PM unveils online NHS hospitals for 2027 as unions warn of safety risks and digital exclusion

The National Health Service is preparing for its most radical shift in decades: a fully online hospital service. Prime Minister Sir Keir Starmer will announce at the Labour Party annual conference that NHS Online will launch in 2027, a digital platform designed to cut waiting lists and transform patient care.

Starmer will declare that a “new world is coming,” as the government promises a system staffed by dedicated doctors and nurses who will oversee patients opting for digital treatment. Consultations, consultant check-ups, assessments, and follow-up appointments will be carried out entirely online. For the first time, patients will also be able to book scans, tests, and procedures through the NHS app, connecting directly with community diagnostic centres.

The service will not arrive all at once. Instead, NHS Online will be phased in gradually, focusing initially on conditions where patients often need monitoring but rarely require inpatient treatment. NHS sources said ophthalmology, gynaecology, and digestive conditions are among the areas likely to be included.

But the challenge lies in separating those patients who can be safely managed online from those needing face-to-face care. NHS England has stressed that only areas deemed clinically safe will be part of the rollout. Ministers have set an ambitious target: 8.5 million appointments and assessments in the first three years, four times more than an average NHS trust currently delivers.

NHS England’s chief executive, Sir Jim Mackey, has hailed the plan as a milestone in modern healthcare. He promised that by the end of the decade, millions of extra appointments would be delivered, offering patients greater control and an alternative to crowded waiting rooms.

The initiative builds on projects already piloted across the NHS. At University Hospital Southampton, a virtual follow-up system for patients with low-risk inflammatory bowel disease cut routine visits dramatically. Three-quarters of patients were managed remotely, and waiting times dropped by 58%. At Moorfields Eye Hospital in London, a virtual triage system for non-emergency eye referrals ensured more than half of cases were handled in local clinics without the need for specialist treatment.

However, critics warn of unanswered questions and looming dangers. Daniel Elkeles, chief executive of NHS Providers, described the online hospital as a “very significant” development but cautioned that the success depends on careful planning. Issues of data security, patient safety, and digital exclusion — particularly for elderly and disadvantaged groups — must be resolved before launch.

Dr Becks Fisher of the Nuffield Trust said that while the project was “an interesting experiment,” crucial details remain missing. She questioned where doctors and nurses would be sourced from to staff the online hospital, and how safely patients would be transitioned from digital care to physical treatment if their conditions worsened. “This service will only be safe for certain patients,” she warned. “The challenge is making sure it stays limited to them.”

Concerns about digital healthcare are not new. The British Medical Association recently raised an alarm over a separate nationwide GP booking system due to launch this week. Designed to replace the frantic “8 am scramble” for appointments, the system lets patients request same-day consultations online. The BMA fears it could lead to chaos and serious health problems being overlooked.

Health Secretary Wes Streeting has defended both initiatives, insisting safeguards are in place and the changes will ultimately prioritise patient safety. Yet doubts remain. The online hospital promises efficiency and speed — but for critics, it also risks shifting the NHS into dangerous and untested territory.

As Starmer prepares to unveil the project in Liverpool, one thing is clear: Britain’s health system is on the cusp of a digital revolution, and its success or failure will shape millions of lives.