NHS trusts across England and Wales are deploying digital tools to deliver care outside hospital settings, with recent examples ranging from voice therapy for neurological conditions to augmented reality in surgical planning. The practical results, where data exists, suggest genuine gains in clinical capacity and patient experience rather than technology adoption for its own sake.

The clearest example comes from University Hospitals of Derby and Burton, where the speech therapy team working with Parkinson’s disease patients at Florence Nightingale Community Hospital has introduced a voice therapy app that allows patients to complete prescribed exercises at home. The model is straightforward. Patients attend an initial in-person assessment, during which they are guided through downloading and using the app on their own device. Exercises are then set remotely, and patients return to clinic four weeks later for review and reassessment. A pilot of the app saved between 14 and 17 hours of clinical time per month, the equivalent of six additional therapy slots per week. Caroline Bartliff, a specialist speech and language therapist with the team, described the time saving as a direct result of reducing the need for patients to travel in for appointments that could be managed remotely.

The human impact is harder to quantify but no less real. One patient supported by the team was able to resume telephone contact with his daughters living at a distance, something that had become difficult as his Parkinson’s affected his voice. Stephen Posey, chief executive at the trust, presented the team with a Making a Difference Award, describing the work as an example of digital tools delivering genuinely person-centred care rather than simply modernising process.

In the North East, Tees, Esk and Wear Valleys NHS Foundation Trust has been examining why older adults are not using digital mental health services at the rates expected. A 100-day improvement challenge, focused on the trust’s Talking Therapies service, surveyed more than 240 people aged 65 and over. The results were instructive. Ninety-six per cent of those surveyed already used a phone, tablet, or laptop at home, which largely rules out basic access as the barrier. What emerged instead were concerns that online therapy felt less personal than face-to-face sessions, and a widespread lack of awareness that video-based face-to-face therapy was even available. Rebecca Morley, the team manager leading the work, said the findings would inform how the trust approaches outreach and communication to this age group going forward.

Wales, meanwhile, has made measurable progress on eye care digitisation. All health boards have now implemented OpenEyes, the national electronic patient record for ophthalmology, and OPERAi, the national electronic referral system, either fully or in part. The Welsh Government says the rollout is supporting real-time sharing of clinical information across the country and standardising how patients are referred and triaged for eye conditions. It is an area where fragmented record systems have historically created delays, and a consistent national infrastructure should help address that.

At Chelsea and Westminster Hospital, augmented reality is being used to help patients understand conditions that are notoriously difficult to explain, particularly deep infiltrating endometriosis and uterine fibroids. The technology produces anatomically precise three-dimensional models at large scale, which clinicians can interact with directly from their computers, enlarging specific regions to illustrate where disease has spread and marking precisely where surgical excision will occur. For patients facing complex gynaecological surgery, understanding what is happening inside the body has often relied on diagrams or verbal description. The visual model changes that in a meaningful way.

Across these cases, the direction is consistent. Digital tools are being used to extend clinical reach, reduce unnecessary attendance, and give patients a clearer view of their own care. What varies is the pace of adoption, and how much trusts are learning from what others have already tried.

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