The NHS is setting up an ‘online hospital’ – NHS Online – in a significant reform to the way healthcare is delivered in England. The new model of care will not have a physical site, instead digitally connecting patients to expert clinicians anywhere in England. The first patients will be able to use the service from 2027.
The expectation is that patients will be seen faster, as teams can triage them quickly through the NHS App and let them book in scans at times that suit them at Community Diagnostic Centres closer to home.
When a patient has an appointment with their GP, they will have the option of being referred to the online hospital for their specialist care. They will then be able to book directly through the NHS App and have the ability to see specialists from around the country online without leaving their home or having to wait longer for a face-to-face appointment.
If they need a scan, test or procedure, they’ll be able to book this in at a time that suits them at Community Diagnostic Centres closer to home. They’ll be able to track their prescriptions and get advice on managing their condition from the comfort of their home.
NHS Online will deliver the equivalent of up to 8.5 million appointments and assessments in its first three years – four times more than an average Trust – while enhancing patient choice and control over their care. Initially the focus will be on a small number of planned treatment areas with the longest waits. Over time this will be expanded to more treatment areas. Treatment areas will only be offered if the NHS knows it is it is clinically safe to do so remotely.
In the first instance, 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 last five years and build it into the programme as it develops.
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.
Sir Jim Mackey, NHS chief executive, said: “This is a huge step forward for the NHS and 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.
“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.”
Jacob Lant, CEO of National Voices, said: “The NHS aims 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.
“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, said: “NHS Online is 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.
“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.”
Case studies
NHS Online will build on tried and tested virtual innovations already in place across the country. Some examples include:
- University Hospital Southampton’s outpatient clinics were overwhelmed with follow-up appointments for patients with low-risk inflammatory bowel disease flare-ups. They 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.
- Moorfields Eye Hospital identified issues with long waits for referrals to be reviewed, causing anxiety and distress for patients waiting for care. They introduced a single point of access for virtual triage across multiple providers with all referrals coming into a single shared system. Staff assessed each referral digitally to quickly decide what kind of care was needed and where it should happen, with patients prioritised if urgent, directed to the right clinic if routine, or promptly informed if a referral wasn’t appropriate. Referral processing time reduced from 11 hours to 2, with 58% of urgent referrals safely downgraded to routine clinics.
- At Barking, Havering and Redbridge University Hospitals NHS Trust, a programme there has enabled virtual triage of 99% of referrals within 48 hours. This model has allowed 79% of patients to be seen virtually and 82% to be discharged without requiring a face-to-face appointment, demonstrating how digital triage can manage high volumes safely and efficiently.
