Sabina Kuzmiakova
Sales Consultant, Kerv | Sales
Have a question?
Get in touchPublished 04/08/26 under:
Digital transformation remains one of the NHS’s biggest opportunities, but also one of its greatest challenges. While technologies such as AI, automation, cloud, and low-code platforms are creating new possibilities for improving patient care and operational efficiency, NHS organisations continue to navigate increasing demand, workforce pressures, financial constraints, and complex legacy environments.
As part of our recent webinar, we sat down with Tom Brown, CTO at Worcestershire Acute Hospitals NHS Trust, to discuss how NHS leaders can balance ambition with practicality, where automation and AI are delivering tangible value today, and why the most successful transformation programmes start by solving operational bottlenecks rather than pursuing technology for its own sake.
In this Q&A, Tom shares his experience of delivering digital change in a large acute trust and offers practical advice for organisations looking to turn digital ambition into measurable outcomes.
Q1. From your perspective as CTO, what does the current digital reality look like inside NHS trusts, both in terms of opportunities and constraints?
Tom Brown: From my perspective, the digital landscape in NHS trusts, certainly here in Worcestershire, is defined by huge opportunity sitting within very real constraints. On the opportunity side, we’ve never had more potential. The maturity of cloud services, low-code platforms, automation, AI, and modern integration tools means we can unlock value faster than ever before. We can redesign care pathways, remove repetitive work, close safety gaps, and free up staff time. Technologies like Power Platform, virtual agents, and ambient clinical documentation are genuinely transformational in their potential.
However, we’re operating within significant pressures:
• Growing patient demand
• Workforce shortages
• Financial constraints across both capital and revenue budgets
Every investment has to demonstrate quick, tangible benefit, while digital expectations from clinicians and patients continue to rise. We’re expected to modernise, automate, integrate, and innovate, all while maintaining services under constant operational strain.
At our Trust, we’ve made major progress, for example:
• Rolling out Sunrise EPR across inpatient and emergency care
• Bringing ED into the same digital ecosystem as wards
• Enabling workstations on wheels and tap-and-go login, reducing paper use and wasted time
• Delivering EPMA, replacing paper drug charts and improving medication safety, accuracy, and auditability
These improvements have real impact. Every gain in medicines safety prevents harm and reduces downstream costs.
But none of this would have been possible without investing in strong digital foundations, upgrading networks, strengthening Wi-Fi, improving security, and stabilising infrastructure.
Despite this progress, system fragmentation remains a reality. We still operate multiple clinical systems that don’t fully integrate, and we can’t replace them overnight due to funding limitations. That’s why the opportunity lies in bridging systems through integration, automation, and AI, rather than replacing everything outright.
Q2. How do you move from an initial idea through to delivery at pace in the NHS environment?
Tom Brown: We approach this through four key steps: evidence, alignment, speed, and transparency.
1. Evidence
Even the best ideas need proof. We run quick discovery cycles, days, not months, to validate demand, quantify opportunity, and understand impact.
We’ve invested in digital clinical teams, including CCIOs and senior digital nurses, who engage frontline staff early. This ensures we’re solving problems that genuinely matter.
2. Alignment
Securing buy-in is much easier when the problem is clearly defined and owned by the service.
We position ourselves as digital enablers, not problem owners. We focus on shared value, what the solution delivers for clinicians, patients, operations, and finance. When everyone sees themselves in the outcome, momentum builds from day one.
We’re also evolving toward a more agile delivery model to improve how we iterate and adapt.
3. Speed to Value
Pace isn’t about working faster, it’s about reducing friction.
Using low-code tools, automation, reusable patterns, and integration templates allows us to get working solutions in front of users quickly. Once people can see and interact with something, engagement increases significantly.
4. Transparency
Clear governance, honest communication, and visible progress are critical.
When we demonstrate incremental wins, like automating a 20-minute task, removing paper steps, or integrating systems, people start pulling the change forward instead of resisting it.
Q3. Where are automation, AI, and integration having the biggest practical impact right now?
Tom Brown: Many processes are crying out for automation, not because they’re poorly designed, but because we don’t have the time or resources to keep doing them manually.
We operate multiple systems across the Trust, including Sunrise, ICCA for critical care, and BadgerNet for maternity. They’re all essential but don’t naturally integrate, which creates significant administrative burden:
• Re-keying data
• Copying notes between systems
• Correcting errors
This fragmentation is the root cause.
We’ve begun addressing this through automation and AI. With Kerv’s support, we’ve moved onto a Power Automate journey, transitioning from a more expensive RPA platform to a scalable Microsoft-based approach.
Examples of impact include:
• Invoice processing automation using AI Builder, removing manual data entry for finance teams
• Automating data transfer between systems, reducing duplication and errors
These solutions are most valuable where:
• Staff are under pressure
• Systems are fragmented
• Manual effort is high
• Errors or delays have real consequences
That’s where we’re focusing our efforts.
Q4. What advice would you give on building internal capability for automation and AI?
Tom Brown: The reality is NHS organisations don’t have unlimited capacity, funding, or large digital teams, so capability must be targeted and repeatable.
We start with people, not technology. We don’t have large numbers of developers, so we’ve adopted platforms like Power Automate to enable small teams to deliver more with less. This shift was also driven by cost, scalability, and alignment with our Microsoft ecosystem. Crucially, these tools unlock AI-driven automation, allowing us to scale impact without scaling headcount.
Capability also grows through successive wins:
• Sunrise Inpatient → Sunrise ED
• EPMA
• Ongoing optimisation and automation
Each success builds credibility and reduces resistance to future change.
When developing business cases, we focus on:
• Hours saved (not theoretical efficiencies)
• Risk reduction
• Improved patient flow
• Reduced duplication and wasted clinical time
• Cost avoidance, which is often more immediate than long-term savings
Q5. What final advice would you give to NHS leaders starting or scaling digital transformation?
Tom Brown: Start with real operational pain, then build your strategy around it. In most acute settings, that pain is patient flow, but it extends across wider care pathways.
Right now, the NHS is facing:
• Stretched workforce
• Tight budgets
• Rising demand
• Unpredictable capital investment cycles
• Persistent legacy systems
These systems aren’t going away overnight. So the biggest wins won’t always come from shiny new technology. They come from solving real bottlenecks, such as:
• Removing manual rekeying
• Reducing medication errors
• Speeding up movement between sites (e.g. tap-and-go solutions)
• Eliminating paper
• Improving data flow between systems
• Supporting corporate and finance teams through automation
When you solve these consistently, even in small increments, you:
• Build trust
• Free up capacity
• Reduce costs
• Create headroom for larger transformation
That’s what ultimately enables the bigger leaps forward.
Key Takeaways
Tom’s insights reinforce an important truth about NHS transformation today: success is rarely achieved through a single, large-scale technology programme. Instead, it comes from consistently solving the everyday challenges that create friction for staff and patients.
Whether that’s reducing manual data entry, integrating disconnected systems, improving medication safety, or automating administrative processes, the greatest impact comes from focusing on operational pain points and delivering measurable improvements quickly.
For NHS leaders, the message is clear: build strong foundations, start with real bottlenecks, demonstrate value early, and use each success to create momentum for further change.
Continue the Conversation: get in touch with the Healthcare team here at Kerv if you’d like advice on how to start or progress your digital transformation.
To hear more from Tom Brown on the practical realities of NHS digital transformation, watch the full webinar on demand.
You can also read our companion article, Why NHS Digital Transformation Must Start with Bottlenecks, Not Big Technology, which explores the key themes and insights discussed during the session.
