Healthcare’s Freeserve Moment

This article was published by HealthTechX360 on 20 August 2025.

The launch of Freeserve was a founding moment for Europe in 1998. People queued outside electronics shops to get the free CD that gave them free internet access from home. This followed opening up the nation’s telecoms network to the private sector. The UK’s regulatory revolution was copied across the rest of Europe and a bounty of innovation came to consumers.

We may be witnessing a similar founding moment with the NHS App in England. England’s market is large enough to matter, larger than most in Europe. It is not chaotic like the USA’s as the NHS login has identity verification which patients can complete from anywhere and the NHS App’s terms of service protects them from exploitation. And it is open for entrants unlike any other market in Europe.

From the beginning, the NHS App team focused on a narrow set of features: GPs’ record access, appointment booking and prescription renewal. For everything else it signaled a desire for a market. This is unusual – Scotland and Northern Ireland have no such market or desire. NHS Wales followed England’s footsteps by using the original source code of the NHS App. Denmark, Estonia, France, Hungary Italy, Spain, Sweden and Turkey each contracted with one software developer and locked out everyone else. This was a pattern which we saw in our book “Personal Health Records for Governments”. This was the pattern of national telecom monopolies of old.

England began the process with digital suppliers for GP buyers. Econsult and others online triage systems allowed GPs, and then ICS regions, to choose between different approaches to assessing a patient. AccuRx and others handled online consultations between patient and GP surgeries. Both Econsult and AccuRx received venture capital funding.

Expanding the market to hospitals increased the available budgets. Zesty and others allow appointment booking, handling the complexity and heterogeneity across different hospital departments. More venture capital funding flowed.

For us at Patients Know Best, it is a privilege to work with the newest generation of innovators. We show the patient their medical records in the NHS App. Our APIs allow anyone serving a patient to add to the medical record, which we show in the NHS App. And the innovators are expanding and redefining what is useful in the medical record.

PocDoc does cholesterol checks at home. Testcard does urine infection tests at home. MyHealthChecked does other blood tests at home and recently expanded to generic tests. Holly Health teaches and tracks health habits. MyRenalCare provides automated kidney dialysis advice. All the data flowing in is medical coded so that today’s doctors’ medical records systems can consume them and tomorrow’s AI systems can do things I cannot even imagine today. Crucially in this model, It’s the patient who has ownership of their PKB record, deciding who they share their data with and when.

The next generation of innovators is building on the NHS record of the patient, combining it with data from the patient’s phone to give automated care plans. Your smartphone is the best behaviour change tool in humanity’s history. Wouldn’t it be good if it supported good changes.

Other European governments have not yet picked this up from the UK. But they always do and they will. And we already see emerging markets seeing these benefits. That widens the market for investors, and they hasten the innovation for consumers. It won’t happen as fast as the Freeserve revolution – this is healthcare after all – but it won’t be as slow as before. Sensors plus AI plus a market means a new era.

This is why the audience IBIS is pulling together at HealthTechX is so important and so timely. 2026 will be a great year for patients and it will be because of the innovators who attend HealthTechX 2025.