Building a Prevention-First, Data-Enabled NHS by 2035: Insights from a techUK, Axiologik and Opencast roundtable
Ahead of the techUK Health & Social Care Dinner in Leeds, techUK convened a senior, invitation-only roundtable in partnership with Axiologik and Opencast to explore a critical question: what would a genuinely prevention-first, data-enabled NHS look like by 2035 - and what must change to make it a reality?
The discussion brought together senior leaders from across the NHS, regulators, research bodies and industry. It focused on the practical enablers required to move from a predominantly reactive, sickness-based model of care to one centred on prevention, early intervention and population health management - placing particular emphasis on the transformative potential of genomics and data.
The roundtable highlighted both the scale of ambition set out in the NHS 10-Year Plan and the systemic challenges that must be addressed across data infrastructure, workforce capability, governance, commissioning and delivery models.
From treatment to prevention
A consistent theme throughout the discussion was that the NHS today remains fundamentally structured as a sickness service, rather than a prevention system. Participants agreed that achieving a prevention-first model will require not just incremental improvement, but a fundamental redesign of how care is delivered, funded and experienced.
Moving upstream by identifying risk earlier, intervening sooner, and supporting people to stay well demands a shift in mindset across the system. This includes rethinking where care takes place, how services are accessed, and who holds responsibility for health outcomes. While the NHS will play a central role, participants emphasised that prevention extends beyond healthcare alone, encompassing wider determinants such as lifestyle, environment and socioeconomic factors.
A key challenge is engagement: how to reach those who do not traditionally interact with NHS services until they become acutely unwell. Innovations such as home-based testing, expanded use of the NHS App and community-based diagnostics were seen as essential to “meeting patients where they are.” However, participants cautioned against assuming digital-first approaches will work for all, highlighting the need for inclusive design.
Data, interoperability and the foundations of prevention
The conversation underscored that a prevention-first NHS must be built on robust, interoperable data infrastructure. While the NHS holds vast quantities of data, participants repeatedly highlighted the paradox that much of it remains fragmented, inaccessible, or underutilised.
Key priorities identified included:
- Integrating genomic and risk data into routine care pathways, ensuring that insights are not siloed but used to inform clinical decision-making at scale;
- Improving interoperability and standards, so that data can flow across organisational boundaries and care settings; and
- Translating insight into action, bridging the gap between analytics and frontline delivery.
There was strong interest in emerging approaches such as population health “digital twins” and advanced AI models capable of predicting disease trajectories. However, participants stressed that the challenge is not simply technical. It is equally about building trust - in data, in systems, and in how insights are used.
A recurring concern was that the NHS often generates insight that it lacks the capacity or mechanisms to act upon. Without changes to pathways, workforce models and incentives, data risks becoming an underutilised asset rather than a driver of transformation.
From risk prediction to real-world prevention
The roundtable explored what it means in practice to move from predicting risk to preventing disease. While the tools to identify high-risk individuals are improving rapidly, embedding these insights into everyday care remains a significant challenge.
Participants pointed to the Genomics Medicine Service as an important step forward but noted that scaling its impact requires clarity on what “good” looks like for both clinicians and patients. This includes defining how genomic risk is communicated, who is responsible for acting on it, and how it is incorporated into clinical workflows.
A central question emerged: how do we identify and engage individuals with undiagnosed conditions before they present in crisis?
AI-enabled triage, risk stratification tools, and proactive outreach were all discussed as potential solutions. However, these approaches depend on high-quality data, clear governance frameworks, and system capacity to respond.
There was also recognition that prevention requires greater personal agency. Some participants argued for stronger incentives for individuals to engage in healthier behaviours, while others emphasised the need for supportive systems that make prevention easier and more accessible. One participant highlighted that current estimates suggest over 20% of adults may have undiagnosed long-term conditions - a cohort whose needs, if unaddressed, represent one of the largest single burdens on the NHS. Identifying and engaging this group was seen as arguably a higher priority than lifestyle-focused prevention alone, and one that makes the case for proactive data-driven screening and risk stratification even more compelling.
Trust, governance and the use of data and AI
Trust was identified as the single most important enabler of a data-driven prevention model. Without public confidence in how data is used, shared and protected, even the most advanced technologies will fail to deliver impact.
Participants highlighted several key components of “trusted use”:
- Transparency about how data is used and the benefits it delivers
- Robust governance and assurance mechanisms, particularly for AI
- Clear communication with the public, including involving patients in shaping solutions
- Demonstrable outcomes, showing how data improves care and health outcomes
There was broad agreement that the UK has the technical capability to deliver world-leading data-driven healthcare, but that cultural and institutional barriers - particularly risk aversion - remain significant constraints.
The proposed Health Data Research Service was seen as a potential step forward, offering a “single front door” for data access. However, participants stressed that improving access must go hand-in-hand with building trust and ensuring data is used responsibly. Several participants noted that surveys suggest the majority of the public are in fact willing to have their data used to improve healthcare - and that the challenge lies less with public attitudes than with the failure of the system to communicate effectively and build on that latent goodwill. One proposed model for empowering patients was the ability to control and port their own health records - similar to current account switching in banking - giving individuals granular control over who sees what, and enabling a genuine shift from data as a system asset to data as something patients feel ownership over.
A further concern raised was the risk of AI models encoding or amplifying existing biases - producing outcomes that are discriminatory or inequitable across different population groups in ways that may not be immediately visible. Participants emphasised the importance of robust bias auditing and noted that the UK’s emerging regulatory framework, which requires AI systems used in clinical settings to carry a unique identifier enabling retrospective analysis of their outputs, offers a distinctive and valuable safeguard. This was cited as an area where the UK should have genuine confidence in its position.
Workforce, skills and system capability
Delivering a prevention-first NHS will require new skills and capabilities across the workforce. While many of the necessary skills already exist within the system, they are often fragmented or not deployed effectively.
Key gaps identified included:
- Digital and data literacy across clinical and operational roles
- Specialist expertise in genomics and data science
- Capability in procurement and commissioning to support innovation
- Leadership skills to drive cultural and organisational change
Designing for the NHS of tomorrow
A critical insight from the discussion was the need to design for the future NHS, rather than optimising the current system. Participants cautioned that much of today’s innovation is constrained by existing operating models, limiting its transformative potential.
To unlock prevention at scale, the NHS will need to:
- Shift care from hospitals to communities, supported by digital infrastructure
- Strengthen vertical integration, connecting services across the patient pathway
- Reform payment models, incentivising prevention rather than activity
- Increase decentralisation, enabling local systems to innovate
This will require what several participants described as “bravery” - a willingness to move beyond incremental change and embrace new models of care. This theme of bravery ran throughout the discussion - and participants were clear that it is currently absent. There is a pervasive culture of caution within the NHS in which doing nothing is often perceived as safer than taking action and making a mistake. This risk aversion, while understandable given the pressures facing the system, was seen as a significant drag on progress. One exchange in particular captured this tension sharply: the question of whether a clinician who discovered something in a patient’s data that they could not immediately act upon would be obliged to tell the patient. The discussion surfaced a view that non-disclosure might be preferable – precisely to avoid triggering obligations that the system currently lacks the capacity to fulfil. For many participants, this illustrated starkly how institutional caution can work against the very prevention-first ambitions the system is trying to pursue. The view was clear: greater permission to innovate, and a loosening of the constraints that discourage action, could materially accelerate progress.
Key takeaways and next steps
The roundtable surfaced a clear set of priorities for policymakers, system leaders and industry:
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Define a shared vision of prevention
Establish a clear, system-wide understanding of what a prevention-first NHS looks like in practice.
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Unlock the value of data
Improve interoperability, access and governance to ensure data can drive real-world impact.
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Build trust with the public
Engage patients transparently and demonstrate the benefits of data use.
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Reform incentives and delivery models
Align funding, commissioning and organisational behaviour with prevention objectives.
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Invest in workforce capability
Develop the skills and leadership needed to deliver a data-enabled system.
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Design for the future, not the present
Move beyond existing constraints to build a system fit for 2035 and beyond.
Continuing the conversation
The insights from this roundtable will inform a series of follow-on activities led by techUK, Axiologik and Opencast throughout 2026, including further stakeholder engagement and member discussions.
Achieving a prevention-first NHS will require sustained collaboration across the health ecosystem. This roundtable represents an important first step in shaping that collective ambition - and identifying the practical actions needed for delivery.
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