Chief Medical Officer tells NHS to accelerate telemedicine for ageing rural England

Professor Chris Whitty, the Chief Medical Officer for England, published his 2026 annual report on 4 November, and it tells the NHS to speed up telemedicine and digital services in rural areas and small towns¹². The Department of Health and Social Care released a 288-page report alongside a 21-page executive summary and set of recommendations².

What the report found

The case rests on demography. Older people are concentrated outside the cities, and the gap is widening because people move away from metropolitan areas before old age¹. In 2024, 28% of adults in smaller rural settings were 65 or over, against 12% in London¹. Whitty argues that, per head, rural areas and small towns therefore need more healthcare than cities, and that this should be treated as a national problem rather than a local one¹.

Physical access is the second strand. Using Defra data for 2019, the report shows that around 90% of urban residents can reach a hospital within 60 minutes by public transport or on foot, compared with around 50% of rural residents¹. Staffing is fragile too: the report describes services where losing one or two people could threaten viability, and says the share of GP trainees placed in a small town or rural setting rose only from around 25% in 2021 to around 28% in 2026¹.

The report also finds a data problem. It says standard deprivation measures such as the Index of Multiple Deprivation are built around urban patterns and are not reported at a fine enough geographical level, so pockets of rural need are averaged away¹. It adds that clinical research and NHS service pilots under-recruit rural populations, leaving an evidence base that describes cities better¹.

What it means for the market

Recommendation 3 is the one most relevant to digital suppliers and commissioners. Whitty says telemedicine and digital care can be a reasonable alternative to many in-person appointments, citing wider availability of good broadband in rural areas and growing public familiarity with digital services¹. He qualifies it: "Telemedicine is not a panacea", and remote care should be clinically appropriate, delivered by trained staff where no physical examination is needed, and acceptable to the patient¹. The report suggests that a supported video consultation at a local site, such as a GP surgery or a library, may suit many patients better than a call to the home¹. That points to a model of assisted, site-based telemedicine rather than purely direct-to-patient apps.

Interoperability is the second opening. The report calls for better digital and clinical links between defence and NHS systems so that military families who move often are not disadvantaged, and suggests shared standards for medical records, results, clinical handover and referral tracking¹. It notes that gaps between Defence Primary Healthcare and NHS secondary care persist¹.

On data, the report asks the ONS, the NHS and academic partners to treat better statistical measures of rural deprivation as a priority over the longer term, with local public health teams filling gaps in the meantime¹. For workforce, it backs digital education technologies alongside more rural placements and medical schools in semi-rural and rural places¹.

Caveats

The report sets direction rather than policy. Its recommendations are addressed to a range of national and local bodies, and it attaches no funding, targets or deadlines to them¹. The more detailed recommendations in individual chapters reflect the views of the chapter authors¹. Whitty also warns that patients who need or prefer face-to-face care must still be able to get it as telemedicine expands¹. Some of the access figures date from 2019, and the report says transport policy, one of the main barriers it identifies, lies outside its scope¹.