This year’s GIANT health event made a splash. In its wake, residual “drops” of healthcare wisdom are left on the sidelines, reflecting what looks to be a future driven by fancy technology and robots performing surgeries. Perhaps the clearest image, though, is the small changes that are happening right now. Reinventing the wheel is all well and good, but when it comes to healthcare, “slowly and surely wins the race” might be a better strategy. 

Innovation with nowhere to go

David Lawson, Director of Medical Technology and Innovation at the Department of Health and Social Care, set the tone early. The NHS, he argued, excels at generating innovation but struggles to deploy it at scale. Start-ups and MedTech SMEs encounter fragmented procurement processes, inconsistent value assessments and a system that still prioritizes short-term cost over long-term benefit. Too often, promising technologies stall behind what Lawson described as “multiple locked doors,” or – as it’s commonly known now – “pilotitis”.

He hinted that one of the major bottlenecks, unsurprisingly, is not imagination; we know that start-ups are producing “sci-fi”-esque bits of tech that could, probably, tell you the size of your big toe just by taking a picture of your eyes. Rather, it’s decision-making. Policymakers need to decide what is actually worth investing in and separate this from shiny technologies that fast-track companies to yet another closed door. Without a shift towards value-led adoption, even proven solutions will continue to languish in “pilot purgatory”.

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That theme was reinforced through a concrete example from outside the UK. Piotr Orzechowski, CEO of Infermedica, presented lessons from Australia’s national rollout of AI-enabled triage through HealthDirect. By replacing rigid decision trees with a probabilistic, multi-symptom inference engine, the system achieved higher completion rates, reduced emergency-care intention, and a sharp drop in patient uncertainty.

But Orzechowski was careful to avoid technological triumphalism. The success, he argued, had less to do with the AI itself than with the conditions around it: clinical co-design, integration into existing pathways, and sustained change management. In other words, AI triage worked because it complemented the system, rather than “going against the grain.” It’s a principle that seems intuitive, but is rarely followed in practice. 

Broken access, broken care

Subsequent discussions exposed how far the NHS still has to go. Patients continue to navigate disconnected entry points across general practice, urgent care and emergency services, often repeating their story at each step. Panels examining access and navigation made a simple observation: patients should not have to “start again” every time they seek care.

Digital tools, including the NHS App, were framed as potential connectors, getting patients to the right care first time round. But speakers repeatedly stressed that technology cannot fix fragmentation on its own; without the right conditions it’s impossible to onboard the newest tech solutions and, in certain cases, it may just make health institutions more fragmented. 

The conversation then shifted beyond hospitals towards prevention and community health – two cornerstone ideas of the NHS 10 Year Plan. Examples ranged from remote monitoring in care homes to blood-pressure checks in barbershops, mosques and high streets. The underlying argument was that prevention only becomes meaningful when services are commissioned differently and delivered where people actually live their lives.

As one panellist put it, real transformation hinges on redesigning the way we do things around people rather than organizations.

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Rebuilding care around patients

Day two brought that principle into sharper focus, starting with patient voices. Transplant patients Deborah Duval and Mr Mahee shared their experiences of kidney failure, multiple transplants and long recovery journeys. Their accounts highlighted familiar gaps: inconsistent communication, generic information and the burden of repeatedly explaining complex medical history. 

Kabir, 39, described the shock of moving from peak fitness into sudden kidney failure and dialysis. Following a transplant earlier this year, he was blunt about a common misconception. “A lot of people fail to understand that a transplant isn’t a cure,” he said. “It’s just a better treatment.”

The problem, he argued, is what comes next. Patients are discharged with little guidance on how to manage radically altered lives. “Seeing your doctor once a month doesn’t tell them what you’ve been through in between,” Kabir said. “That’s my body; I should know what’s changing.”

Duval, who has undergone multiple pancreas and kidney transplants and is now awaiting her fifth, described a slightly different failure – outdated records. Although her pancreas transplants meant that she “didn’t need insulin two times for ten years,” she described how nurses would still manually check her blood sugars every four hours while she was in the hospital, none the wiser to the transplants that meant her blood sugars didn’t need checking. “The most frustrating thing is the lack of total knowledge with all the people around me,” said Duval.

Both patients described compensating for system gaps themselves  – tracking data, correcting records, even addressing basic ward conditions – that, without their input, could’ve slowed down treatment or resulted in the wrong one altogether. For some, this can be especially nerve-racking when the situation is out of the patient’s control, such as during surgical procedures. 

As Duval noted: “I feel nervous when I'm unconscious, because I can't then be in charge. I want to know exactly what's going on. I want to be involved in any big decisions that are made.” 

That is precisely why patients must be involved earlier. “Patients are really powerful,” Duval said. “If you get patients on your side, they will experiment with your innovation and help you improve it.”

That patient-centred lens carried into discussions on surgical robotics and training. Panels examining the scaling of robotics across the NHS emphasised that success depends far less on equipment than on people and systems. Training, governance and national consistency emerged as decisive factors.

Extended reality and simulation were highlighted as ways to democratise access to surgical training in a system where theatre time is limited and unevenly distributed. Professor Tan Arulampalam even remarked that the surgical headset may become “the stethoscope of the 21st century”.

The most immediate value of AI in this context, panellists argued, lies not in reducing administrative burden, freeing up time for training and patient care: it’s a sentiment we see crop up time and time again. Innovation, they stressed, is only innovation if it works for everyone.

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Hospitals are still doing too much

Later sessions confronted the push – or goal, at least – towards community-based healthcare. Speakers brought up a good point: hospitals remain the default destination for patients who could be better served elsewhere.

Peter Lewis, Chief Executive of Somerset Foundation Trust, described efforts to rebuild care around patient need rather than organisational convenience. Initiatives such as rural health hubs and homeless nursing services take care into communities rather than pulling patients into hospitals. Somerset’s “Open Mental Health” model, shaped directly by patient feedback, has already reduced emergency attendances, admissions and bed days.

Michael Bell, speaking for London system leaders, was more blunt. Too many hospital beds, he argued, are occupied by people who should not be there. Predictable trajectories of long-term conditions are being managed reactively, often causing harm. Two-week hospital stays for urinary tract infections leave older patients deconditioned, more prone to falls and with worsened dementia symptoms.

Virtual wards and ambient voice technology offer alternatives, but only if funding follows patients out of hospital. Bell revealed that London’s Integrated Care Board plans to shift 1% of its £12 billion budget into primary and community care in the coming year, rising to 6% over three years. The ambition is modest, but the message is significant.

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Incentives decide everything

Stephen Donnelly, former Irish Minister for Health, placed these challenges in a broader international context. Ireland, he explained, had previously been teetering towards the brink, with six-year waits for cataract surgery, emergency department overcrowding and mounting political pressure. 

Reform was absolutely essential. And, eventually, it came. New multidisciplinary community and modernised care pathways expanded capacity closer to patients’ homes, helping reduce waiting lists; for example, one HSE report shows 28,414 patients removed from hospital outpatient waiting lists in 2024 thanks to these new pathways. Advanced practice nursing roles are now structured to assess, treat and discharge patients more quickly and avoid unnecessary admissions, and early evaluations suggest these changes are improving access and throughput. 

Other data suggests significant reductions in long waits – roughly a 65% drop in those waiting over 12 months for care – under community-based reform programmes aimed at moving care out of hospitals. Reinvestment into the community, at least in this case, worked. 

That example then bled into discussions on Integrated Health Organisations closer to home. Speakers highlighted how acute care – short-term, emergency treatment – continues to eat away at the NHS “money pot”, with one 2023 report from Nuffield Health noting that acute care funding has “grown much faster” than overall funding. 

This is precisely what the NHS 10-Year Plan is meant to reverse. The plan promises a “decisive shift in the pattern of health spending,” with “proportionally greater investment in out-of-hospital care”. How that shift will actually happen, though, remains foggy to most of the public.

If it can be pulled off, earlier, community-based intervention could improve outcomes and reduce pressures. But Ireland’s example tells us that there needs to be a financial incentive. If local services aren’t allowed to keep the money that they save, they’ll burn out; we risk going round in circles. Proper reinvestment would open the door to a more sustainable “hospital to community” approach, as many of the speakers reiterated throughout the event. 

From talking to doing

GIANT Health Event 2025 did not suggest that transformation would be straightforward. If anything, speakers were candid about how difficult change has become inside a system under constant financial pressure. Still, there was a clear sense of alignment across disciplines. Technology, many argued, should make clinicians’ lives easier, not add another layer of work. Patients should help shape services, rather than be expected to navigate ever more complex ones. Training needs to keep pace with new tools, and prevention must be treated as more than a slogan if it is ever to make a dent in demand.

One of the most revealing moments came near the end of the conference. Reflecting on the current state of the NHS, a senior leader admitted: “We wouldn’t start from here,” referring to the state of the economy, “but we don’t have a choice.”

What stood out was that few of the solutions discussed were speculative. Many already exist, scattered across pilots, local programmes and parallel systems. Now, we need to actually use them. As many describe, the NHS needs to walk before it can run.