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NHS Reset for the Big Data Economy (2014-2019) Part 6 – The Expose

February 2, 2026
WWIII The Documentary | Armstrong Economics
Originally posted by: Exposé News

Source: Exposé News

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NHS Reset for the Big Data Economy (2014-2019) Part 6

The ‘NHS Long Term Plan’, released in 2019, aims to transform the NHS by 2029.  It focuses on digital technology, including the use of the NHS smartphone app as a “digital front door” to online triage and AI-run automated smart systems.

The plan prioritises preventive and anticipatory care models, self-management of conditions, and the use of wearable devices and home-based monitoring equipment to predict and prevent hospital admissions.

The ‘Topol Review’, also released in 2019, explores the workforce changes needed to deliver the digital future of the NHS. It describes the use of genomics, artificial intelligence and robotics, and anticipates a significant shift in professional roles, with the potential replacement of trained professionals with virtual therapists and automated systems.

A supplementary report to the Topol Review envisions a future where data from various sources, including smartphones, sensors and social media, will be linked with electronic health records to enable predictive analytics and precision psychiatry – which suggests predictive profiling of digital citizens and, possibly, a pathologisation of dissent.

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The Real Left is publishing a series of essays titled ‘The Health and Social Care Reset for the Big Data Economy’. You can read the first part, ‘The Great Health and Social Care Reset for the Big Data Economy Part 1.1’, which is a timeline of NHS capture during the years 1970s-2013, HERE. 

The following is a section of the second part, which is a timeline of NHS capture during the years 2014-2019.  We have published the essay in several parts because, totalling a little under 10,500 words, it’s longer than most would read in a single sitting.

The Great Health and Social Care Reset for the Big Data Economy Part 1.2

By Emily Garcia, as published by Real Left on 27 January 2026

Table of Contents

‘The NHS Long Term Plan’ Released in 2019

‘The NHS Long Term plan’ (“LTP”) was launched in January 2019. The key takeaways are summarised below.

It details a patient’s experience of “markedly different” planned models of care by 2029, [182] centred on use of the NHS smartphone app, (or browser equivalent), as a “digital front door” [183] to an online triage with “tiered escalation depending on need,” which will “help them manage their own health needs or direct them to the appropriate service.” Increasingly, AI-run automated smart systems will manage the triage. [184]

To enable the self-management of conditions, the plan commits to working “with the wider NHS, the voluntary sector, developers and individuals in creating a range of apps to support particular conditions.” [185]

“Preventive and anticipatory care models” [186] are a major focus of the plan, with the “connecting of home-based and wearable monitoring equipment” (examples given include digital scales to monitor the weight of someone post-surgery, a location tracker for someone with dementia and home testing equipment for someone taking blood thinning drugs) envisaged to “predict and prevent events that would otherwise have led to a hospital admission.” [187] The plan states that even when ill, people will be “increasingly cared for in their own home,” with an “option” of physiological monitoring with “wearable devices.” [188]

The 2019 government commissioned ‘The Topol Review: Preparing the healthcare workforce to deliver the digital future. An independent report on behalf of the Secretary of State for Health and Social Care’ (examined below) reveals more about the NHS app’s planned functionality: “By 2021, [the NHS App] will allow people to upload data from their wearables and lifestyle apps … and consent for those data to be linked with their health records.” [189]

The intent to merge multiple digital surveillance data streams with each patient’s single electronic healthcare record is confirmed in the LTP where it states:

We will make frictionless APIs [application programming interfaces – key to achieving data interoperability] available to industry and the developer community to stimulate innovation and support integration with other products … The initial API and workflow integration initiatives will develop towards full integration with smart home and wearable devices [my emphasis]. [190]

Of key import is the clear coordination with the burgeoning UK health and social care impact investing market, evident in both the plans’ prioritised objectives and their stated vision of “putting the NHS back onto a sustainable financial path.” [191]This will be enabled through “longitudinal health and care records linking NHS and local authority organisations,” like those in the Connected Health Cities project. [192]

The ‘NHS Long Term Plan Implementation Framework’ further confirms this in its summary of the LTP:

The Long Term Plan set out how the NHS is supporting wider social impact across England including support focused on health and the justice system, veterans and the armed forces, health and the environment, health and employment, and anchor institutions. [193]

Specific objectives of the LTP noticeably correspond to outcomes from active or completed social impact bonds by 2025 in the UK healthcare policy sector. This includes:

  • The withdrawal of A&E care, specifically for heavy user groups including those with substance abuse issues [194] (e.g., Cornwall Frequent attenders Project/Addaction) [195] and the elderly (e.g., End of Life Care integrators Bradford, [196] Somerset, [197] Sutton, [198] Hillingdon, [199] and North West London [200] and Enhanced Dementia Care service, Hounslow). [201]
  • Social prescribing to help patients manage their long-term health conditions in lieu of use of primary and secondary care services [202] (e.g., provision of a social prescribing framework and offer at scale across Northamptonshire, [203] Ways to Wellness, [204] and Community Owned Prevention/Thrive).[205]
  • Preventative lifestyle interventions of weight loss, improved nutrition and improved mental wellbeing for adults at risk of developing Type 2 diabetes [206] (e.g., Healthier Devon [207]).
  • Cross-sectoral targeted interventions comprising “alternative life pathways” (educational achievements, “health literacy”, etc.) for vulnerable/at-risk children [208] (Chances Programme – being delivered by 15 different councils). [209]

The LTP also commits to “supporting people with severe mental illnesses to seek and retain employment,” [210] and boasts of having already launched “the world’s largest trial of IPS (Individual Placement and Support) services” in collaboration with national and local government in 2018. [211]

The question of why the UK’s national health provider is assuming a malevolent Department of Work and Pensions function of coercing the severely unwell “back to work,” whether paid or unpaid, is illuminated by understanding the NHS’s emerging role, including more recently as commissioner, in the nascent social impact ecosystem. Thanks to the work of the Department of Work and Pensions Innovation Fund, since 2015, “employment and training” is the most developed social impact sector in the UK to date, and the very unwell are an important pool of exploitable human capital for this.

‘The Topol Review’ Released in 2019

‘The NHS Long Term Plan’ references Professor Eric Topol’s report, ‘The Topol Review: Preparing the healthcare workforce to deliver the digital future’, [212] into workforce changes needed to “maximise the opportunities of technology, artificial intelligence and genomics in the NHS,” [213] as the guidance used for the‘NHS Workforce Implementation Plan’.

Similarly to the research interests of Sandy Pentland explored in the previous article, Eric Topol’s biomedical research company, Scripps Research, is credited by the World Economic Forum as a pioneer in exploring how wearable devices like activity trackers and smartwatches can provide valuable health insights, “including a more precise identification of viral infections.” [214] And like the MIT Media Lab, Scripps Research pivoted to covid-19 detection through wearables research projects during the covid-19 event.

The February 2019 published review was supplemented by a report by Dr Tom Foley and Dr James Woollard: ‘The digital future of mental healthcare and its workforce: a report on a mental health stakeholder engagement to inform the Topol Review’. [215]

Both reports anticipate a sea change in professional roles, entailing the replacement of trained professionals with virtual therapists, [216] speech recognition and natural language processing triage bots [217] and rehabilitative, wearable, companion robots. [218] Staff will train to use robotics and other transformative technologies at simulation centres [219] and through “digital education platforms such as Massive Open Online Courses (MOOCs)” [220] in place of teaching professionals since, “The traditional model of learning clinical skills from senior colleagues will not apply. In many cases, more junior staff will be early adopters and champions.” [221]

A prominent focus on genomics is expected to yield the benefits of routine polygenic risk scoring through low cost “genotyping arrays that allow stratification of individual levels of genetic risk for a host of common diseases,” [222] to be used in conjunction with demographic and lifestyle scoring [223] and, further into the future, the re-writing of the genome and CRISPR gene editing. [224]

The Topol Review states, “The convergence and complementarity of the three major technologies – genomics, sensors and AI – will enable the development of virtual medical coaches.” [225]

A quote featured in the report from Topol himself explains:

[U]ntil now the digital revolution has barely intersected the medical world. But the emergence of powerful tools to digitise human beings with full support of such infrastructure creates an unparalleled opportunity to inevitably and forever change the face of how healthcare is delivered. [226] [My emphasis.]

As with Nesta’s future healthcare vision discussed above, the intersection of the digital revolution with medicine imagined in these two reports necessitates a dystopian level of surveillance, which would preclude any vestige of a private life for patients/citizens.

Foley and Wollard admit “profound implications in terms of the level of surveillance that … [some of these technologies] place on the patient” [227] but envisage “changing public attitudes to data sharing” and “a new values-based approach” replacing “current medical ethical frameworks” as potential enablers. [228]

They state that “data from smartphones, sensors, social media, neuroimaging and genomics will be linked with data from EHRs, as well as from health and care data sets … [229] in the next five years it will become increasingly common to link NHS data sets with others from outside of healthcare.” [230]

Additionally, “an increasing range of sensors in the home and on the person will give remote clinicians access to data that would currently not even be available on an inpatient ward.” [231]

Intra-body surveillance through ingestible and nanotech sensors forms part of this expected network. [232] Developing the evidence base for digital biomarkers and their correlation to mental states, including the physiological, e.g., heart rate; cognitive, e.g., screen use; behavioural, e.g. global positioning system data; and, social, e.g., call frequency, is a stated priority for the next ten years. This, in order to facilitate “opportunity to rapidly feed back and adapt the non-healthcare (digital and real world) environment to promote better mental health,” with the involvement of “employers and government organisations.” [233]

Foley et al. elucidate: “Effectively, the workforce may become a sensor network, initially recording text, then voice, and eventually, even the staff’s physiological indicators could drive predictive algorithms to identify potential high-risk or high-cost events in inpatient or community settings.” [234]

Moreover, mentions of applications for “phenotypic information … extracted from social media to aid the prediction and monitoring of mental health disorders”; [235] the “ubiquitous use” of the “predictive analytics” embedded in electronic patient records; [236] the potential of these technologies to “challenge longstanding diagnostic classifications” and provide opportunities for “preventative and early intervention strategies” [237] (under the label of “precision psychiatry”) [238] are strongly suggestive of a potential pathologisation of dissent (the precedent for which exists in historical totalitarian societies [239]). “Good mental health” appears to be equated to successful adaptation to dehumanising and repressive systems of surveillance-based control. What’s more, the emphasis on predictive analytics in the guise of preventative health illuminates a drive towards the predictive profiling of digital citizens as potential debt burdens to society, to align with global finance-driven impact markets. [240]

Part 1.3 of the series explores the evidence for covid-19 as a “reset” and fast-forward for the pre-planned and already partially implemented internal reorganisation of health and social care to a digital-first, and increasingly digital-only, care model, which embeds intrusive surveillance and data harvesting.

References

Featured image taken from ‘NHS75 – History of the NHS’, NHS North East London, 4 July 2023

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While previously it was a hobby culminating in writing articles for Wikipedia (until things made a drastic and undeniable turn in 2020) and a few books for private consumption, since March 2020 I have become a full-time researcher and writer in reaction to the global takeover that came into full view with the introduction of covid-19. For most of my life, I have tried to raise awareness that a small group of people planned to take over the world for their own benefit. There was no way I was going to sit back quietly and simply let them do it once they made their final move.

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