UK's digital hospital plan meets analog reality check
- Reference: 1759306394
- News link: https://www.theregister.co.uk/2025/10/01/nhs_online/
- Source link:
Tech suppliers asked to support single electronic health record across England [1]READ MORE
However, some have questioned how it will find staff and whether it will exclude patients not able to use digital services.
Patients in England needing some types of specialist care will be able to [2]book online appointments with consultants working for NHS Online through the NHS app. If they need a scan, test or procedure they will receive these at local community diagnostic centres.
The NHS is notorious for waiting times for non-urgent hospital care. An analysis of NHS England data by doctors' trade union the British Medical Association (BMA) found that [3]6.25 million individuals were waiting for such treatment in July , with around 2.78 million waiting more than 18 weeks and 191,600 for more than a year.
NHS England said its new service will initially focus on "a small number of planned treatment areas with the longest waits" and will be expanded over time to other areas which are clinically safe to deliver remotely. NHS Online will provide up to 8.5 million appointments and assessments in its first three years from 2027, the government hopes.
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According to healthcare charity the King's Fund, [5]NHS hospitals in England provided 141 million patient episodes in 2022/23 , suggesting the new service could provide around 2 percent of this capacity over its first three years.
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Health secretary Wes Streeting said some NHS services, including those in Southampton for inflammatory bowel disease and several provided by London's Moorfields Eye Hospital, have successfully introduced online consultations and he wants to expand this nationally.
"If you have a condition where it is both safe and effective to be seen online through the new NHS Online service, you will get faster access to the right care in the right place at the right time," he told BBC Radio 4's Today program.
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The service will be run by a publicly owned NHS organization and could be established as an NHS trust, which run hospitals and secondary healthcare services in England. A budget has yet to be published.
"Bringing digital care approaches together through a new 'online hospital' is an interesting experiment," [9]wrote Dr Becks Fisher, director of research and policy at health think tank the Nuffield Trust.
"But there are some difficult questions looming about how this new service will be implemented: will doctors and nurses for this service be able to take on this work without it impacting on existing face-to-face work? And how will they pass patients who need care from digital to physical services?"
[10]Johnson, Cummings met Thiel months before Palantir won NHS pandemic role
[11]NHS disability equipment provider on brink of collapse a year after cyberattack
[12]Qilin ransomware attack on NHS supplier contributed to patient fatality
[13]How sticky notes saved 'the single biggest digital program in the world'
Fisher said there is a risk the service will be used only by relatively healthy and digitally literate patients. "This will be an interesting initiative and helpful for some. But it is not a transformative shift for most NHS patients, who will still want and need treatment in person," she added.
The BMA raised further questions. "We are told that there will be dedicated doctors assigned to this service," said Dr Tom Dolphin, chair of the BMA Council. "We're keen to find out where this extra staffing is going to be sourced from. Doctors are already flat out across the NHS and there is little spare capacity to go around."
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He added that the union was concerned over how patients would be guided when using the service as well as its potential to exclude older people, some with disabilities, those without a smartphone or good internet access and those who speak English as a second language.
"We want to be assured that no one will be left behind in this new online hospital," he said. ®
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[1] https://www.theregister.com/2025/05/13/uk_health_department_calls_for/
[2] https://www.england.nhs.uk/2025/09/new-nhs-online-hospital-to-give-patients-more-control-over-their-care/
[3] https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/nhs-backlog-data-analysis
[4] https://pubads.g.doubleclick.net/gampad/jump?co=1&iu=/6978/reg_onprem/publicsector&sz=300x50%7C300x100%7C300x250%7C300x251%7C300x252%7C300x600%7C300x601&tile=2&c=2aNz7uFy9Y3No-lg7ZT5bywAAAso&t=ct%3Dns%26unitnum%3D2%26raptor%3Dcondor%26pos%3Dtop%26test%3D0
[5] https://www.kingsfund.org.uk/insight-and-analysis/data-and-charts/NHS-activity-nutshell
[6] https://pubads.g.doubleclick.net/gampad/jump?co=1&iu=/6978/reg_onprem/publicsector&sz=300x50%7C300x100%7C300x250%7C300x251%7C300x252%7C300x600%7C300x601&tile=4&c=44aNz7uFy9Y3No-lg7ZT5bywAAAso&t=ct%3Dns%26unitnum%3D4%26raptor%3Dfalcon%26pos%3Dmid%26test%3D0
[7] https://pubads.g.doubleclick.net/gampad/jump?co=1&iu=/6978/reg_onprem/publicsector&sz=300x50%7C300x100%7C300x250%7C300x251%7C300x252%7C300x600%7C300x601&tile=3&c=33aNz7uFy9Y3No-lg7ZT5bywAAAso&t=ct%3Dns%26unitnum%3D3%26raptor%3Deagle%26pos%3Dmid%26test%3D0
[8] https://pubads.g.doubleclick.net/gampad/jump?co=1&iu=/6978/reg_onprem/publicsector&sz=300x50%7C300x100%7C300x250%7C300x251%7C300x252%7C300x600%7C300x601&tile=4&c=44aNz7uFy9Y3No-lg7ZT5bywAAAso&t=ct%3Dns%26unitnum%3D4%26raptor%3Dfalcon%26pos%3Dmid%26test%3D0
[9] https://www.nuffieldtrust.org.uk/news-item/nuffield-trust-response-to-the-plans-for-a-new-online-hospital
[10] https://www.theregister.com/2025/09/10/johnson_cummings_thiel_meeting/
[11] https://www.theregister.com/2025/07/31/nhs_disability_equipment_provider_nears/
[12] https://www.theregister.com/2025/06/26/qilin_ransomware_nhs_death/
[13] https://www.theregister.com/2025/05/16/universal_credit_commons_committee/
[14] https://pubads.g.doubleclick.net/gampad/jump?co=1&iu=/6978/reg_onprem/publicsector&sz=300x50%7C300x100%7C300x250%7C300x251%7C300x252%7C300x600%7C300x601&tile=3&c=33aNz7uFy9Y3No-lg7ZT5bywAAAso&t=ct%3Dns%26unitnum%3D3%26raptor%3Deagle%26pos%3Dmid%26test%3D0
[15] https://whitepapers.theregister.com/
Re: "treatment in person"
Your appointment has been made. You can choose your consultant from one of these weird Microsoft avatars.
"We want to be assured that no one will be left behind in this new online hospital," he said.
Don't hamstring them from day 1. Getting 10% using it - and finding the problems would be a major start.
It is not that the current system works. My aunt had to take two buses to get to and from a specialist hospital and it took all day.
After a week of this, my brother took time off work to take her ... and that was 3 hours round trip.
He would have been happier to take a laptop to my aunt, set it up for her, and leave her too it.
Rural access
Took my daughter to an outpatients appointment - it is possible by public transport, but it takes over 2 hours each way (30 minutes by car), with a 35 minute walk between busses (hardly what I would call "a connection"). We gave up trying to park at the hospital after 15 minutes, finding a spot in a car park 15 minutes walk away (hospital staff know this is a major issue and causes a lot of people to be very late for the appointments - we made it just in time, as I suspected we would have trouble finding a space). None of this is ideal for someone with mobility issues!
Unfortunately, that appointment needed diagnostic equipment, so online wouldn't have worked. However, I think it's a good idea where it can be made to work, even if some people will still need face-to-face.
Re: Rural access
if some people will still need face-to-face.
The watercooler moments, cross-pollination of ideas...
Re: Rural access
In a hospital environment the term you're looking for is cross-infection.
An analysis ... by doctors' trade union ... found that 6.25 million individuals were waiting
Did it mention that a significant proportion of those waits were as a result of them striking for a 25% pay increase?
They are now threatening to strike because:
1. They want another big pay increase; and
2. They have been told that GPs will be required to allow people to book appointments online.
Will it be a better experience than the video appointments I had with a local specialist team, where the first minute of each call is figuring out which one of you is muted? (Always them... But have to go through the motions...)
Every private health co offers this..
here in Spain. It's considered normal practice and a sales benefit... and doctors can concentrate on those who require a bit of reassembly or new parts.
Seems to work fine and the software exists so it should be a COTS deploy.
Re: Every private health co offers this..
COTS not allowed. It will have to be one of the usual suspects.
Hmm
And the answer is (spins the wheel) Take two asprins.
And the answer is (spins the wheel) Take more exercise
And the answer is (spins the wheel) Stop feeling sorry for yourself. Get over it!
What about using whatsapp video for triage though? When many GPs can't handle phone calls for appointments what hope is there for this?
That's where it gets more complicated
I am not installing WhatsApp (or similar) to access any service.
Opthalmology
Opthalmology was given as an area of medicine suitable for 'digital' treatment.
How do you measure eye pressure through a smart phone? How do you conduct a visual fields check? How do you look at the retina? How do you even check for cataracts?
"treatment in person"
But . . but . . that costs money !
And you can't shove AI in there !