The National Health Service (NHS) has invested significantly in digitisation over the past two decades. Yet frontline clinicians often report that software systems remain inadequate, frustrating and slow.1 Rather than a streamlined digital environment, they face duplicated input, inconsistent interfaces and missing features. For child health, this problem is even more pronounced. Essential paediatric functionality, such as accurate growth monitoring, structured data capture for audit and child-specific prescribing support, is often unavailable or unfit for purpose in NHS information technology (IT) systems. Historically, children and young people are under-represented in health tech innovation,2 and existing market incentives tend to compound, rather than redress, this imbalance.

This persistent gap is not simply the result of underinvestment. Rather, it reflects a structural failure in how digital health technology is developed and deployed.

Software suppliers understandably prioritise areas with greater commercial return and lower regulatory complexity. This often results in features vital to child health being delayed or entirely omitted from systems on which clinicians rely. This is compounded because the NHS must pay repeatedly to build the same features across each of the clinical systems in use. This is wasteful of taxpayer funds, and the lack of standardisation in clinical interfaces undermines clinical safety and our ability to train new clinicians.

This is an example of market failure, but the NHS is not well configured to address this failure. Despite having a vast economic scale and enjoying a unique position as the centrepiece of the UK’s social welfare apparatus,3 the NHS fails to …