The NHS App must evolve into a person-centric platform that reduces inequalities, empowers citizens, and strengthens system sustainability through intelligent design.
After 76 years, the NHS faces a choice: keep patching workflows designed for a different era or seize this moment to re-imagine and architect intelligent, interconnected systems that will power British healthcare for the next century.
The NHS 10-Year Plan, Fit for the Future, sets out a clear ambition:
· From sickness to wellness
· From analogue to digital
· From hospital-centric to community-based care
We believe the NHS App sits at the centre of this transformation. Once a transactional record keeper for prescriptions and appointments, it now has the potential to become what Health Secretary Rt. Hon. Wes Streeting has called a "doctor in your pocket": a trusted digital front door to prevention, care and personalised support for all of England's 58 million citizens.
Why the NHS App matters
By the end of 2023, 33.6 million adults had downloaded the app; monthly logins exceeded 50 million in the first quarter of 2025; and 99.7% of GP practices were connected. It has already avoided 1.5 million missed appointments and replaced 50 million paper letters. During COVID-19, it became a national gateway to vaccination and travel certification.
These are strong foundations, but numbers alone don’t equal health. The true test of success is not downloads and login metrics but whether the app can help people stay well, better manage their health, prevent illness at scale and provide equitable access to timely care.
Internationally, examples like Australia’s My Health Record, which now cover 99% of citizens, show that inclusive digital health infrastructure can scale. We believe, the UK has the same opportunity, if it commits to prevention as seriously as it funds treatment.
In perspective: Marcus’s story
Marcus is a 45-year-old construction worker with a family history of heart disease. At a routine health check, he is told his blood pressure and cholesterol levels are slightly raised. These are early warning signs - not yet at the treatment threshold, but serious enough to act on.
Today, his path is predictable: generic advice, a leaflet, and a request to return in six months. There is little structured follow-up, no support between appointments, nor a recognition of his wider circumstances. Risks quietly accumulate until a health crisis strikes Marcus.
Now imagine an alternative.
In a reimagined NHS, Marcus’s NHS App is his health partner. Built on person-centric architecture, embedding the latest AI models and other emerging technology, it integrates his clinical record with wearable data, local services and even postcode-linked risks like air quality. Instead of generic advice, Marcus now receives realistic prompts – meal options he can fit around long shifts or nudges when his wearable detects stress. All of this flows back into his GP record, giving his care team a longitudinal view of his health, not just isolated snapshots.
Six months later, Marcus’s blood pressure is lower, but more importantly, his behaviour has changed. He is supported by digital infrastructure that sees him as a worker, father, and citizen. The likelihood of a costly cardiac emergency is dramatically reduced.
This is what a true “doctor in your pocket” looks like: not a record keeper, but a partner in health.
From prescription to prevention
Currently, the NHS is largely reactive, focussed on treating illness as it emerges. But the burden of chronic disease makes this unsustainable. Diabetes alone cost the NHS over £10 billion annually. More than 2.5 million people are inactive due to long-term sickness, 400,000 more than in 2019.
Prevention is not optional. It is the only way to make the system sustainable. Evidence shows primary prevention delivers a four-fold return on investment, with far greater gains in quality-adjusted life years than conventional treatment. Yet in 2023, only 5.2% of total government healthcare spending went toward preventive care. Until the prevention budgets are treated as seriously as surgery budgets, the NHS will remain stuck in firefighting mode.
Key opportunities for innovation:
At Cognizant, we see four areas where innovation can help the NHS App evolve into a true health partner:
· Everyday Companion: Expand the NHS App from an access point into a regular touchpoint that helps citizens make intelligent health decisions based on their health profile.
· Smart Guidance: Draw on health records and context to direct people to the right care at the right time.
· Predictive Alerts: Apply innovations in Artificial Intelligence to flag risks such as medication conflicts, missed follow-ups, or rising health concerns before they escalate.
· Personalised pathways: Connect GP, hospital, pharmacy, and social care services so navigation across health interactions feel seamless.
This is where person-centric architecture is critical. Systems must be designed around people’s lives, not institutional or technical silos, embedding prevention and support as the default, not the afterthought.
Transformation, scale through ecosystems
No single organisation can deliver this transformation alone. We need ecosystems: partnerships that bring together diverse expertise across design, strategy, technology, and digital inclusion. Together, we can build digital tools architected as intelligent platforms rather than isolated applications; sandboxes that can enable safe testing of new services; and platforms that integrate seamlessly and securely with NHS infrastructure while preserving data sovereignty, adapt and scale over time, and keep citizens at the centre.
It enables citizens to become active participants in their care, not passive recipients of services. This is essential when life expectancy already differs by nearly 19 years between England’s richest and poorest communities.
By weaving inclusivity into every layer, so that digital poverty, literacy, or access don’t become barriers, we ensure the “doctor in your pocket” truly works for everyone, ensuring nobody is left behind.
The risk of doing nothing
The greatest risk is not that the NHS App fails. To us, it’s that it succeeds on the wrong terms: optimised for efficiency but not for better health outcomes.
That would mean:
· Fragmented care that fails to prevent avoidable illness
· Digital tools that widen, not narrow inequalities such as exclude underserved groups
· Unsustainable pressure on acute services as demand rises
What will success look like
Clear outcomes will define success:
· Equity: Nobody left behind.
· Prevention: Lives extended, conditions like that of Marcus’s are prevented, crisis averted.
· Sustainability: Reducing demand on hospitals, freeing capacity for complex cases, and bending the long-term cost curve.
If the NHS App can deliver on these outcomes, it won’t just be a platform for efficiency, it will be the foundation of a healthier nation.
That for us at Cognizant, is a transformation worth building.
