Demand is rising, capacity is constrained, and too many patient journeys are slowed by fragmentation: disconnected entry points, handovers between services, and records that don’t move with the patient. The result is delay, duplication and pressure shifting to the most stretched parts of the system. The result is delay, duplication and pressure shifting to the most stretched parts of the system.

This paper argues that the next step is not more isolated digital tools, but a shift in the operating model of care: clinically governed, end-to-end pathways that work across settings and modalities. Digital-first care, done well, will improve access and continuity while reducing avoidable administrative burden for clinicians. It can do so without compromising safety, equity or accountability.

The paper sets out a practical reference model for delivery:

Scaling this model requires more than technology. The barriers are structural: fragmented policy ownership, inconsistent standards, uneven trust, and persistent digital inclusion gaps. Treating connectivity, digital identity and data standards as core health infrastructure is essential to ensuring digital-first care scales safely and fairly.

The paper also makes the economic case for action. Poor health is a growing drag on productivity, with rising long-term sickness and economic inactivity. Earlier access to clinically governed support - including through employers and occupational health pathways - can speed recovery, reduce absence and strengthen workforce participation, particularly when embedded into return-to-work models.