The health service unveils ambitions to build on discrete remote care and digital triage models offer by individual trusts with a national virtual programme, which aims to tackle waiting list
The NHS has revealed plans to create a new ‘online hospital’ that will fulfil millions of appointments each year while delivering a major transformation of “the way healthcare is delivered in England”.
The service is due to begin operating in 2027 and will offer patients that have made an appointment to see their GP an alternative “option of being referred to the online hospital for their specialist care”.
If users opt for the digital service, they will then be offered a digital triage process via the NHS App. This will then inform a referral for a remote consultation with the relevant specialist clinician. Where necessary, the app will also provide users the ability to book scans or tests at local centres, as well as functions for tracking medications and obtaining advice on managing illnesses and conditions.
The digital hospital – called simply NHS Online – aims to fulfil 8.5 million appointments and assessments during its first three years in operation. The service will initially focus on treatment areas with the longest waiting times, before expanding into other areas over time. The health service said that it will only offer consultations in a new area “if the NHS knows it is it is clinically safe to do so remotely”.
Before it launches NHS Online, the health service will “study research on patient experience of online care over the last five years and build it into the programme” – which the NHS said is “being developed with a commitment to patient partnership in design and delivery”.
Government and health service leaders will also engage with clinical staff and the unions that represent them to gain insights “on how best to deliver this new model of care”.
The digital hospital will incorporate and build on a number of “virtual innovations” that have already been implemented at various individual trusts around the country.
This includes remotely delivered follow-up care provided to inflammatory bowel disease patients by University Hospital Southampton – which has “used digital tools to monitor… symptoms and support decision-making”. Through this initiative, about three quarters of patients are now cared for virtually.
Other examples cited by the NHS include Moorfields Eye Hospital, which has implemented a single unified digital triage bringing together multiple providers onto one system, while remote triaging at Barking, Havering and Redbridge University Hospitals NHS Trust has resulted in 82% of patients being discharged without the need for an in-person appointment.
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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.”
National Voices is a coalition of more than 200 member charities operating in the health and care sector. The organisation’s chief executive Jacob Lant acknowledged the potential benefits of the online hospital model, while urging the health service to deliver the initiative carefully.
“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,” he said. “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.
He added: “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.”
