16 June 2026
Glaucoma care was used as an example of how the new digital NHS trust, NHS Online, will benefit both patients and practitioners at NHS Confed Expo 2026 (10–11 June, Manchester Central Convention Centre).
Dr Peter Thomas, executive director of digital development at Moorfields Eye Hospital and clinical adviser to NHS Online, was joined by John Browett, the new chair of NHS Online, and Omar Din, a non-executive director at the trust, for the panel session.
The event was hosted by Dame Caroline Clarke, regional director for London at NHS England.
During the discussion, Thomas highlighted how NHS Online would operate, using a hypothetical glaucoma case study as an example.
In the case study, a patient had problems with their eyesight but was unable to travel far because of caring responsibilities. After their appointment in community optometry, a referral was made, and the patient was able to choose between hospital and NHS Online care.
With assistance, the patient was able to access the NHS App, from which they received a message informing them that they were now under NHS Online care. A specialist working for NHS online then looked at their results, before diagnosing them with mild glaucoma.
The patient was then prescribed eye drops through the NHS App, with their GP record being updated automatically.
Good practice in primary and secondary care communication highlighted
Image sharing capability via Community Ophthalmic Link, as demonstrated in optometry practices in Gloucestershire, was also highlighted by Thomas as an example of current digital good practice in the NHS.
“Image sharing between optometry and the hospital avoids a lot of appointments and unlocks capacity,” Thomas said.
Discussing Moorfields’ single point of access for referral and coordination (SPARC), which has been rolled out in North Central London and parts of North East London, Thomas noted a significant reduction in waiting times for hospital eye care.
In cases of age-related macular degeneration, waiting 11 days for a referral could have a significant impact on the patient, Thomas said.
He noted that, as a result of SPARC, the average waiting time for an AMD referral is now two hours.
SPARC has allowed 38% of urgent referrals to be moved into routine clinic slots, Thomas said.
In terms of cataracts, SPARC has cut unnecessary referrals and has allowed clinical expertise right at the start of the pathway, he explained.
Thomas also noted that, under NHS Online, scans could take place on the High Street rather than in secondary care.
He also acknowledged that ophthalmology has historically had trouble in being able to provide feedback on referrals from optometry.
At Moorfields, many non-attendees became regular attendees when offered video consultations rather than in-person appointments, Thomas noted.
Looking to the future with NHS Online
Browett described the advent of NHS Online as a “big leap forward for the NHS.”
The new trust “should enable us to use the resources that we have in the NHS much more effectively,” Browett told attendees.
NHS Online will not replace local NHS provision, but will act as a service to the NHS as a whole, he emphasised.
Browett called the newly launched trust an “opportunity to improve consistency” that will be “incredibly patient-centred” when it starts seeing patients at the end of 2027.
He emphasised: “If we get this right, it should support the system in reducing waiting lists.”
NHS Online will make the flow of patients through the system “much quicker,” he added.
Browett also noted that patients will be able to see exactly where they are on the waiting list, removing the need to get in touch with practitioners to check.
Din told attendees: “When we diagnose faster, we treat faster.”
“NHS Online is thinking about the patient journey. From week one, we’re looking at the patient experience of primary care: getting referred into NHS Online, getting their appointment faster, getting treated faster, getting out of the service faster, and being able to manage themselves better,” Din noted.
He added: “That’s the mentality that we’re going to go out with from the beginning.”
Clarke, hosting the panel, acknowledged that the effectiveness of NHS Online will only be proven when it has gained the trust of patients.
When asked if NHS Online is likely to cause more work, and how patients will flow into it, Din told attendees that NHS Online will utilise the existing NHS workforce.
“You must be working in the NHS if you’re going to work in NHS Online,” Browett confirmed.
Only a certain percentage of employees from each specialty will be able to work for the new trust, Browett said, in order to “safeguard our trusts and other parts of the system.”
The desire is not to take clinicians away from the valuable work that they are already doing, he said.
For those eligible to work within it, NHS Online represents the opportunity of a “portfolio career,” Browett said.
Thomas emphasised that he sees NHS Online as “a really significant opportunity.”
“Everything that we’ve learned from doing online care at Moorfields over the past five or 10 years has seen that it works much better when you have a dedicated part of the organisation, or a dedicated organisation,” he said.
Having an organisation that focuses all of its attention on digital will allow the NHS the “bandwidth to try and do digital services really well,” Thomas added.
Treatment for eye conditions included in newly established Online NHS Trust
The trust was established on 1 June, with glaucoma, cataracts and medical retina amongst the conditions to be covered
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