Digital adoption is a regular theme in consultant interviews and candidates need to know how to relate this rapidly changing landscape into their preparation and answers. We feature a new NHS England announcement on an online hospital model. It has profound implications and panels will want to know if you understand not only the benefits but also the risks of digital tools and how you would respond as a consultant leader.
In a press release dated 29 September 2025, NHS England announced NHS Online, a national “online hospital” that will connect patients with specialist teams virtually and coordinate investigations through Community Diagnostic Centres. The first patients will use the service from 2027. NHS England projects up to 8.5 million appointments and assessments in the first three years, focused initially on planned treatment areas with the longest waits and only where remote care is clinically safe. Referrals will come via GPs, and patients will manage their pathway using the NHS App.
Source: https://www.england.nhs.uk/2025/09/new-nhs-online-hospital-to-give-patients-more-control-over-their-care/
The substance of this announcement
NHS Online will not have a physical site. It will digitally connect patients to expert clinicians anywhere in England, triage them through the NHS App, and link to Community Diagnostic Centres for tests at convenient locations and times. If procedures are needed, patients will attend physical facilities as usual. The launch plan targets a small number of planned treatment areas first, expanding where remote care is safe. The policy aims to cut local waits by matching capacity and expertise nationally, while improving choice and convenience and protecting those who are not digitally enabled.
https://www.england.nhs.uk/2025/09/new-nhs-online-hospital-to-give-patients-more-control-over-their-care/
How this adds to what is already known
Virtual wards and remote follow up exist in many services, but most are local or pathway specific. This is a national hospital-level model with its own triage flow, a capacity ambition in the millions, and an explicit route through the NHS App. The 2027 start date clarifies when services will begin to feel the impact. The announcement also adds a national commitment to equity and standardisation across regions, while keeping an emphasis on clinical safety and evaluation.
https://www.england.nhs.uk/2025/09/new-nhs-online-hospital-to-give-patients-more-control-over-their-care/
Implications for the NHS system, trusts and professionals
NHS Online signals a national shift in outpatient access and triage. Criteria for remote suitability are likely to be shaped nationally, especially in pathways with mature virtual models, which means local teams may have limited scope to set the rules. Local leadership will still matter in how services interface with online flow, how GPs are supported to refer the right patients, and how equity and training are protected.
Expectations
Trust level
- Prepare for a national referral stream that uses local diagnostics and theatres.
- Align governance for remote consultations, information sharing and results.
- Monitor equity. If older or less digitally confident patients struggle, ensure assisted routes are available without excessive delays.
Service level
- Map which parts of your pathway are clearly remote suitable and where in-person review is needed, using national criteria where set.
- Strengthen outreach and education for local GPs, so appropriate patients are referred online first time, reducing churn and misdirection.
- Anticipate workload patterns. Virtual follow up may increase throughput in some tasks but can redistribute complex, time-consuming cases to local face-to-face clinics. Balance clinic templates accordingly.
- Protect training. Junior exposure may fall if routine work shifts online. Plan observed clinics, case reviews and supervised lists to preserve learning.
Consultant and leadership level
- Lead practical guidance in your specialty on remote suitability, red flags and conversion to face-to-face.
- Proactively support GPs with concise education materials and advice and guidance to improve referral quality.
- Watch for unintended inequity. Streaming older patients to physical routes only can protect safety but risks increasing pressure on local clinics, since older patients may need longer appointments. Advocate mitigations, such as assisted digital support, telephone options and tailored scheduling.
Interview relevance
Panels will test whether you can translate national reform into service-level action. Expect to be asked how you would keep patients safe when moving between online triage, Community Diagnostic Centres and local procedures, how you would educate GPs to choose appropriate patients, how you would protect equity for older patients, and how you would preserve junior training when more care occurs virtually. The strongest answers balance opportunity and risk, showing clear steps you would take as a consultant.
Possible interview questions
- Which elements of your pathway are suitable for NHS Online and which should remain face-to-face, and why.
- How would you work with local GPs to improve case selection for online referral.
- How would you monitor and mitigate digital inequity, particularly for older patients.
- How will you adjust clinic templates and training plans if routine follow ups move online.
- What handoff rules would you set between online triage, diagnostics and local treatment to maintain continuity and safety.
How to use this information
- Local homework: check your trust’s digital strategy, CDC scheduling and current remote activity in your specialty.
- GP outreach: prepare a short referral aide for GPs that clarifies inclusion, red flags and when to convert directly to face-to-face.
- Equity plan: agree how older or less digitally confident patients will be supported. Consider assisted booking, telephone follow up, written instructions, and longer in-person slots where needed to avoid clinic gridlock.
- Training: set a plan for juniors that includes observed online clinics, case-based reviews and protected time on in-person lists.
Summary
NHS Online will start from 2027, aiming for up to 8.5 million appointments and assessments in three years. It can shorten waits by matching patients to national capacity, but it also shifts how local services work. Consultants will need to engage GPs, protect equity, maintain training, and set clear rules for safe conversion between online and in-person care.
Reference: https://www.england.nhs.uk/2025/09/new-nhs-online-hospital-to-give-patients-more-control-over-their-care/
Cheat Sheet: how to say this in interview
- “NHS Online will begin in 2027 and aims for up to 8.5 million appointments and assessments in three years by matching patients to national specialist capacity.”
- “Criteria will likely be set nationally in pathways with mature virtual models, so I would focus on GP education and advice and guidance to improve case selection.”
- “I would monitor equity, because older patients may struggle with digital routes. If they are streamed to face-to-face only, I would protect capacity by adjusting templates and providing assisted options.”
- “I would set clear handoff rules between online triage, diagnostics and local treatment, and ensure juniors have structured learning in both virtual and in-person settings.”
