British patients aren’t waiting for the NHS to catch up. Their behaviours have already changed. A systematic review of patient needs found that people want clear information about how to access a practice, the ability to choose a clinician and consultation modality and easy booking using simple systems and with short waiting times. Remote interactions are no longer fringe: in one study 76.2 % of respondents said they wanted to use online consultation again rather than booking a face‑to‑face appointment and emphasised the appeal of 24/7 online platforms.
These expectations aren’t limited to a tech‑savvy minority. The 2024 GP Patient Survey introduced an “online‑first” methodology and found that while 49.7 % of patients still say contacting a practice by phone is easy, 47.9 % say the same for using the practice website and 44.8 % for the NHS App. When last contacting their practice, 67.8 % phoned, 11.1 % used the practice’s website and 3.9 % used the NHS App. These numbers are modest compared with other sectors, but they point to rapidly growing digital engagement.
The cost of staying analogue
The operational models inside many practices still mirror workflows of twenty years ago. GPs spend a significant proportion of their time on administrative tasks such as documentation, correspondence handling and patient communications, leaving less time for direct patient care. Administrative inefficiency contributes to burnout and early departures from the workforce. The “paperless NHS” vision remains only partially realised, with incompatible electronic systems and inconsistent use of templates. If each GP saved just ten minutes per session through better digital workflows, the aggregate effect would be dozens of hours of reclaimed clinical time across a practice each week – time that translates into revenue‑generating appointments or preventive interventions.
Analogue processes also manifest in expensive no‑shows and poor capacity utilisation. Before the pandemic an estimated 7.2 million GP appointments were missed annually in England, costing the NHS around £216 million. Each missed slot represents lost revenue for independent providers and wasted capacity for NHS practices. The move to “total triage” approaches – telephone‑ and digital‑first – was intended to address this. Remote consultations now account for **around 37.7 % of general practice appointments (up from 10 % in early 2020)**. While remote models can reduce DNA rates, they also introduce new risks (missed call‑backs, digital exclusion). Practices relying on call‑backs may find themselves making multiple outbound calls for one appointment, compounding administrative workload. These operational headaches are a direct consequence of trying to retrofit digital interactions onto analogue infrastructure.
Evidence that digital‑first works
Executives who question whether a digital‑first model will pay off should study data from Babylon GP at Hand, a 24/7 digital‑first NHS practice. A retrospective analysis comparing its patients with those registered at other practices in the same region found that acute hospital spending per patient was between 12 % and 54 % lower than the regional average in FY18/19 and 15 % to 51 % lower in FY19/20. The practice delivered 23 % more appointments per weighted patient than the national average and yet still generated net savings: after adjusting for the extra cost of providing more primary care, the study estimated savings of £78–£326 per patient. These savings accrue to the wider health system through avoided hospital admissions and reduced demand on urgent care. For private operators, digital‑first models open opportunities to grow capacity without commensurate increases in estate or staff costs.
The investment gap
The mismatch between patient expectations and operational reality is not just a workflow issue – it’s a capital challenge. Research commissioned by the Health Foundation and undertaken by PA Consulting estimates that bringing the NHS and adult social care fully into the digital age would require around £8 billion of capital investment to put in place the necessary digital infrastructure and capabilities across the UK. An additional £3 billion of one‑off revenue investment would be needed to design, implement and transition to new digital technologies, and about £2 billion per year to maintain and improve digital operations. These costs aren’t just about AI; the basic building blocks such as **modern networks, up‑to‑date electronic patient records (55 % of trusts may need to replace or upgrade their system)**, digital social care records and corporate IT all need funding, and achieving policy ambitions for remote monitoring and virtual care will require almost £1 billion in capital. The government’s 2024 Spring Budget pledged £3.4 billion for NHS technological and digital transformation over three years, roughly doubling central digital spend, but the Health Foundation cautions that present spending levels will still need to rise.
Beyond tech: trust and inclusion
Digital transformation isn’t just about hardware. Public attitudes research shows that while people generally believe technology and data can improve care quality, they still value the ability to talk to NHS staff when needed and support for health technologies varies across socioeconomic groups. For practice leaders, this means investing not only in digital platforms but also in change management, training and alternative channels for patients who lack digital access. New operational models must blend digital convenience with human connection, not replace it.
Why it matters for executives
The evidence is clear: digital‑first expectations aren’t going away. Patients will increasingly choose providers that offer 24/7 access, transparent communication and simple booking. Practices that cling to analogue workflows risk higher operational costs, lost revenue through missed appointments and growing dissatisfaction. At a system level, failing to invest in digital foundations will perpetuate inefficiencies and widen inequalities.
For boards, the question is not whether to digitise but how quickly and strategically. That means budgeting for capital and revenue investment, prioritising interoperability and modern EPRs, adopting proven digital‑first models for triage and communication, and designing inclusive experiences. It means recognising that administrative time saved is revenue and capacity gained, that every missed appointment is a financial loss, and that digital infrastructure is as critical as physical estate.
As Meddbase has seen across its client base, the organisations that thrive are those that treat digitisation as a transformational opportunity rather than a bolt‑on. They reimagine the entire patient journey – from booking and triage through follow‑up. In a way that meets modern expectations and unlocks cost efficiencies. They invest in the foundational systems today to avoid being outpaced by digital‑first competitors tomorrow.
