NHS England has awarded a contract with a total value of £9.9 million to Kainos Software Limited for support with a range of services in preparation for the new NHS Online Trust.
The contract covers data management services, digital definition, DevOps, and end-to-end development, as part of the virtual hospital programme Alpha Development Phase 2. According to NHSE, the contract may also be used in support of “short term/time bound/outcome based statements of work” across related initiatives.
NHSE lists key deliverables for clinical workflow tooling including standard operating procedures to enable standardisation and scalability of processes central to trust operations and care delivery; integration with national NHSE systems to support national reporting; and integration with the NHS App.
“A clinician workflow that supports the full pathway lifecycle: the workflow should support progression from referral, through triage, diagnostics, consultation, prescribing, discharge and onward care,” NHSE outlines. “It should act as the primary control point for the service, through which the pathway is managed in practice. Clinical logic, workflow progression and safety controls should be embedded and exercised through normal use.”
By the end of the contract, clinicians should be able to progress patients through the end-to-end pathway in a beta-ready service covering clinician interaction and support, patient access and communication, operational flow management, and prioritisation.
Testing should ensure that data captured at the point of use can enable traceability of decisions and auditing; identity and access controls should support allocation of work to appropriate clinicians; AI should be integrated where appropriate to support decision making or the reduction of manual effort; and the service should support prioritisation in line with clinical need.
According to NHSE, the clinician workflow “should be treated as the main control surface through which the pathway is executed and evidenced”, and success will be judged by whether the service can be run, tested, and supported end-to-end in a controlled setting.
Setting out guidance on what is needed for clinicians and patients in terms of capabilities, NHSE notes that foundations for clinician workflow tooling and patient journey through the NHS App have largely been developed through earlier alpha phases, but will need to be uplifted to be production ready, with user testing and iterative feedback incorporated.
Activities for clinicians cover accessing patient information, ordering diagnostics “on a national scale”, prescribing medicines, interacting virtually supported by ambient AI, referring patients to physical providers, placing patients on PIFU, assigning patients to ongoing monitoring, and discharging patients to a GP.
Activities are also set out for patients, including viewing information and services via the NHS App; and the wider workforce or NHS Online management team, including onboarding, training, ensuring regulatory compliance, and having visibility of performance data.
Speaking on the launch of the new trust, NHSE states: “The digital-first entity will deliver patient care unconstrained by geographical boundaries, offering the ability to better align clinical capacity with patient demand. Patient pathways will be delivered remotely, utilising the existing workforce more effectively through flexible working arrangements whilst taking full advantage of the latest technologies and innovations to deliver standardised and timely patient care.”
Plans for the new “online hospital” were first announced last year, with a go-live date set for 2027 and an aim to deliver up to 8.5 million appointments and assessments in its first three years. The service will aim to connect patients virtually to clinicians based anywhere in England, with triage to be completed through the NHS App, and appointments for scans then offered at local community diagnostic centres.
The trust will initially focus on nine common health conditions, including menopause and prostate problems, aiming to support faster access to specialised care. NHSE published a preliminary market engagement notice in May, seeking to explore the feasibility of establishing end-t0-end diagnostic testing pathways for the virtual hospital service.
Recruitment began for key roles in July, seeking “vision, experience and enthusiasm” to help shape the future of healthcare services across leadership positions such as medical director, chief nurse, chief people officer, and chief financial officer. John Browett, former Tesco.com chief executive, was also named as chair, alongside seven non-executive directors.
Wider trend: Health tech procurement
An open framework for the future procurement of 
Digital Primary Care General Practice Information Technology (GP IT) solutions, valued up to £838 million, has been announced by NHS England. The framework procurement process is expected to open next month, ahead of an anticipated launch of the framework in Q3 2027. It’s to span three lots, covering: foundation electronic patient record (EPR) solutions, clinical and operational support solutions, and research and development.
The North West London Acute Provider Group has shared its intent to procure an ambient voice technology solution, launching a market engagement opportunity. The group, covering Imperial College Healthcare NHS Trust, Chelsea and Westminster Hospital NHS Foundation Trust, London North West University Healthcare NHS Trust, and The Hillingdon Hospitals NHS Foundation Trust; estimates that a future contract for the solution will run from 1 April 2027 to 31 March 2030, a total of three years.
Berkshire Healthcare NHS Foundation Trust (BHFT) is seeking to engage with the market on the potential for a digital clinical triage service capable of assessing MSK conditions and navigating patients to relevant services “without human intervention”. The trust states that it will use the outcomes from the soft market engagement exercise to improve its understanding of the provider landscape, to refine its requirements, and to inform its views of how to structure a “potential downstream procurement project”. According to the notice, the tool will serve BHFT services covering community physiotherapy, specialist physiotherapy, the integrated pain and spinal service, and MSK podiatry.
