By Peter Corpe, industry leader, UK public sector at Appian
New research shows the NHS is the most trusted organisation for responsible AI use – ranking higher than any other public or private sector organisation – with 63% of citizens trusting the NHS to use AI responsibly. However, comfort with specific use cases remains significantly lower.
Less than half (40%) say they are comfortable with AI analysing scans and diagnostics, highlighting a clear gap between institutional trust and confidence in the use of AI for clinical decision-making.
Prioritising patient communication
Though AI in healthcare will undoubtedly bring significant benefits, public trust understandably remains cautious. Today, diagnoses and treatment decisions involve human judgement. Clinicians can be questioned on how and why choices are made. In contrast, as multiple AI capabilities become orchestrated into clinical processes, understanding the “why” becomes far more complex, with no human available to fully clarify every decision if required.
Patients don’t necessarily need a technical breakdown of every AI use case in the patient journey, but there should be transparency when it influences a diagnosis or clinical decision. This makes transparency, auditability, and process alignment critical.
NHS organisations should pair AI rollout to a process with clear communication on human oversight, robust guardrails, and demonstrable safety measures. Capturing audit trails – what data was used, how decisions were made, and how systems interacted – will be essential to enable retrospective understanding.
Building trust will depend on making AI use visible, explainable, and accountable. This alignment will, by proxy, help the public better trust AI-enabled clinical outcomes moving forward.
Patients understand the value of AI
One year on from the AI Opportunities Action Plan, where the Government allocated £2bn to implement AI research and resources, our research also found that the NHS is the entity most likely to benefit from AI investment, with 30% of public sector workers and 29% of citizens agreeing.
When asked how they hope to benefit from integrating AI into public services, citizens placed faster services and shorter wait times (35%), improved safety (26%), and easier-to-use digital services (26%) at the top of the list.
Demonstrating that the NHS is widely seen by citizens as the area of public services most trusted and likely to benefit from AI. To bridge the delivery gap, healthcare leaders must avoid the temptation of ‘shiny new toys’ and instead look to improve the patient journey with AI embedded in core processes to give it purpose and make it effective, safe and measurable.
Is the NHS ready?
Despite strong public trust in AI opportunity, there are relatively low levels of organisational readiness within the NHS, with just 6% of respondents working in healthcare describing their organisation as “fully able” to leverage AI, signifying a substantial delivery gap.
A majority of respondents say process readiness and “fixing basic processes” should be a priority over AI implementation, with both public sector workers and citizens agreeing (55% and 56%, respectively) that this should come before introducing new AI technologies.
From pilots to public impact
Implementation alone is not a strategy. The real challenge is direction – ensuring AI is applied in ways that deliver clear public value. The next phase of NHS AI adoption will not be defined by new models or new tools. It will be defined by how effectively organisations embed AI into the processes that matter most.
That means moving beyond isolated use cases and towards integrated systems. It means designing AI into processes from the outset, rather than adding on afterwards. And it means measuring success not by internal efficiency alone, but by outcomes that patients can see and experience.
There’s no ambiguity around whether healthcare bodies are adopting AI. What we need to ask now is whether they are considering the bigger picture when implementing AI. Until that is addressed, AI will continue to deliver pockets of value but fall short of the systemic transformation that has been promised.
The advice is clear to healthcare leaders: Give AI the right data, guardrails and purpose, and organisations will deliver outcomes that are safe, auditable and easier for the public to get behind. The key is to start with the process and embed AI within it.
The 2026 UK Public Sector AI Adoption Outlook is available now for the full findings.
