The virtual model aims to deliver millions of extra appointments while tackling postcode inequality.
England’s National Health Service (NHS) is embarking on a major digital reform with the launch of its first “online hospital” – a fully virtual model of care designed to connect patients with specialist clinicians anywhere in the country.
NHS Online is due to take its first patients in 2027 but will not have a physical site. Instead, it will operate through the NHS app, enabling patients to book virtual consultations, schedule diagnostic tests closer to home, and manage prescriptions and treatment plans remotely.
This article originally ran on TMR’s sister site, Health Services Daily. TMR readers can sign up for a discounted subscription.
The new model aims to deliver the equivalent of 8.5 million extra appointments and assessments within its first three years, significantly easing waiting lists while giving patients greater choice and flexibility.
Initially, NHS Online will focus on planned treatments in areas with the longest waits, before expanding into additional specialties where remote delivery is clinically safe.
Patients referred by their GP will be able to connect directly to NHS Online and book appointments with specialists across the country.
If scans, tests or procedures are required, these will be arranged at local Community Diagnostic Centres, while follow-up and ongoing condition management can take place virtually.
NHS leaders described the initiative as central to the 10 Year Health Plan to shift services from analogue to digital.
Sir Jim Mackey, NHS chief executive, called the project “a huge step forward” that will “deliver millions more appointments by the end of the decade, offering a real alternative for patients and more control over their own care.”
“Patients who choose to receive their treatment through the online hospital will benefit from us industrialising the latest technology and innovations, while the increased capacity will help to cut demand and slash waiting times,” he said.
“The NHS can, must and will move forward to match other sectors in offering digital services that make services as personalised, convenient and flexible as possible for both staff and patients.”
Initially the service will build and scale tried-and-tested innovations already in place across the country, such as AI and remote monitoring, with millions of patients already accessing online appointments and using the NHS app to manage their care.
Before NHS Online goes live, the NHS will learn from existing research on patient experience of online care over the past five years and build it into the program as it develops. The programme is being developed with a commitment to patient partnership in design and delivery.
Connecting patients with specialists across the country means the same high-quality care available to everyone regardless of postcode, helping to reduce variation and inequalities. It will also help to spread out demand, with patients no longer held back by long local waiting lists.
Related
Jacob Lant, CEO of National Voices, said the NHS aimed to provide free and universal healthcare, “but at the moment there are plenty of people who don’t have easy access to specialist hospital care simply because of where they live in the country”.
“The creation of an online hospital has the potential to fix this basic barrier, and by building on the wealth of patient feedback about the roll out of existing digital NHS services, there is a chance to build something genuinely transformational,” he said.
“The new service will need to dock in seamlessly with physical services for when people need tests and treatment, and it can do this by making sure patients are fully included in both the design and ongoing evaluation.
“The NHS will need to be live to the risk of digital exclusion, ensuring that people without access to technology or the right skills are supported to get the help they need. But get this right, and it could unlock vital extra capacity that benefits all patients.”
Rachel Power, chief executive of The Patient’s Association, described NHS Online as “a promising step towards enhancing accessible care and shorter waits for digitally confident patients”.
“This model has real potential to cut waiting times and connect patients with expert care more quickly,” she said.
“We’re pleased to see patient partnership built into the programme and it will be vital that patients shape the design and delivery of this online hospital. While this initiative will take time to implement properly, it represents an important investment in the NHS’s future capacity alongside high-quality, in-person care.”
NHS Online will build on tried and tested virtual innovations already in place across the country. It highlighted the University Hospital Southampton’s outpatient clinics as an example.
The clinics were overwhelmed with follow-up appointments for patients with low-risk inflammatory bowel disease flare-ups.
Hospital staff developed a virtual follow-up pathway, enabling patients to access care remotely and initiate follow-up when needed, rather than being booked into routine slots.
They used digital tools to monitor their symptoms and support decision-making. This led to a 73% reduction in consultant-led outpatient appointments, over 75% of patients managed virtually, and a 58% reduction in waiting times.
Louise Ansari, chief executive of Healthwatch England, welcomed the new NHS Online model, saying it offered the prospect of patient referrals being triaged more quickly and some patients getting scans and diagnostic tests sooner.
“It is also welcome that government has committed to working with Healthwatch and patient groups on its delivery,” she said.
“It will be key, for example, that all patients have an equal opportunity to benefit, not just those who are tech-savvy.
“The public will need clear communication about how to benefit and access from this scheme – including support, if required, to sign up to and use the NHS App. And digitally excluded people will need reassurances that their local physical hospital remains a good option for their care.”
Dr Jeanette Dickson, chair of the Academy of Medical Royal Colleges said the novel and potentially game changing model had the potential to reduce health inequalities.
“Obviously, we need to make sure that those who aren’t digitally enabled are not penalised in any way, but if this approach can be delivered safely and effectively, freeing up capacity in bricks and mortar hospitals at the same time then it could potentially be a really good thing,” she said.
Rosie Beacon, Re:State’s head of Health, described NHS Online as “exactly the sort of game-changing reform the NHS needs”.
Note: If you’re interested in canvassing some of the latest models of connected care being used in hospitals, including case studies, and the sort of funding alignment changes and political will that might be needed to expedite hospital connectivity and transformation, then maybe have a look at our upcoming summit: New Models of Care Reshaping the Future of Hospitals, 16 October, Aerial Centre, UTS, Sydney, HERE.
