Digital first primary care in NHS England: evaluating alignment with patient-centered care and implications for future practice

The Digital First Primary Care (DFPC) model, introduced by NHS England, aims to enhance healthcare accessibility and efficiency by leveraging digital tools such as telemedicine, digital triage, and virtual consultations. In this structured narrative review, we synthesized UK-focused empirical, policy, and implementation literature to examine DFPC through the patient-centered care (PCC) domains of access, autonomy, shared decision-making, continuity, relational quality, and equity. The available evidence suggests that DFPC can improve convenience, flexibility, and timeliness of first contact for some patients, but these gains are unevenly distributed and depend heavily on system design, workflow integration, and patient capability. Evidence generated during the COVID-19 emergency should not be conflated with the evaluation of routine, policy-driven post-pandemic DFPC, because the goals, constraints, and patient expectations differ across these contexts. We therefore argue that DFPC aligns with PCC only when implemented within a flexible hybrid model that preserves modality choice, supports continuity, provides safe escalation to in-person care, and actively mitigates digital exclusion. Future research should prioritize patient-reported experience, continuity, safety, and equity outcomes under routine post-pandemic conditions.