Consent: what does ‘agreeing to tech’ really mean?

Consent in Digital Care

The UK's push for digital integration in health and social care has accelerated since 2024, driven by government initiatives like the 10 Year Health Plan. This plan aims to create a unified patient record system by merging data from NHS services and adult social care providers. Adoption of digital social care records has doubled from 40% to 80% since July 2024, enabling faster care planning but raising questions about how consent is obtained for ongoing data use.

Recent legislation, including the Data Use and Access Act passed in 2025, mandates information standards for interoperability. These standards require IT systems to facilitate seamless data exchange, but they also complicate consent. For instance, vulnerable groups such as older adults or those with cognitive impairments may not fully grasp data flows involving AI monitoring or sensor technologies in homes. Families often step in to consent, yet evolving tech introductions— like robots addressing workforce shortages—can outpace initial agreements.

Real-world impacts are stark. Poor consent practices have led to increased litigation, with claims related to inadequate informing of risks costing the NHS substantial sums. In social care, where 90% of recipients now benefit from digital records, inaction on consent could delay treatments or erode trust. Deadlines loom: by 2027, NHS Online will connect patients digitally nationwide, demanding clear consent frameworks to avoid disruptions.

Non-obvious tensions emerge in balancing explicit versus assumed consent. Assumed consent might suffice for routine monitoring but falters in high-stakes scenarios, like AI-driven diagnostics. Cyber resilience adds another layer; the sector's strategy to 2030 highlights vulnerabilities in shared systems, where breaches could expose sensitive data without recourse. Stakeholders—providers, commissioners, and ethicists—grapple with these trade-offs, as innovation promises better outcomes but risks diminishing personal control.