the investment in reliable and scalable charging infrastructure in the UK, and the urgency of the need.
“EV uptake will continue to grow as drivers see more infrastructure going into the ground and are given the confidence to make the switch to electric. At Believ, we are very proud to be at the heart of this journey.”
Health tech growth partner Highland has today revealed its new identity – reflecting a sharper focus as it helps health tech companies to find market opportunities, convince target audiences, and drive growth.
Known for nearly a quarter of a century as Highland Marketing, the company has built a strong reputation for launching and championing many successful health tech brands.
Setting a trend in the early 2000s, the company became one of the first integrated marketing and communications agencies to focus solely on health tech. Since then, it has helped a wide range of technology companies as they have hit headlines, won major contracts, influenced policy, and become market leaders.
Now formally known as Highland, the company’s updated identity reflects innovation in service provision that goes beyond traditional marketing. Health tech companies have engaged Highland to understand their viable market, to engage and convince health and care audiences, and to grow their business through a range of strategies to get directly in front of decision makers.
Mark Venables, CEO of Highland, said: “Health tech companies need more than just traditional marketing to succeed and grow. The ability to project our customers’ messages into the market remains important. But we have listened carefully to health tech companies as requirements have evolved, innovating in response. Resulting impact and the ability to respond to business objectives has led to us becoming a growth partner in health tech. Our updated identity reflects more than a brand refresh – but another leap forward to help drive health tech adoption, and take-up of technology that can make a meaningful difference to people’s lives.”
Highland’s message comes at a time of significant national focus on technology adoption in health and care. During 2025 alone the NHS 10-year health plan placed significant emphasis on moving from analogue to digital, and a separate Life Sciences Sector Plan has spelled out the importance of health tech for both health resilience and the UK economy. An urgency to scale innovation was also described in Lord Darzi’s 2024 independent review of the NHS, and in a November report on the NHS Innovation Ecosystem.
Susan Venables, founder and client services director of Highland, said: “There was an unprecedented opportunity for technology in healthcare when Highland Marketing was launched in the early 2000s. National policy is again focussed heavily on technology adoption. The emergence of innovation, including AI, is rapidly developing. And a rich UK health tech sector with thousands of companies means there is an especially strong opportunity to advance health and wealth.
“Delivering on that requires a new approach in 2025, so that innovative companies can respond to a new era in health tech – that’s why Highland has become a growth partner for our clients. I am immensely proud of the trust and confidence our team has earned in the sector, something we never take for granted. It means we have the connections, the expertise, and the services to be a driving force for health tech. As we help companies navigate the complexities of a changing sector, we are committed to helping them to find, convince, and grow their market.”
Full details of how Highland can support growth in the health tech sector can be found at highland.health.
Royal Navy sailors and marines interdict vessels carrying £35 million worth of illegal drugs in the Gulf of Oman
HMS Lancaster used crewed and uncrewed air assets to detect, monitor and intercept several high-speed drugs boats
Vital work disrupts flow of illegal drugs around the world, helping to keep narcotics off UK streets as part of the Plan for Change
Royal Marine snipers disabled a drugs boat speeding across the Gulf of Oman as frigate HMS Lancaster dealt a £35m blow to the illegal narcotics trade.
Commando snipers brought the ‘skiff ‘– zipping over the waves at speeds in excess of 40 knots while its crew tried to ditch their illegal cargo – to an immediate halt with a bullseye shot to knock out the boat’s engine.
The snipers took aim from a Wildcat helicopter launched from the warship to intercept three suspect craft in one of the most dramatic counter-drugs intercepts the Royal Navy has been involved with in the Middle East.
Pictured: HMS Lancaster’s wildcat helicopter and Royal Marines Boarding Team prepare to conduct a drugs seizure in the Gulf of Aden as part of operations in the Middle East in support of Combined Maritime Forces Task Force 150, and UK Maritime Component Command as part of Operation KIPION
More than 1½ tonnes of drugs were recovered in all – heroin, crystal methamphetamine and hashish with an estimated UK street value in excess of £35M.
Keeping the country safe is the Government’s first priority, and an integral part of its Plan for Change. The work of the Royal Navy at home and abroad is critical to the security and stability of the UK and directly contributes to the government’s Safer Streets Mission.
The UK remains steadfast in its commitment to our armed forces and has pledged to raise defence spending to 2.6% of GDP from 2027, with the aspiration to further increase it to 3% during the next parliament.
Minister for the Armed Forces, Al Carns, said:
“Outstanding work by the crew of the HMS Lancaster who stopped and seized £35M worth of dangerous and illicit drugs at sea. Moreover, a well-planned operation culminating in a surgical shot by a Royal Marines sniper disabling the engine of a vessel traveling at 40 knots. That’s excellence at work.
“Not only have our Royal Navy and Royal Marines disrupted a major criminal enterprise and kept drugs off our streets and away from our kids, but have once again demonstrated effectiveness, decisive action and the exceptionally high standard of our Royal Navy and Marines.
“I salute our Royal Navy and Royal Marines for their indefatigable work keeping us safe at home and strong abroad.”
This is the first time snipers have been called upon to use non-lethal force to disable a suspicious boat in the Gulf region – where typically slow-moving dhows are used to hide the illicit cargoes – unlike the Caribbean, where the tactic has proved effective on several occasions.
The operation began when HMS Lancaster launched her Wildcat from 815 Naval Air Squadron on a dawn patrol over the Gulf of Oman.
Her crew soon picked up three suspicious skiffs travelling at speed – and secretly shadowed them while relaying critical information back to the warship.
That allowed Lancaster to launch her Peregrine mini-helicopter drone to continue monitoring the skiffs – again undetected – providing a live video feed to the ship’s operations room.
Meanwhile, the Wildcat returned to refuel and embark a Maritime Sniper Team from 42 Commando – the Royal Marines’ specialists in boarding operations – to close in for the interception.
Pictured: HMS Lancaster’s ships Helicopter (Wildcat HMA Mk2) aircraft surveillance imagery of skiffs transiting through the Gulf of Aden, during HMS Lancaster narcotics seizure as part of operations in the Middle East in support of Combined Maritime Forces Task Force 150, and UK Maritime Component Command as part of Operation KIPION
When the helicopter appeared over the skiffs, their crews immediately increased speed to more than 40 knots and began hurling their cargo into the water to reduce weight.
Ultimately, it led to two of the skiffs being abandoned – but not the third which persisted in trying to get away.
At this point, the marines targeted the outboard engine, neutralising it with a single round, while crew of the warship’s sea boat recovered the discarded packages and located a partially-submerged abandoned skiff.
The operation highlights HMS Lancaster’s capability to deter illicit activities and disrupt the narcotics trade.
Commander Sam Stephens, Commanding Officer of HMS Lancaster said:
“I’m hugely proud of the team’s professionalism, patience, and skill throughout what was a protracted chase,”
“This operation saw Lancaster’s crewed and uncrewed aircraft working hand-in-glove under the direction of the ship’s operations room. The outcome was a highly-successful bust, removing large quantities of narcotics from the streets and preventing their profits from fuelling extremism.”
Wildcat pilot Lieutenant Guy Warry added:
“Non-lethal disabling fire has not been seen in the region and was essential in preventing the drug runners from moving their product.
“Being the Wildcat pilot carrying out a live weapons firing on drug-running skiffs whilst flying backwards to provide a stable platform for the snipers was definitely a career highlight.
“This interdiction is a true testament to the high levels of training that both the flight, MST and ship have achieved prior to the bust.”
HMS Lancaster is a Type 23 frigate deployed to the Middle East region on a long-term mission as part of wider efforts by the UK to provide regional maritime security and stability.
It’s the first bust Lancaster has scored since she intercepted a £30m shipment of illegal narcotics in late May.
Foreign Commonwealth and Development Office (FCDO) sought to optimize its system of suppliers’ code compliance and create total visibility across its commercial department via a single, unified platform. By leveraging JAGGAER’s Supplier Management, Sourcing, and Contracts solutions, the FCDO’s Supply Chain Risk: Ethics team has reduced supplier complaints, streamlined compliance and procurement processes and improved record keeping and collaboration.
What is FCDO?
The Foreign, Commonwealth & Development Office (FCDO) was established in 2020 following the merger of the Foreign and Commonwealth Office (FCO) with the Department for International Development (DFID). It leads the UK’s diplomatic, development and consular work around the world. Its staff operate a global network of 281 offices worldwide. The FCDO’s work in international development and aid is building a safer, healthier, more prosperous world.
The Challenge
The FCDO procures a wide range of goods, services, and contracts work, from embassy construction to technical assistance. To foster best practice and ensure effective use of UK taxpayers’ funds, suppliers must adhere to the FCDO’s values on ethics, sustainability, and responsible business, as outlined in its Supplier Code of Conduct (the Code). Historically, the FCDO’s Supply Chain Risk: Ethics team used a manual process, collecting supplier information through WeTransfer, Excel and PowerPoint, an approach that quickly became unmanageable. As a result, the team pivoted to a system originally designed for Supply Relationship Management (SRM) colleagues, inputting questions for suppliers to demonstrate compliance with the FCDO’s Code by submitting documents for evaluation. However, this system did not meet the team’s needs; it lacked scoring functionality, requiring a workaround using Excel spreadsheets to score responses and provide feedback. It was also unstable; recurring issues were seldom resolved promptly, and explanations for them rarely forthcoming. In all, the situation added growing ‘non-value’ time by having to explain issues to suppliers and eroded confidence in the platform within the team. The introduction of a new interface to the SRM system proved a tipping point for the FCDO to make a change. “We didn’t like it, we didn’t have the bandwidth to train our suppliers to use it, and it only presented the same information in a new format—we gained nothing,” says the FCDO Supply Chain Ethics Risk Manager. The team realized they needed a more reliable and stable solution, with integrated review, scoring, workflow, and reporting features.
The Solution
JAGGAER was selected as the Procurement platform for the newly created FCDO organization in 2020. This required substantial change within the commercial department, as the Supply Chain Risk: Ethics team, historically based in the Department For International Development (DFID), had not previously used JAGGAER, having relied instead on a supplier information management system. With limited time until their previous supplier’s contract expired, and subject to the same budgetary constraints as all other government departments, it was apt for the team to investigate the functionality for managing compliance inherent within the platform. “Plus, it tied in with the wider strategy of ‘one commercial’—that we would all work on one tool, with data available across different teams for different uses, but in a single location,” says FCDO Supply Chain Risk: Supplier & Financial Team Lead. When coupled with the opportunity to deliver cost savings and work across the FCDO’s entire commercial department from a “single system”, the platform’s potential presented a vast opportunity and an easy decision for leadership to support. Indeed, integrating compliance processes with the procurement process within a single system has created potential for greater collaboration within that wider commercial department. “That’s why we first and foremost investigated JAGGAER—it met those needs. And it didn’t need complex procurement after that because it had the functionality we were already paying for within our contract,” they continue.
With the system already in place at the FCO as a source-to-pay procurement platform, the newly merged FCDO added Supplier Management, Sourcing, and Contracts solutions. Information was transitioned from the legacy SIMS system to the new platform. The Supply Chain Risk: Ethics team supported suppliers with onboarding through the creation of training videos and user manuals with the Supply Chain Ethics Risk Manager and colleagues acting as ad hoc consultants to address any outstanding issues or queries—mostly around log-ins. “I’m still in the process of an initial deployment, as we have certain points in our cycle where we’re doing things for the first time in the live environment,” says the FCDO Supply Chain Ethics Risk Manager. While around 450 people are currently using JAGGAER across the commercial department—with a total of 500 licenses— that figure is around five for compliance, predicted to grow to 100, including suppliers.
When the platform was implemented as a compliance tool, it dramatically improved the supplier experience. After launching JAGGAER it for supplier collaboration, supplier complaints dropped significantly freeing up FCDO resources from circular investigations. “We had very positive feedback from suppliers,” reports the FCDO Supply Chain Ethics Risk Manager. “They like the way JAGGAER looks, the way it works, and the fact that it’s stable and reliable.” Where scoring was previously stand-alone via Excel spreadsheets—now, question sets, responses and scoring are all contained within the system. This enables better record keeping and makes it easier to access records and transfer responsibility for suppliers between team members in the event of absence or role change. Staff within the wider procurement team have visibility into whether a supplier is Code compliant or not, and integrating compliance processes with the procurement process within a single system has enabled greater visibility of supplier code compliance status within the wider commercial department.
With JAGGAER, The FCDO can now align the supplier’s Code compliance record with the Standard Selection Questionnaire (SQ) process—the first step in proving a supplier is qualified to submit a tender which involves them providing a considerable amount of basic information. Previously, suppliers had to provide this twice—once when preparing the tender and again as part of the compliance process. “Because we’re now on the same system, we’ve aligned the questions we’re asking for process documents in SQ to the questions we ask under the compliance process,” says the FCDO Supply Chain Ethics Risk Manager. “We’re comparing apples with apples—so if suppliers can show they’re Code compliant, they’re spared the time and effort of having to do it again.” The Supply Chain Risk: Ethics team successfully delivered the transfer of supplier information from its legacy compliance system to the new platform within a tight timescale. In doing so it is supporting an essential process of government with compliance now integrated into the full procurement lifecycle.
By Erica Hodgson, Change Management Practice Director at Differentis
The NHS isn’t broken because of who’s been in charge.
It’s broken because of how it works and how change has been managed in the past.
Earlier this year, the Government announced one of the biggest shake-ups in decades: abolishing NHS England and bringing the service back under the Department of Health and Social Care. Alongside this, a £3.25 billion Transformation Fund and a 10-Year Health Plan promise leaner operations, digital-first care, and more joined-up services.
On paper, it sounds ambitious. In reality, we’ve seen this before.
If you’ve worked anywhere near the frontline, you’ll know the issue isn’t structure. It’s the experience of trying to deliver care through broken systems, outdated processes, and exhausting workarounds. That’s where transformation fails: not in vision, but in execution.
As someone who helps NHS Trusts deliver change that sticks, I can say with certainty: transformation doesn’t fail because of policy. It fails when it isn’t built around people, process, and behaviour.
We don’t need another top-down restructure. We need a ground-up redesign that tackles what really stops progress: poorly managed change, disjointed processes, and systems that make care harder, not easier.
The Government’s reform and the real problems
To make this transformation meaningful, we need to be honest about what’s holding the NHS back. Without tackling deep-rooted inefficiencies and outdated infrastructure, this reform risks becoming another reorganisation without reform.
As Bev Wright, Head of UKI Public Sector at Adobe, says: “The Transformation Fund is a welcome signal of intent to unlock productivity and capability benefits of AI, but without organising data and replacing legacy systems first, it risks not moving us forward.”
The ambition vs reality:
What the Government says reform will achieve:
Reduce bureaucracy
Centralise decision-making
Streamline operations and funding
What the Transformation Fund aims to deliver:
Reduce inefficiencies
Drive transformation and reform
Support a leaner, more cost-effective public sector
But the reality remains complex. At an operational level, the NHS still faces:
Siloed data and fragmented digital systems
Poor process design and lack of interoperability
A culture that prioritises KPIs over patient experience
The State of Digital Government Report found that over half (50.4%) of public sector organisations spend more than 40% of their time and budget maintaining legacy systems — rising to 63% among arm’s-length bodies. In the NHS, 42% of processes are still paper-based. These legacy systems don’t just slow progress — they block it.
The other risk? Running before walking.
AI has been positioned as a key pillar of the Transformation Fund, but without solid foundations, it could add burden rather than value. NHS Digital leaders remain cautious, and rightly so. Without strong governance, robust data infrastructure, and clear standards, AI could become another compliance headache rather than a catalyst for change.
And while the 10-Year Health Plan promises neighbourhood health centres and digital-by-default pathways, these ambitions will fail without the right operational groundwork.
The risk of another ‘reorganisation without reform’
Previous NHS reorganisations, however well-intentioned, have often increased complexity instead of reducing it. Layering new governance over broken systems simply shifts the problem, rather than solving it.
Meanwhile, financial pressures are tightening. Trusts are expected to deliver 4% efficiency savings in 2025/26 — almost double last year’s target, and four times the NHS’s historical productivity growth rate. This comes as real-terms funding growth sits closer to 2% once inflation and cost pressures are accounted for.
These demands risk driving short-term cost-cutting rather than long-term reform. And with the dissolution of NHS England creating uncertainty around funding, many Trusts are left unsure how to progress digital projects or access new transformation resources.
That’s why the ability to control processes and maximise the use of existing funds has never been more important. Without clear safeguards, this reform risks deepening — not solving — the problems it aims to fix.
The five priorities the Government must get right
If this is to be more than another missed opportunity, reform must go beyond governance. It must address how care is delivered, how systems connect, and how change is managed.
Real transformation starts at the operational level and not the boardroom. Intelligent transformation is the key: designing systems and processes around people, powered by data, and driven by continuous improvement.
1. Follow the patient, not the process
The system must be designed around the full patient journey, not organisational silos. Clinicians cannot treat what they cannot see.
The 10-Year Health Plan promises to rebalance care around patients’ lives. But that vision depends on interoperability: the ability for systems to speak the same language, ensuring information flows seamlessly across GP, hospital, and community care.
At Nottingham University Hospitals, before rolling out electronic prescribing, we mapped every patient touchpoint — across wards, roles, and systems — to ensure digital tools matched real workflows. The result: fewer handover delays, better coordination, and safer prescribing.
That’s the difference between transformation that looks good on paper and transformation that works in practice.
2. Fix the way people work before you digitise it
Technology should amplify what works. Not hard-code what doesn’t.
Too often, new digital systems are implemented without addressing process inefficiencies first. This is where capability mapping comes in: understanding how departments actually operate, identifying breakdowns, and using technology to solve real problems, not hide them.
This approach prevents inefficiencies from being hard-wired into new systems. It ensures digital tools support — rather than disrupt — the way people work.
3. Stop draining staff to power broken systems
NHS staff don’t need resilience training. They need systems that work.
Transformation fatigue sets in when change demands extra effort but delivers little improvement. Staff want to be part of the solution, not the testing ground for poorly designed systems.
True reform must be collaborative. That means continuous feedback, co-design, and empowering teams to own change rather than endure it.
As we’ve seen in our NHS projects, co-creation reduces friction, simplifies workflows, and returns time to care. Transformation should make work easier, not harder.
4. Trust the people closest to the patient
Integrated Care Boards (ICBs) understand their communities — their needs, pressures, and digital maturity — better than any central body. They’re not a risk to reform; they’re the key to making it work.
The Government should set national standards and direction but give local teams the freedom to adapt solutions to their context. The most successful transformation programmes are those that flex to local realities, not those dictated by one-size-fits-all models.
5. Redefine what ‘good’ looks like
Dashboards don’t save lives. Better decisions do.
If the patient’s journey feels seamless for the system but painful for them, the metrics are wrong. The NHS needs to measure what matters: faster recovery, earlier diagnosis, fewer delays, and higher confidence in care.
Data should be actionable, not decorative. Every dataset should have purpose — who uses it, why it’s needed, and how it improves care. Transformation isn’t about collecting more data; it’s about using it intelligently to create meaningful outcomes.
A once-in-a-generation opportunity
This reform could be a defining moment for the NHS, but only if it tackles the operational challenges that sit beneath the headlines.
We need to stop pushing transformation onto NHS staff and start building it with them. Real reform means designing services that fit around people, not the other way around.
That’s where effective change management becomes essential. It’s not about training slides or communication plans. At its best, it’s the art and science of helping people adopt new ways of working with confidence and clarity. When done well, it connects strategy to behaviour, surfacing blockers and ensuring change sticks.
At Differentis, we’re working with NHS Trusts across the UK to help leaders map capabilities, define value, and make confident progress, even when the funding picture is uncertain. Our focus is on intelligent transformation: operational insight, people-first design, and change management that delivers measurable results.
The NHS doesn’t just need a new structure. It needs a new strategy. One built on data, collaboration, and human insight.
If the Government gets this right, it could mark the beginning of a truly smarter, more connected NHS.
A once-in-a-generation opportunity to make transformation real.
How East Riding Council is using data to drive energy decisions across its estate
As the public sector accelerates its decarbonisation efforts, East Riding of Yorkshire Council is proving that sustainability can unlock innovation, efficiency, and lasting impact.
With an urgency to decarbonise the public sector estate, one council is demonstrating that sustainability can be a driving force for transformative change.
In a recent interview, TEAM Energy spoke with Robin Barmby and Stephen Fisher, Principal Asset Officers at East Riding of Yorkshire Council, to explore their pioneering energy initiatives and strides in operational efficiency. Their approach demonstrates how data-led decision-making and creative solutions can deliver meaningful environmental impact alongside substantial cost savings.
Driffield Leisure Centre Solar Car Port
Implementing energy efficiency measures
East Riding of Yorkshire Council has made significant advances in solar energy, investing more than £2 million in rooftop installations since 2012, supported by the Feed-in Tariff initiative. Several schools have benefited from similar projects, and one of the most rewarding efforts involved revisiting sites initially deemed unsuitable and finding creative ways to install panels.
“We’ve had the most success with our solar panel rollouts,” said Robin Barmby, Principal Asset Officer. “Revisiting sites that were initially omitted and finding innovative ways to install panels has been particularly rewarding.”
The council also launched a small-scale solar farm connected to a caravan park—one of its highest energy consumers—where solar generation aligns well with peak usage. In addition, Stephen Fisher, also a Principal Asset Officer, highlighted the integration of photovoltaic (PV) systems into the council’s annual roofing programme for council-owned housing. Combined with insulation upgrades, this has proven to be the most cost-effective method for improving Energy Performance Certificate (EPC) ratings in residential properties.
Elevating energy efficiency projects through training and technology
Stephen Fisher emphasised the importance of strategic training with facilities managers, particularly on optimising Building Management Systems (BMS) to reduce energy usage. The council’s Climate Change team also plays a crucial role in raising awareness and promoting good environmental behaviours across the organisation.
Robin Barmby discussed the vital role of technology in identifying and delivering energy savings. By using benchmarking and submetering, the council has been able to pinpoint the exact zones or equipment within buildings driving poor performance. This data-led approach has made the entire process far more efficient and impactful than traditional energy audits alone.
Innovative solutions with significant impact
One of the most effective technologies implemented by the council is the Variable Speed Drive (VSD), which allows precise control of motor speed based on actual demand. This technology has been particularly impactful in leisure centres, where it has led to significant energy savings with a quick payback period.
Achieving cost savings and carbon reduction
The council’s solar projects have had the most significant impact on cost savings and carbon reduction. Additionally, LED street lighting upgrades with percentage dimming have contributed to long-term savings across the estate.
Securing funding for energy efficiency initiatives
East Riding of Yorkshire Council has been proactive in securing funding for its energy efficiency projects. Over the past 12 months, the council has secured approximately £6.5 million in funding, enabling nearly £17 million worth of project work. This includes funding from the Public Sector Decarbonisation Scheme (PSDS), the Mayoral Fund, the Swimming Pool Support Fund via Sport England, and Warm Homes funding.
Advice for other councils
Robin Barmby advises other councils to start with reducing demand, then focus on efficiency, and finally look at renewables. Stephen Fisher adds that data analysis and benchmarking should be the first step to understanding performance across the estate and prioritise interventions.
Andrea Shoel, Business Development Manager at TEAM Energy, said:
“East Riding of Yorkshire Council’s approach to energy efficiency is a testament to the power of data-driven decisions and innovative solutions. Their success story is an inspiration for other councils aiming to achieve similar goals.”
Looking ahead
East Riding of Yorkshire Council’s energy journey is a powerful example of what’s possible when data, innovation, and strategic thinking come together. By focusing on demand reduction, efficiency, and smart deployment of renewables, the council has delivered measurable carbon and cost savings. Their success underscores the importance of long-term vision, internal capability, and dedication to revisiting and rethinking legacy projects.
Overall sentiment towards the new legislation was focused on integration and simplification, with almost 80% saying HMRC needs to do more to integrate its systems and simplify its processes
75% suggest they will be looking for technology to help manage compliance and conduct real-time audits.
Varun Monteiro
As HMRC announces its decision to introduce Joint and Several Liability in April 2026, new research from Finity has found that almost 80% of recruitment agencies want the tax authority to do more to integrate its systems and simplify processes.
Commissioned by recruitment back office platform, Finity, the survey of employees within finance departments in temporary recruitment agencies explored sentiment towards the landmark ‘Tackling Non-Compliance in the Umbrella Company Market’ legislation, set to take effect from 6 April, 2026.
Integration, simplification and technology is key
An overwhelming four-fifths (79%) of respondents state that HMRC needs to do more to integrate its systems and simplify processes. This was followed by the need for technologies to support adherence to these new legal obligations, with three-quarters (75%) suggesting they will be looking for technology to help manage compliance and conduct real-time audits.
Varun Monteiro, CEO at Finity, said: “The latest update from HMRC marks a welcome, but significant change for umbrella companies and agencies, with accountability pushed further up the supply chain and significant financial repercussions for errors.
“However, our data shows a clear call from recruitment businesses for urgent action from HMRC and the broader industry when it comes to systems, processes and enabling technologies.
“Our research, combined with our detailed whitepaper, presents a bold call to action for HMRC to provide the digital infrastructure required to tackle compliance at source. While HMRC’s accompanying Transformation Roadmap is a positive step forward, it is clear better integration and the ability to cross-check payslips with HMRC data through simple APIs, directly within payroll systems, is vital.
“Only by making essential tax information more accessible and instant, can the recruitment sector be truly empowered to verify their tax liabilities efficiently and with confidence.”
The need for a modernised and transparent tax system, powered by technology
Dale Simkiss, compliance expert and Non-Executive Director at Finity, added: “Currently, businesses in the recruitment sector face significant challenges in verifying whether tax liabilities have been accurately reported and settled in their supply chain.
“As the industry prepares for a new legislative landscape, now is the time to modernise the way we manage tax compliance, which will help ease the burden on the sector, mitigate financial risks and create a more transparent and trustworthy tax system.”
Varun Monteiro, concluded: “This will be made even more challenging with HMRC’s new regulations which seek to enforce stronger measures for tax transparency and accountability.
“As our research has indicated, there is strong desire for new technology, not least because of the lack of efficient, real-time access to tax data, which is likely to hamper efforts to comply, leaving businesses vulnerable to compliance failures, fraud or reputational damage.”
To view the full report, which outlines the roadmap Finity is proposing to help HMRC and the wider market deliver a modern and compliant tax system, please visit www.finity.co.uk/tax-compliance-whitepaper/.
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