Offshore wind turbines are an attractive source for clean and renewable energy for reasons including their proximity to population centers and higher capacity factors. One obstacle to the more widespread installation of offshore wind turbines in the USA, however, is that recent projections of offshore operations and maintenance costs vary from two to five times the land-based costs. One way in which these costs could be reduced is through use of a structural health and prognostics management (SHPM) system as part of a condition-based maintenance paradigm with smart loads management. Our paper contributes to the development of such strategies by developing an initial roadmap for SHPM, with application to the blades. One of the key elements of the approach is a multiscale simulation approach developed to identify how the underlying physics of the system are affected by the presence of damage and how these changes manifest themselves in the operational response of a full turbine. A case study of a trailing edge disbond is analysed to demonstrate the multiscale sensitivity of damage approach and to show the potential life extension and increased energy capture that can be achieved using simple changes in the overall turbine control and loads management strategy. Finally, the integration of health monitoring information, economic considerations such as repair costs versus state of health, and a smart loads management methodology provides an initial roadmap for reducing operations and maintenance costs for offshore wind farms while increasing turbine availability and overall profit.