Reimagining NHS care with smart hospitals

A wide range of digital initiatives, funding streams, and programmes are now available to the NHS to support transformation, alongside the New Hospital Programme (NHP), which aims to deliver a new generation of state-of-the-art hospitals. Collectively, these efforts signal the NHS’s strategic ambition to create the smart hospital of the future.  

Delivering digital-enabled hospital services will lead to a more efficient health system, with full digitisation delivering a significant return on investment (ROI). Although the costs and benefits of smart technologies in hospitals are not yet well established—largely due to the limited number of fully smart hospitals currently in operation—the early evidence is encouraging. Our analysis of hospital digitisation within the NHP using Intelligent Hospital Capabilities suggests that NHS Trusts could achieve a net return of £1.20 to £3.50 over five years for every £1 invested. Returns at the upper end of this range are possible, but they typically depend on several factors, including the organisation’s existing level of digital maturity, the breadth of digital system implementation, and the strength of clinical engagement.

In particular, digitisation schemes and the NHP offer a chance to accelerate modern care pathways, but funding often targets isolated improvements, such as frontline digitisation, virtual wards, and Shared Care Records, creating a fragmented approach rather than a cohesive future hospital model. So, what will the hospital of the future look like, and what role should it play within the overall health and care system?  

The NHS 10-Year Plan provides us with the starting blocks 

A good starting point is the NHS 10-Year Plan (10YP),. The new care model marks the change to give patients more convenient access to care, either within their home or within their community, and only moving care to the hospital where necessary. 

In line with the vision of the 10YP, the smart hospital of the future should be a dedicated hub for treatment, emergency care, and complex, personalised diagnostics – with long-term condition management, low complexity diagnostics, and step-down inpatient care shifting to the home or local communities. With this, the role of the hospital will shift from the confines of the physical building, to becoming a set of services delivered in a variety of ways. This includes face-to-face, video call, and wearable technologies, from a variety of locations such as hospital sites, health centres, pharmacists, and home, to create the ‘hospital of the future’.

The future of outpatients is zero

The smart hospital will streamline outpatient services, making the hospital a hub for diagnosis and treatment. It will harness digital technology to deliver long-term condition management remotely, even when specialists are hospital-based.  

Achieving this will mean maximising the use of both new and current technologies to accelerate existing initiatives. For example: 

• In the hospital of the future, patients will be discharged onto a Patient-Initiated Follow-Up pathway supported by remote monitoring, uploading real-time data to a portal with educational resources. AI will track metrics and trigger appointments if results fall outside safe ranges. Early models, such as Guy’s & St Thomas’ Rheumatology pathway, show promise. However, scaling this approach will require NHS–industry collaboration, as most consumer wearables (Oura, Whoop, smartwatches) are not yet certified as medical devices. As evidence of their clinical accuracy grows, more patients could opt into remote monitoring without relying on hospital‑issued equipment.

• In the smart outpatient department of the future, referrals will start as ‘Advice and guidance’, with AI-enabled triage managing lower-complexity cases and converting only a few cases to in-person visits. Pilots such as Chelsea and Westminster’s autonomous system for benign skin lesions have freed over 30 percent of dermatologist appointments for urgent cases. 

In essence, technology, remote monitoring, and AI-driven triage will enable care to happen almost entirely beyond hospital walls, driving outpatient interaction to near-zero.  

Hospital diagnostics should be specialised and personalised 

As the 10YP calls for shifting more diagnostics into the community to streamline the outpatient pathway, the role of the smart hospital in delivering advanced diagnostic imaging will evolve significantly. Expanding diagnostic capacity within neighbourhoods will position Community Diagnostic Centres (CDCs) as the hubs for these services, and the ideal vehicle for high-volume, low-complexity diagnostics. This shift should redefine the role of the hospital, so that it moves its focus to providing rapid, streamlined diagnostics for non-elective patients and advanced, complex diagnostics for elective cases. This includes cutting-edge genomic testing to identify specific mutations and enable more personalised treatments. 

In this new diagnostic landscape, digital technologies will play a critical role in accelerating results reporting and enabling clinicians to collaborate seamlessly across organisational boundaries. This will make hot reporting – providing same-day results on scans and blood tests – a reality and help manage demand across healthcare systems. Key enablers include: 

• Shared digital systems and teleradiology: These tools allow clinicians to report diagnostics across boundaries. For example, NHS Northeast and North Cumbria Integrated Care Board has recently invested in regional order communications and AI-powered imaging tools, laying the foundation for more responsive services. 

• AI-driven reporting: While the current market for AI diagnostic solutions is fragmented, its future promises a world where hot reporting becomes standard practice. Early innovations are already showing strong results, such as Harrison.ai’s chest X-ray AI solution, now deployed across more than 40 NHS Trusts. This technology has delivered a 45 percent improvement in diagnostic accuracy and a 12 percent increase in staffing efficiency.

Accelerating recovery times

Long hospital stays increase risks such as infection, emotional strain, and mobility loss. Future hospitals will focus on high-acuity care, with stepdown recovery in community beds or virtual wards. 

The hospital of the future will also focus on efficient delivery of surgery while maximising health outcomes. Surgical robots will support an increase in throughput and improve recovery times for patients, as seen at Queen Alexandra hospital in Portsmouth, although results of this programme are yet to be seen, the programme is already improving patient outcomes, lowering the costs and reducing patients' length of stay. 

Room design will also be key to promoting recovery. Here technology can be harnessed to host patients in customisable rooms where they can more easily control features such as lighting and temperature, and maintain virtual connections with clinicians and the outside world. At Slagelse Hospital in Denmark, a sensory delivery room incorporates calming sounds, ambient lighting, and audiovisual effects to create a birthing environment that contributes to better, safer outcomes. Single room wards will become the norm, like those at Midland Metropolitan University Hospital where 50 percent of wards have single en-suite rooms, improving privacy and reducing risk of spreading infections. Patient wellbeing will need to be part of the design, supported by digital solutions that ensure safety – such as smart beds and monitoring systems – while fostering a sense of connectedness throughout the patient journey. 

Moving care into the home

Moving care into the home represents a fundamental shift in how health systems deliver treatment, reducing reliance on inpatient beds and empowering patients through digital innovation. Virtual wards and home-based care models are at the heart of this transformation. 

To shift low-dependency care into the community, virtual wards will enable home monitoring instead of inpatient beds. Virtual wards programmes in the UK have already shown how it can reduce hospital bed capacity, such as in South West London, where length of stay was reduced by two to three days at Epsom & St. Helier hospitals in 2021 by opening capacity for 100 virtual beds.  

The UK can look to other countries paving the way with digital innovation, such as the Danish and Norwegian health systems. To fund its ‘Healthcare at Home’ approach, Denmark has set aside more than €65m to innovate hospital services and roll out home treatment from 2023-2028. As part of this, the country has been aiming to cut hospital visits for Chronic Obstructive Pulmonary Disease (COPD), diabetes, and heart failure in half by delivering outpatient care, follow-ups, and virtual wards at home. Most strikingly, hospitals in Norway have been trialling the efficacy of home-based Neonatal Intensive Care Unit for infants at a stable phase of their illness. Scaling these types of interventions across the NHS offers a powerful opportunity to move care beyond the hospital setting through digital innovation.

Looking ahead – delivering digital-first, community-based care models

With unprecedented investment in digital transformation across the NHS and a NHP in progress, there is a unique opportunity to redefine the vision for the smart hospital of the future.  

The hospital should evolve from a default care destination to a specialised hub for emergency treatment, complex diagnostics, and high-acuity services. These should be supported by digital-first models and community-based care, marking the end of the traditional secondary care structure as we know it, and the rise of a true hospital without walls. In line with the UK Government‘s plan to shift care from the hospital to the home, long-term condition management, diagnostics, and step-down inpatient care will take place remotely, with greater power in the hands of the patient.