‘There is a moment that every doctor recognises.
You’re sitting in front of a patient, the consultation is flowing and then the screen pulls you away.
A notification, a mandatory field, a drop-down menu that requires three clicks to reach the option you need.
The patient is still talking, but your eyes have left them. In that moment, something small but essential breaks the thread of attention that is, at its core, what medicine is about.’
These insightful, knowing words are from a new book by Prof Shafi Ahmed called INTELLIGENT: The Evolution of AI Transforming Healthcare and very good it is, too. It’s a nailed-on, must-read.
He takes on something rather tricky in the AI debate by occupying the middle ground between breathless evangelism and cynical dismissal.
That’s refreshing.
Ahmed’s central argument is not that AI will replace doctors, but that AI will fundamentally reshape the conditions under which medicine is practised.
Remember that.
He frames AI less as a technology story and more as a question about the nature of intelligence, judgement and trust in healthcare.
The strongest aspect of the book is its authenticity.
Ahmed is not a management consultant peering into healthcare from the outside. He is a leading surgeon, with an international reputation, who has spent years at the frontier of digital medicine, virtual reality, surgical streaming and medical education.
There is nothing artificial about him, neither his knowledge, experience nor global teaching.
That matters because healthcare AI has become crowded with people who understand algorithms but not hospitals. The NHS is not a software problem. It is a human system with software attached.
The book sensibly avoids the ‘machines will solve everything’ trap. Ahmed repeatedly stresses evidence, ethics, oversight and accountability and that’s important because much of the current AI conversation borders on magical thinking.
Politicians and national bodies increasingly talk about AI as though it were a substitute for workforce planning, coherent management and operational discipline.
It isn’t.
AI may read scans faster, automate administration, support diagnostics and accelerate drug discovery, but the NHS’ biggest problems are often organisational rather than computational.
As Roy Lilley recently argued in The NHS at 77 – still the world’s best idea in healthcare, technology alone cannot compensate for operational instability.
The real issues remain:
- flow
- discharge
- workforce shortages
- fragmented accountability
- poor implementation capability
That’s where the book becomes most useful for NHS readers.
The NHS has a long history of confusing innovation with transformation. We buy technology and expect behaviour to change automatically. Usually it doesn’t.
The hard part is not the software. It’s redesigning workflows, incentives, culture and trust around it.
Ahmed knows that distinction.
One particularly interesting theme is his warning against over-claiming. The NHS has suffered from decades of ‘pilot-itis’; endless small experiments that never scale because the service is federated, fragmented and financially constrained.
Roy Lilley explored similar concerns in Reform without clarity, is a risk the NHS can’t afford.
AI risks becoming the next version of this; hundreds of local proofs of concept, few embedded operationally.
The challenge is not whether AI works.
The challenge is whether the NHS can absorb it.
That’s a management problem, not a technical one.
There’s also a deeper question running underneath this book…
… what happens to professional judgement when machine systems become increasingly influential?
Medicine has always relied on tacit knowledge, intuition, pattern recognition and trust. If clinicians begin relying on opaque algorithms…
… who carries responsibility when the machine is wrong?
That tension is probably the most important issue in modern healthcare.
Managers wrestling with modernisation pressures may also find value in Neighbourhood Health Services – ambition needs delivery.
My guess is, the book will appeal most to clinicians and managers who are curious but sceptical.
It’s not a technical manual, nor a utopian manifesto. It’s a fast-paced narrative that takes the reader with it on a journey…
… with an informed guide written by someone who has spent enough time in operating theatres to know that healthcare is messy, contingent and stubbornly human.
In many ways, the NHS is the perfect test case for Ahmed’s thesis. If AI can succeed in a financially stretched, operationally chaotic, federated system like the NHS, it can probably succeed anywhere, but…
… if the NHS simply layers AI on top of broken processes, poor interoperability and confused leadership structures, then ‘intelligent’ systems may simply automate dysfunction, faster.
As discussed in Roy Lilley’s health reform update – November 2025, leadership confusion and constant restructuring remain major barriers to meaningful transformation.
AI has arrived at exactly the wrong time for the NHS; in the middle of a chaotic reorganisation and a jobs cull… or…
… is this exactly the right time…
… and why Ahmed’s question is so pertinent…
… is the NHS intelligent enough to use artificial intelligence, properly?
News and Comment from Roy Lilley
Contact Roy – please use this e-address roy.lilley@nhsmanagers.net
Reproduced at thetrainingnet.com by kind permission of Roy Lilley.
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