GENOMICS
its “autonomy, adaptability, scalability, and probabilistic reasoning” as key to addressing clinical challenges.25
However,
the ‘Gen AI paradox’, where function- specific use cases fail to scale beyond pilots, underscores the need for a human- driven strategy for rollout.1-2,26-27
The
People Ontology Plan open ecosystem strategy as agentic AI create and refine digital twins which is translated from research into horizontal rollout, with human oversight verifying AI outputs.26-28 Table 4 illustrates the real-world application of this stewardship, outlining how predictor-intercept classifications can be ethically and safely applied across various patient groups. For example, with ‘Teen mental health’, the plan necessitates coordinating multidisciplinary roles from development to adoption and ensuring semantic interoperability for the sector. Similarly, for ‘Elderly multimorbidity’, the focus is on data-driven decisions and risk stratification for effective PHM.7,25-28 Furthermore, the Ethical People Ontology Plan is instrumental in achieving economic growth and addressing national best biopharma practice.2-4
By investing
in biomarkers, digital twins, and a skilled workforce using quantum agentic AI, the UK can reduce reliance on foreign and costly pharma and improve outcomes through sovereign innovation.29-32
The
AISI Alignment Project, for instance, ensures that AI systems align with desired outcomes, building the national and global trust necessary for international scalability.33
This proactive, preventative
healthcare model is designed to be a significant economic driver, with AI strategy benefits that are both national and international in scope.34
Conclusions
The ‘Align Four UK Plans in an Ecosystem for Agentic Pre-Post eXam Predictors and Intercepts’ manuscript for an ecosystem represents a pragmatic approach to transforming UK healthcare in a decade through Genomic Champions. The Biological Pre-Post eXam, powered by agentic AI and HPO, provides technical architecture for this transformation. However, as figure 1 illustrates, the entire cycle is a means to a greater end: the realisation of an Ethical People Ontology Plan for the community. This plan is the crucial final phase that ensures the profound benefits of anticipatory, personalised care are delivered within a resilient, equitable, and trustworthy ecosystem providing truth at the point of need.
By developing a skilled and ethically
grounded workforce, engaging the public in transparent dialogue upon genomic predictor Pre-eXam and eXam
The eXam phase translates predictive intelligence into precise, personalised interventions, enabling the development of personalised therapeutics and digital twins, which can simulate the effects of different treatments on an individual’s unique HPO.
intercepts, and upholding the ‘first do no harm’ principle through proposals like HEMSS and HIMSS, the UK can transition to a proactive healthcare ecosystem. The Ethical People Ontology Plan may be seen as the foundation when appropriately written, ensuring that as science and technology evolve, they remain deeply attuned to every individual’s unique biological and lived experience. This strategic alignment in science and technology will not only position the UK as a global leader but will also realise a healthier, fairer, and more prosperous future health for all of us. This ecosystem strategic alignment
offers a visionary path forward, yet its success is contingent on addressing its communication challenges. While the ecosystem is technically sound and coherent for experts, its adoption as a national programme requires a targeted public communication strategy. The People Ontology Plan proposition is designed to simplify this complexity, focusing not on technical jargon but on the human-centric phases of ‘Pre- eXam’ (prediction and diagnosis) with ‘eXam’ (precision targets). This deliberate strategy ensures the public can easily understand their health journey and the guidance they receive, building the trust needed for a well-informed workforce and a confident society to embrace this new era of healthcare.
References 1 NHS England. Draft NHS Genomic
Medicine Service: Service Specification. (NHSE, 2025)
WWW.PATHOLOGYINPRACTICE.COM SEPTEMBER 2025
2 UK Government. Life Sciences Sector Plan. (
Gov.uk, 2025)
www.gov.uk/government/ publications/life-sciences-sector-plan
3 Department of Health and Social Care. Fit for the future: 10 Year Health Plan for England - executive summary. (
Gov.uk, 2025)
www.gov.uk/government/ publications/10-year-health-plan-for- england-fit-for-the-future/fit-for-the-future- 10-year-health-plan-for-england-executive- summary
4 NHS England. We are the NHS: People Plan for 2020/21 – action for us all. (NHSE, 2020)
www.england.nhs.uk/ publication/we-are-the-nhs-people-plan- for-2020-21-action-for-us-all/
5 Genomics England. New research sets out an effective framework for genomic newborn screening. (Genomics Eng, 2025)
www.genomicsengland.co.uk/news/new- research-sets-out-an-effective-framework- for-genomic-newborn-screening
6 Sadeghi Z, Alizadehsani R, Akif M, et al. A review of Explainable Artificial Intelligence in healthcare. Computers and Electrical Engineering. 2024;118(A):109370 doi:10.1016/
j.compeleceng.2024.109370
7 Ory MG, Adepoju OE, Ramos KS, et al. Health equity innovation in precision medicine: Current challenges and future directions. Front Public Health. 2023;11:1119736. doi:10.3389/ fpubh.2023.1119736
8 Alvarellos M, Sheppard HE, Knarston I, et al. Democratizing clinical-genomic data: How federated platforms can promote benefits sharing in genomics. Front Genet. 2023;13:1045450. doi:10.3389/ fgene.2022.1045450
9 NHS England. NHS England and NICE 51
AdobeStock / nikomsolftwaer
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