Kate Warriner’s first NHS job, while still studying music at Liverpool University, was a part-time gig as a ward clerk, “getting lots of paper case notes”, she recalls. “The irony of starting there when you’re in a digital leadership role!”. Twenty-five years later, as Alder Hey’s chief transformation and digital officer, leading innovations like electronic patient records, digital patient portals and AI scribes, she’s one of a new generation of tech leaders who are dragging the NHS—kicking and screaming, sometimes—into the digital age.

And Warriner has good claim to be the tech leaders’ tech leader. Last year, she was named top digital leader in the prestigious UK CIO 100 awards—the IT industry ‘Oscars’—ahead of counterparts from Bentley, Lloyd’s Bank and Chelsea Football Club, among many others in a largely private sector (and male) dominated field.

It’s a big personal accolade but one she modestly prefers to see it as recognition for how Alder Hey works with its patients and clinicians to advance digital technology (much more about that later). “The NHS is notoriously always behind the rest if the world on [digital], but Alder Hey’s board has always backed digital, backed innovation, and to see that recognised by my profession and through the industry is something we’re really proud of,” she says.

But it’s also quite a coup for the NHS, a sign of the service’s growing digital maturity and the backing given to the digital leadership profession in recent years. Most NHS organisations now have a chief digital or information officer, like Warriner, with a seat on the board and a remit that often goes way beyond traditional IT management to encompass innovation of all kinds.

Her job has “evolved quite significantly” since she joined Alder Hey in 2019, Warriner says, and the addition of ‘transformation’ to her job title three years ago was more than symbolic. “I think the board and the chief executive realised that… digital underpins all of the transformation of our services,” she explains. She now has board-level responsibility for transformation and innovation across the trust, including overseeing Alder Hey Innovation, a multidisciplinary collaborative hub with a mission to explore the frontiers of paediatric care.

Warriner describes herself as a “natural people person”, and she certainly speaks human—not always the first language among tech leaders of the past. She barely mentions hardware or software during our talk and not a single piece of tech jargon passes her lips. Today’s digital leadership is “all about relationships and about people, underpinned by great technology. But the technology should never come first,” she says.

She likens technology to a “fourth utility”, part of the organisation’s wiring and “embedded in everything we do”. Under the trust’s multidisciplinary approach, digital expertise and project skills are distributed across the organisation rather confined to a few boffins locked up in an IT department.

She’s keen to showcase the trust’s “CXIOs” – clinical leaders given dedicated time to spend on digital projects, AI and service innovation. “[They] work in and amongst our services on the ground, spotting things that could improve how we operate and people’s lives, then working as the voice of those [services] within our leadership team,” she explains.

In turn, digital staff are “embedded” within clinical teams through a “clinical shadowing programme”, she adds. “We’ve got a number of [digital] colleagues who are attached to different clinical services… They’ll go out and understand where support might be needed or what new things they might want to try.”

Alder Hey Innovation extends this collaboration beyond the trust, working with tech firms, other NHS bodies, patients and academics—and getting clinicians engaged early with innovation. Recently, the hub helped to develop an AI tool for predicting missed appointments, a remote monitoring tool for childhood obesity care and a device for collecting urine specimens from pre-continent children.

Alder Hey is a strikingly modern hospital in the Knotty Ash area of Liverpool, three miles from the city centre and across the road from Liverpool Heart and Chest Hospital, where Warriner doubled up as chief digital officer until 2024. Originally a Victorian workhouse, Alder Hey became a children’s hospital in 1914. In 1944, the hospital tested penicillin on a child for the first time, saving the child from pneumonia.

The hospital moved to nearby Springfield Park in 2015 and now sits at the heart of the trust’s leafy ‘Children’s Health Campus’, which also comprises a mental health centre, the research-orientated Institute in the Park, a bereavement care facility and, nearing completion when I visited in July, a state-of-the-art neonatal intensive care unit.

Alder Hey is a big trust, with 270 beds, employing over 4,000 staff and providing care to almost half a million children every year. It’s one of only eight trusts selected to get extra financial freedoms under the government’s ‘advanced foundation trust’ programme. The atmosphere is bright and buzzy but welcoming—about as far from its workhouse roots as you can get.

The trust’s children’s and young people’s forum “worked really closely with the architects to make this place almost not feel like a hospital and feel friendly for children and young people,” says Warriner. The forum meets weekly and its 120 members “have a really loud and important voice in the shape and design of everything we do,” she explains.

That very much includes the trust’s many digital projects. “They want us to bring them the future,” says Warriner. “They want us to be at the cutting edge of technology, and they’re really open and honest with us around that.” One of the forum’s first messages, she recalls, was “why do you keep sending us paper? Stop sending us paper!”

Easier said than done, as everyone in the NHS knows. But with the launch of ‘Alder Connect’ in April, paper is finally on the way out at Alder Hey. The online patient portal will let parents manage their child’s care in one place, gradually replacing traditional patient letters. Developed with tech firm Blinx as part of wider system work with Cheshire and Merseyside ICB, it’s a tangible product of the trust’s collaborative approach.

Collaboration can be difficult to get going in an NHS in which competitive instincts have been encouraged for decades, but seems well-embedded at Alder Hey. Cheshire and Merseyside has a single digital plan, with the CIO at each NHS organisation taking the lead in a different area. Warriner is responsible for the AI programme across the patch, which includes 16 trusts and over 300 GP practices.

The trust recently forged an international partnership—alongside five other NHS trusts—with the SickKids hospital in Toronto, a pioneer in using AI in paediatric care (see below), and Warriner hosted a delegation from the Canadian hospital the week before our meeting. “Some of the work they’ve done over there, and some of the expertise we already have in the UK, is really helping us to push the boundaries with AI and paediatric healthcare,” she says.

Alder Hey also leads on the Paediatric Open Innovation Zone, a £10-million programme of collaboration with local innovators which forms part of the Liverpool city-region’s economic development plan. As well as pioneering new technology to improve children’s health in Liverpool, the project hopes to create “high quality” jobs in a city hit hard by deindustrialisation.

It’s a rich network of mutually-beneficial connections, a million miles away from both the siloed, hierarchical NHS of the 1970s or the ‘let’s pretend’ market model introduced in the 1990s. “We all bring different strengths. But we’re only as good as the sum of all of the talents of the partners working collaboratively together,” explains Warriner.

Another group, the Digital, Data and AI Collaborative—described as “a multi-disciplinary powerhouse” by the UKCIO 100 judges—produced the trust’s AI strategy, published in summer 2025 and widely seen as a benchmark within the NHS. While briefly sketching out an “imagined future” where robot nurses, AI companions and “smart pyjamas” transform the hospital experience “into a thrilling augmented reality adventure”, the 12-page strategy mostly eschews the platitudes and vague promises that characterise most NHS strategies. Instead, there are clear, succinct objectives, and a series of practical initiatives (see above) with milestones up to 2030. The bottom line, the trust hopes, is a 25% fall in clinician burnout and a 15-20% reduction in waiting lists.

“We really thought hard about whether we needed an AI strategy,” says Warriner, “but we felt there was so much going on that it would be good to have something that corralled it all together strategically.” The “thread running through” the strategy, she says, is “how AI can empower people”—children and families, Alder Hey staff and the trust’s many partners.

She’s particularly enthusiastic about the trust’s recent rollout of ambient voice technology (AVT)—AI-powered software which listens to consultations and produces draft clinical notes and letters. It’s one of the biggest AVT deployments yet in the NHS and about 95% of the trust’s outpatient letters are produced using the new technology.

“Have you seen it work? I think you’ve got to see it to believe it, because sometimes it’s like there’s a magician in the room,” Warriner says. “We felt a real moral obligation when we saw the ambient voice technology. I’ve never seen people want something so quickly.”

Those 2030 milestones look tough, but Warriner says she’s optimistic both because of Alder Hey’s forward-looking investment plan (with additional funding from the Alder Hey charity, which helped to pay for the AVT rollout) and because the trust has built the “strong foundations” on which effective AI deployment depends: rigorous standards for clinical safety, information governance and cyber security, a “thoughtful” education programme for staff, and “open and honest” engagement with patients and families.

Does she think AI requires different governance and safeguarding arrangements to previous innovations? “You have to have the same suite of standards that you’d always expect, regardless of the technology,” she says. “You have to ensure that you meet all your safety standards, all the data protection standards and all the key things that keep you safe, effective and ethical.”

But she adds: “What’s perhaps different with AI is the scale of the opportunity and the speed it’s moving at—and the speed [required] to scale it in an agile way. That’s different to electronic patient records, for example.” But as the technology develops, she suggests it will be impossible to separate AI from any “core” change in the way services operate—“the AI is embedded within it, so ultimately they will end up hand in glove together.”

Alder Hey’s young patient cohort is probably less resistant to AI than others, but building trust is still vital and depends as much on good relationships as regulation and governance, she says: “It’s about how you implement change, being open and talking to people, listening to their concerns, responding to that, and changing if you need to change.”

It’s another illustration of what Warriner says is the biggest lesson of her career: “not to focus on the technology, but to focus on the people, and really spend time with the people we’re here to serve. I’ve seen over the years, that if you don’t do that, you don’t get success.”

Leadership, she adds, “is all about relationships and people, being true to your values, being kind and bringing hope and energy to people.”

It’s a management ethos that has brought Warriner to the top of her profession. So, as Britain’s top CIO, is she not seriously tempted by the big bucks that would surely be on offer in industry?

She smiles, slowly shaking her head. The NHS is “a genuine passion”, she insists. “My mum and auntie are both nurses, so the NHS has always been part of my DNA.” Walking around the hospital’s different departments, as she does every fortnight, “it’s so rewarding to see the difference we make to people’s lives,” she says.

Warriner is still a musician and chairs a local community orchestra. She describes how, every Christmas, she brings a group of musicians into Alder Hey: “To be able to go around playing the saxophone with a group of mates to children who are in hospital on Christmas Day, to see the joy that brings, is just amazing. You wouldn’t get that if you were to go and earn the big bucks somewhere else.” //