Box 1.

A day in the life of a consultant gastroenterologist in 2040

8.00am Handover from the Hospital at Night team All patients requiring urgent gastroenterology review are automatically flagged by the electronic patient record (EPR) system. We discharge Philip, a man admitted yesterday for a gastrointestinal bleed. The EPR auto-generates the discharge medication and a discharge letter using natural language processing of the clinical records, which we review and edit in real time. He starts packing immediately – the discharge summary will be with him and his GP by email instantly, and the medication will be delivered to his home that afternoon.

8.30am Multidisciplinary team meeting to discuss inpatients

9.00am Inpatient ward round Ward round maps plot the most efficient route to the patients, factoring in physiological derangement and potential discharges. The integrated analytics system in the EPR picks up trends in blood tests, flagging concerning trends and suggesting additional tests and interventions based on Trust policies. The EPR is linked to guidelines and evidence, and pulls through key links in real time, augmenting decision-making and learning on the round.

12.00pm Virtual ward review and urgent virtual clinic Many patients are managed via the hospital at home set-up and we review them with the community physician associate and nurse via teleconference, with live physiological parameters from the patient from point-of-care sensors linked to the EPR via the internet. One patient requires specialist renal input – we arrange a video consultation with us, the patient and the specialist.

1.00pm Lunch

1.30pm Administration I catch up with my paperwork – there isn't much to do. Referrals are processed by the EPR artificial intelligence system, which then suggests appropriate clinics and investigations for the patients for me to approve. Lab and endoscopy results are also processed by the EPR AI, with letters to patients and GPs created based on my previous correspondence, which I edit as required.

2.00pm Endoscopy list This is a blended endoscopy session. First, I review the AI interpretation of the upper GI and colonoscopy capsules performed yesterday and approve reports for dispatch. There are two clinical and nurse endoscopist lists in parallel with my therapeutic procedure list. Real-time image analysis performs enhanced polyp detection and allows automatic interpretation of pit pattern and morphology to decide whether resection is necessary, assisted by endoscopic robotics for larger high-risk polyps. Endoscopy reports are generated automatically based on the findings.

4.45pm Acute Medical Unit handover

5.00pm Review of patients from the acute medical floor Physician associates and advanced care practitioners work alongside medical trainees assessing patients. The hospital's electronic communication system allows for online specialty advice and input, facilitating patient flow through the unit.

8.00pm Handover to the Hospital at Night team Having done 12 hours work, I hand over to the off-site consultant covering the night. It's recognised my decision-making after 12 hours isn't optimal and being woken at night impacts my performance the next day (when I'm only in for a morning ward round).