According to the legislation.gov.uk text of the Online National Health Service Trust (Establishment) Order 2026, the Secretary of State made the instrument on 13 May 2026 and it comes into force on 1 June 2026. Its central effect is direct: from that date, a new NHS trust called the Online National Health Service Trust exists in law. The instrument was signed on behalf of the Secretary of State by Karin Smyth, Minister of State at the Department of Health and Social Care. For policy readers, the key point is that this is an establishment order. It creates the body itself, rather than setting out a full operating model for online NHS services.
The Order also separates legal creation from full operation. While the trust is established on 1 June 2026, article 6 sets its operational date at 1 February 2027. That means the organisation will have legal status from June, but it is not expected to assume all of its functions until eight months later. This distinction matters in governance terms. A trust can be formed, staffed and prepared before it begins normal service delivery. The Order therefore builds in a formal mobilisation period rather than treating establishment and operation as the same event.
The legal basis is section 25(1) and related provisions of the National Health Service Act 2006. The explanatory material published with the instrument states that the Secretary of State made the Order after completing the consultation required by section 25(3), with the prescribed process in secondary legislation requiring consultation with each relevant Local Healthwatch organisation. The instrument extends to England and Wales, but applies in relation to England only. That drafting reflects the territorial scope of the Secretary of State's powers under the 2006 Act, rather than any cross-border service remit for the new trust.
Article 4 gives the trust a broad statutory function: to provide goods and services for the purposes of the health service. The wording is deliberately wide. The instrument does not set out a detailed service list, patient group or delivery geography beyond the fact that it applies in relation to England. In practical terms, the Order creates the legal body and its powers first, while leaving service detail to later decisions, contracts, approvals and internal planning. On the face of the legislation, this is an enabling measure rather than a full specification of what the trust will deliver on day one.
Article 5 sets the board structure at a chairman, five executive directors and six non-executive directors. That gives the new organisation a clear governance shape from the outset, with executive leadership alongside a non-executive majority for oversight and challenge. Article 6 also fixes the accounting date at 31 March. For finance and audit planning, that places the trust on the standard NHS year-end, which will matter for annual accounts, external audit and the first full reporting cycle after operations begin.
Between 1 June 2026 and 1 February 2027, the trust has limited but important functions. Article 7 allows it to enter into NHS contracts, enter into other contracts including employment contracts, prepare to register with the Care Quality Commission, and do anything reasonably necessary to ensure that it can begin operating satisfactorily on the operational date. In plain English, this is the start-up period. The trust can recruit staff, put supplier and service agreements in place, complete governance preparations and carry out the regulatory work needed before live operation. The Order therefore supports mobilisation activity during the months before February 2027.
The Care Quality Commission is named directly in the instrument because preparation for registration is expressly authorised as a pre-operational function. That drafting point is notable. It shows that regulatory readiness is being treated as part of the trust's formation process, not as a later administrative step once services are already running. The explanatory note also says that no full impact assessment has been produced because no, or no significant, regulatory effect on the private, voluntary or public sector is foreseen. It further records that the statutory route used here remains available: although section 25 and Schedule 4 of the National Health Service Act 2006 were once marked for repeal by the Health and Social Care Act 2012, that repeal was never brought into force, and the relevant 2012 provision was itself repealed by the Health and Care Act 2022. Put simply, the legal power to create an NHS trust in this way is still active, and this Order uses that power to establish the Online National Health Service Trust in 2026.