The 'stuck paradox': what we learned from leaders about AI and digital transformation (29 April 2026)

Summary

Over the past few months, the King's Fund have spoken to nearly 60 health and care leaders about the opportunities and challenges presented by AI, and how they are leading their organisations through a period of rapid technological change.

While many of the insights they shared are not unique to health and care, they speak directly to the realities of leading in an already stretched system.

At the heart of this sits a central tension: the ‘stuck paradox’. Leaders feel an urgency to accelerate the use of AI alongside real constraints on their ability to act. These constraints range from limited resources and transformation capability to gaps in knowledge or confidence to make the right decisions. For many it is a combination of all of these.

This long read shares ten key themes that have emerged from these initial conversations.

Content

1. The 'stuck paradox'
2. What do we mean by productivity?
3. Balancing risks and opportunities
4. Differences across health and care settings
5. Patient trust
6. Widening inequalities
7. Workforce displacement
8. Workforce polarisation
9. Governance and strategy
10. National digital leadership was described as sub-optimal