The future of healthcare in England may see patients meeting their surgeons for the first time only when they are on the operating table, according to Dr. Penny Dash, head of NHS England. Speaking at the HLTH Europe conference in Amsterdam, Dr. Dash outlined a vision where advances in technology and artificial intelligence significantly transform the traditional delivery of care, shifting interactions primarily to digital platforms and smartphones.

Dr. Dash, who has a background in NHS clinical practice as well as public health consultancy, described a scenario in which patients submit symptoms via smartphone apps that use AI to query them further, analyze photos and videos, and manage care pathways with minimal human intervention. She suggested that in the future, for many health conditions, patients might never see a doctor or nurse face-to-face until surgery, and some may not require direct clinical contact at all.

“Some of the things that are being developed and coming downstream, like fully automating a care pathway, are phenomenal,” Dash said. She highlighted the potential for AI and robotic technologies to replace traditional invasive procedures, noting that people may prefer “robotics and non-interventional approaches” over “dirty, clumsy hands.”

This digital shift forms part of broader NHS reforms amid ongoing challenges, including a record backlog of 7.22 million treatments as of April and budget constraints. The NHS is undergoing reorganization, with NHS England reducing its workforce by half and integrating into the Department of Health and Social Care. A new initiative, NHS Online—a fully digital specialist hospital trust—will launch next year, offering expanded services through the NHS App.

Dash emphasized that adoption of these changes will be gradual and deliberate, aimed at improving the patient experience and creating efficiencies. Early implementation of ambient voice technology—which transcribes doctor-patient conversations using AI—is already underway and delivering significant impact. She estimated that digital transformation could free 10 to 20 percent of current NHS resources, which could then be redirected toward preventive care.

However, the move toward predominantly digital healthcare has drawn caution from advocacy groups representing older individuals. Caroline Abrahams, director of Age UK, acknowledged the exciting potential of the NHS App but urged that efforts must ensure accessibility for the millions of older people who are not online or who prefer traditional communication methods.

The Royal College of Physicians also supports greater digital integration but highlighted concerns related to medical education. Mumtaz Patel, the college’s president, stressed the need to adapt training programs so that future doctors can learn, teach, and be supervised effectively within digitally focused care models to maintain clinical standards.

Dr. Dash concluded that while the prospect may unsettle some, embracing technological advances thoughtfully is essential. “We know what we need to do, we’ve just got to be brave enough to do it,” she said, likening the transformation to the initial skepticism of the automobile a century ago.