AI, Digital Maturity and Resilience at HTN Live Leeds

HTN Live Leeds brought together NHS digital leaders, clinical leaders, technical teams and industry partners on 16 September for a day of discussions focused on the practical challenges shaping healthcare transformation across the UK.

As headline sponsor, Rackspace Technology joined conversations spanning enterprise AI, digital maturity, electronic patient records (EPRs), the Federated Data Platform, cybersecurity, cloud infrastructure and interoperability. Rackspace CTO Simon Bennett also presented on how NHS organisations can govern, operate and scale enterprise AI securely across their environments.

Across panels, workshops and peer discussions, several themes surfaced repeatedly. AI adoption is advancing, but governance and clinical oversight remain central concerns. Digital maturity is increasingly being measured by operational capability rather than technology deployment alone. Data platforms are creating new opportunities while raising questions about implementation, sustainability and control. And cyber resilience is moving higher on the agenda as NHS organisations consider how to protect and recover critical systems.

Those conversations point to four priorities shaping the next phase of NHS digital transformation: AI governance, digital maturity, data utility and cyber resilience.

AI adoption is advancing, but governance is shaping how it scales

AI was a recurring topic throughout HTN Live Leeds, but the discussions showed that NHS organisations are adopting it at very different speeds.

Some trusts remain cautious about broader deployment as they work through questions around clinical safety, diagnostic drift and the absence of a clear national recourse model when AI-supported decisions go wrong. Others are already using mature AI capabilities embedded within radiology, picture archiving and communication systems (PACS), patient administration and other clinical systems where the technology supports defined tasks within established workflows. At the same time, individual teams are experimenting with tools such as ambient voice technology for clinical documentation and automation designed to reduce appointment friction.

That uneven adoption is also creating governance challenges. When approved tools do not keep pace with the needs clinicians are trying to address, staff may turn to consumer AI platforms outside centrally managed environments. The discussion around this kind of shadow AI reinforced the need for approved tools, clear controls and visibility into how AI is being used.

Across these different use cases, one principle remained consistent: AI should support clinical judgement rather than replace it. Human oversight, transparent audit trails, deterministic controls and clear governance need to remain part of how NHS organisations evaluate, deploy and operate AI, whether they build capabilities internally, buy them through existing platforms or work with partners.

Digital maturity is evident in operational capability

Digital maturity was another recurring theme at HTN Live Leeds, with discussions extending beyond whether an organisation has deployed a particular platform to how effectively that technology supports the broader care environment.

Frameworks such as HIMSS Stage 6 and the national Digital Maturity Assessment (DMA) can provide a high-level view of maturity. But having an electronic patient record does not show how deeply the system is integrated across acute, community and primary care settings, how confidently staff use it or whether it is reducing pressure on frontline teams. Those operational factors provide a clearer measure of whether digital investments are translating into meaningful capability.

The conversation also highlighted the importance of what happens after implementation. EPR optimisation, interoperability across Integrated Care Systems, workforce digital literacy and an actionable data strategy all influence whether core platforms can deliver sustained value.

Legacy deprecation is part of that picture as well. Running older systems alongside newer platforms can add cost and complexity while preserving vulnerabilities that organisations intended to leave behind. A mature digital environment therefore includes a clear plan for retiring legacy services once replacement platforms are established and operating effectively.

The Federated Data Platform is moving from concept to execution

Discussions related to the Federated Data Platform (FDP) focused on how its enterprise ontology can bring diverse clinical records into a standardised, accessible model and how organisations can extend its value beyond secure reporting and analytics. A key challenge is implementation. Even where hosting or software licences are supported or subsidised centrally, individual trusts still have to extract, clean and map legacy data into a common model. That work can require significant local resources before the platform can deliver value.

Long-term sustainability was another concern. NHS leaders discussed what happens as central funding models evolve and how ongoing hosting, compute and public cloud consumption could affect regional operating budgets.

Regional differences also shape how the platform needs to operate. Patient populations can vary significantly across urban and rural settings, creating different requirements for analytics and AI. The discussion highlighted the need to support local models and use cases, including specialised small language models (SLMs) tailored to population health needs, while maintaining appropriate data boundaries across the broader platform.

There is increasing emphasis on the recovery side of cyber resilience

Cybersecurity discussions at HTN Live Leeds went beyond preventing attacks to focus on how NHS organisations can contain disruption and restore critical services when an incident occurs. Two areas of exposure stood out. The first was the workforce, particularly as social engineering tactics become more sophisticated across mobile and SMS channels. The second was the supply chain, where the resilience of NHS organisations is increasingly tied to the security practices of third-party suppliers and technology partners.

The discussion also turned to how recovery environments are designed. If recovery systems sit within the same production environment that has been compromised, they may be exposed to the same attack. Separating recovery capabilities from production infrastructure and making those environments isolated, immutable and sovereign can give organisations a protected foundation from which to restore critical clinical systems safely and quickly.

Sovereignty should extend across data, AI and operations

Across the discussions at HTN Live Leeds, sovereignty surfaced as a broader operating consideration rather than a single infrastructure decision. It touches how healthcare organisations control sensitive data, where workloads run, how AI is governed, who can make changes and how critical systems are protected and recovered.

For NHS organisations, those decisions have to support both innovation and control. AI and data platforms may span multiple systems, partners and environments, but organisations still need clear boundaries around access, processing, governance and operational authority.

The Rackspace sovereign perspective fits naturally here. It can include repeatable architecture patterns, isolated recovery environments and operating models that define how data, infrastructure and AI are governed across the organisation. The goal is to give healthcare organisations greater control over data, infrastructure and AI while supporting the operational capabilities required to run those environments reliably at scale.

Digital investment should improve how care is delivered

The discussions at HTN Live Leeds pointed to a common challenge across AI, digital maturity, data platforms and cyber resilience: digital investment needs to strengthen day-to-day operations and support care delivery.

That calls for clear AI governance, integrated platforms, resilient recovery capabilities and defined control over data, infrastructure and operations, with progress measured by outcomes such as stronger clinical capacity, reduced legacy debt and improved patient safety.

Rackspace works with healthcare organisations to build and operate secure, sovereign environments across data, applications and AI.

Learn how Rackspace can help NHS organisations support more resilient, reliable care delivery.