Episode Six - Dr David Stables

Building healthcare IT from the inside

David reflects on the early days of computerising general practice, from working in a rural surgery in the 1980s to building systems that replaced paper records and reshaped day-to-day clinical work. He explains why those early design decisions made sense at the time - and why many of them now constrain progress.

When and why innovation stalled

A central theme of the conversation is how healthcare IT lost momentum. David speaks candidly about consolidation, system lock-in, and incentives that prioritised stability and revenue over innovation - and how those forces slowed the pace of change across the NHS.

Why communication matters more than records

David challenges the record-first mindset that still dominates healthcare IT. He argues that care should be designed around communication - between patients, clinicians, and services - with records as a by-product, not the starting point.

Interoperability, platforms, and real choice

Drawing on decades of experience, David is clear that interoperability is not a technical problem but a structural one. He makes the case for open platforms, modular systems, and genuine choice - warning that closed systems ultimately limit innovation and patient care.

Understanding the cycles of innovation

Despite his criticisms, David sees healthcare innovation as cyclical rather than linear. He believes the system is entering a new phase - one that creates a rare opportunity to rethink design, communication, and care delivery, if leaders act decisively while the window is open. An essential listen for current and future NHS leaders navigating change.