GPs to refer patients to ‘online hospital’ from 2027

GPs will have the option to refer patients to a new ‘online hospital’ from 2027 as part of NHS reforms to be announced by the Prime Minister today.

Sir Keir Starmer will set out the new model of care – NHS Online – which will ‘digitally connect’ patients to specialists through the NHS app, in his speech to Labour Party Conference later this afternoon.

NHS England said the plans will mean that when a patient has an appointment with their GP, they will be given 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 ‘see specialists from around the country online’.

The Government said that as part of the plans patients will always have the choice between NHS Online and their local hospital, and that those who opt in to the service will also access and track prescriptions, be referred for scans and tests, and receive clinical advice on managing their condition.

If patients 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’.

As NHS Online is rolled out, the initial focus will be on ‘a small number of high priority treatments’ that currently have the longest waits, and will expand over time to include further types of treatment, the Government added.

Set to be rolled out from 2027, the Government hopes that new scheme will deliver ‘the equivalent of up to 8.5 million appointments and assessments in its first three years’. In the first instance, the service will build and scale ‘tried-and-tested innovations’ such as AI and remote monitoring.

NHS England chief executive Sir Jim Mackey 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.’

The BMA said they had questions about how patients are going to be directed to care through this model, and that there is a risk some patients could be excluded.

BMA chair of council Dr Tom Dolphin said: ‘We are told that there will be dedicated doctors assigned to this service.  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.

‘Secondly, how are patients going to be directed to care? The great thing about GPs is how they guide patients on their journey to the right service, managing the risks as they go. This online service will need to have something similar so patients are informed of the kind of specialist opinion they need.

‘We’re also concerned about the people who risk being excluded from this digital service. Doctors know very well that many patients struggle to access digital services, including some older people and people with disabilities, those without access to smartphones or with poor internet, and patients for whom English is a second language. We want to be assured that no one will be left behind in this new online hospital.’

Nuffield Trust director of research and policy Dr Becks Fisher, who is a GP, pointed out that there are ‘some difficult questions’ looming about how this new service will be implemented.

Dr Fisher said: ‘This service will only be safe and suitable for certain patients. How will we make sure it is kept to them? There is a risk that those who meet this standard will be mostly the relatively healthy, and those with the digital literacy to choose.

‘Then there is the knotty question of how the NHS will pay for this, and whether that covers GPs taking part as well as outpatient hospital services. The centrally directed nature of this will push aside some local experimentation.

‘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.’

NHS Confederation acute and community care director Rory Deighton said that ‘the devil will be in the detail’ in terms of how this service is offered to patients through the primary care front door, as well as ensuring that this does not widen the gap for those who are digitally excluded.

He added: ‘Addressing workforce capacity gaps both in primary and secondary care, as well as how patient data will be used will also be important if this is model is to thrive as an addition to traditional face to face elective care.’

As part of the 10-year plan for health, NHS App will be expanded to include a new ‘My NHS GP’ tool, which will handle non-urgent care enquiries using AI.

As previously announced, the NHS App will also get an AI feature that will allow patients to discuss their health issues and help guide their GP consultations.