Virtual consultations have moved from pandemic necessity to permanent fixture in NHS care delivery. Yet the gap between deploying a video consultation tool and achieving meaningful, sustained adoption across a clinical organisation remains wide - and the consequences of getting it wrong include stranded technology investment, frustrated clinicians, and patients who disengage. In this HTN Now webinar, OX.DH founder John Kosobucki draws on real-world NHS deployments to share what genuinely drives adoption, what to avoid, and how OX.Waiting Room on the NHS Microsoft national tenant is making virtual care simpler, safer, and more integrated than ever before.
Webinar Summary: Key Themes and Insights
1. The Lord Darzi Report: A Digital Wake-Up Call for the NHS
John opened by discussing OX.DH's key takeaways from the Lord Darzi report into NHS performance. The report reinforced something that OX.DH has built its mission around: the critical need to bring the digital experience of healthcare in line with the digital experiences patients already have in other parts of their lives - banking, retail, travel. The intersection of technology and patient care is not a peripheral consideration; it is central to the NHS's ability to recover and thrive.
John was direct about the risk of inaction: "Things won't get better and they continue to stagnate." He drew a parallel with large corporations that already manage complex staff systems and sensitive data at scale, noting that while the NHS has its own distinct characteristics, there are established models from industry that translate well into healthcare - particularly around workflow automation, patient self-service, and secure data management.
2. What Patients and Clinicians Actually Want
A recurring theme in OX.DH's work is the importance of understanding the distinct needs of different user groups before designing any technology. For patients, John distilled the requirements to two essentials: simplicity and accessibility. "All they want is for it to be simple. Make it an intuitive, modern, easy way to interact with healthcare professionals. And they don't want to be downloading an app. It should be click and go."
For healthcare professionals, the picture is more nuanced - because "healthcare professionals" covers a diverse group including IT teams, administrators, clinical coordinators, and the clinicians delivering care. John identified the shared requirements across this group:
- An intuitive interface that is easy to adopt without lengthy training
- The ability to see and engage with patients through scheduled and ad hoc interactions
- A unified view of video, online, face-to-face, and phone consultations in one place
- Integration with existing EPRs and pathways - even across multiple systems
- Security, scalability, and cost-effectiveness from the outset
John noted that integration is often where virtual consultation projects stall: "Getting it right is super helpful but often people want to start with a very basic approach and then incrementally start adding in that integration as their broader ecosystem changes." The key is to ensure the foundation is secure and scalable, so that integration can be layered in over time rather than required all at once.
3. OX.Waiting Room: How It Works on the NHS National Tenant
OX.Waiting Room is OX.DH's cloud-based solution for managing patient workflows in virtual care settings. It is built directly on Microsoft Teams, using the same underlying infrastructure that NHS organisations already have access to through the national Microsoft tenant - making it immediately familiar to clinical and administrative staff, and significantly reducing the adoption barrier.
Key capabilities of OX.Waiting Room include:
- Integration with existing EPRs, pathways, and flat files - OX.Waiting Room does not require organisations to replace their existing systems
- Patient verification at the point of entry - a clinical safety feature not natively available in standard Microsoft Teams, which prevents unauthorised attendees joining consultations
- Automated patient engagement - confirmations, reminders, follow-ups, surveys, PROMs, and custom messages with secure attachments
- One-to-one and group consultation support via the familiar Teams interface
- Real-time KPI dashboards that consolidate data from multiple sources into meaningful business intelligence
- Patient-initiated follow-up - enabling patients to book their own follow-up appointments, reducing administrative overhead
Getting started is straightforward for NHS organisations. Anyone with an NHS.Net account can trial OX.Waiting Room for one month at no cost. The installation is available directly through the national tenant's App Source: an administrator creates a channel, loads the Lobby and Admin tabs, creates a test patient or connects via PDS lookup, schedules a test appointment, and can begin a test consultation within a single session.
4. Lessons Learned from Real NHS Deployments
John drew on the experience of implementing OX.DH solutions across NHS trusts, including the case study from Barnsley Hospital NHS Foundation Trust, where OX.DH was brought in to modernise video consultation infrastructure. Several important lessons emerged:
Technical deployment is fast; change management takes longer. Getting OX.Waiting Room live at Barnsley was quick - but the more time-consuming work was identifying all the different use cases across existing systems and coordinating the communication about transitions across teams. Organisations that invest in thorough change management planning before go-live see significantly smoother implementations.
Audit legacy connections before you start. The Barnsley implementation surfaced a pattern that John has since seen repeatedly: many services within a healthcare organisation are allowing direct access to consultation platforms without any patient verification in place. "There were many services that were allowing direct access without any patient verification," he noted, "and organisations were often getting random queues of people that did not have appointments." Identifying and removing these insecure connection points is a critical early step.
Streamline at the same time as switching. A system transition is an opportunity to remove unnecessary complexity, not just to replicate what existed before. John's team actively looks for connections and processes that can be simplified or eliminated during implementation - often reducing ongoing operational overhead in the process.
Simplicity drives adoption faster than training. When asked for his single most important piece of advice on increasing virtual consultation usage, John returned to the theme of intuitive design: "It's about making things as straightforward and natural to start using. Some systems have lengthy training material that are time-consuming when you introduce those new systems. Ours is pretty straightforward. I log in based on my particular profile and then I see the appointments that I've been configured to see. It makes sense." Where systems require extensive training to use, adoption rates suffer - regardless of how powerful the underlying technology is.
5. The NHS Cloud Strategy and the Direction of Travel
John highlighted the NHS Cloud Strategy adoption plan as important context for NHS organisations thinking about virtual care infrastructure. The plan provides structured guidance for NHS and healthcare organisations on how to adopt cloud solutions and understand the implications for existing server, infrastructure, and application estates. OX.DH's NHS national tenant model aligns directly with this direction - enabling organisations to leverage the cloud investment already made through the national Microsoft agreement, rather than building separate, bespoke infrastructure.
The broader pattern, John observed, is clear: "If you look at the last 12 months, there's been an uptick, particularly in primary care, around providing virtual consultations and integrated phone consultations. And we're getting feedback that what we're delivering aligns very much so with the NHS's direction of travel, as well as what's going on in Scotland and Wales."
Case Studies and Further Reading
- Somerset NHS Foundation Trust goes live with OX.DH virtual consultations
- Barnsley Hospital shares experience using Microsoft tech for virtual consultations
Related OX.DH Resources
- OX. Waiting Room: Product Overview
- OX. Virtual Clinic
- Five Ways Telehealth is Reducing the Cost of Healthcare
- OX.DH Safety & Security
Try OX.Waiting Room with Your NHS Organisation
NHS organisations with an NHS.Net account can access a free one-month trial of OX.Waiting Room via the national Microsoft tenant App Source. To find out more or book a guided demonstration, book a demo or contact our team.
About the Author
John Kosobucki is CEO and Founder of OX.DH (Oxford Digital Health). He founded OX.DH with a focus on cloud-native digital health solutions built on the Microsoft ecosystem, working in close partnership with NHS England and trusts across the country to deliver modern, intuitive virtual care infrastructure. Learn more about OX.DH's founders.