New digital GP providers in England could be required to base themselves in the areas with the greatest doctor shortages, according to new proposals.

The idea has emerged from an NHS England consultation on digital primary care  where the proposals go beyond the anticipated requirement – that on-line GP services would have to have a physical base.

Under the proposals, which NHS England may struggle to get government approval for, digital practices would have to base themselves in the most deprived areas of any region in which they set up. They would also have to prove that they are bringing extra doctors into the community and would have to market their services to the local community.

The report says: “The development of digital general practice now offers the possibility that has never before existed – to expand GP capacity for patients in an area even when the GP sessions are provided at some distance.”

The proposal to place tight restrictions on new licences for digital services may put NHS England in conflict with health secretary Matt Hancock if he continues in his post. Mr Hancock has been an outspoken advocate of digital services.

Dr Rebecca Rosen, from the Nuffield Trust think-tank, said NHS England’s proposals were “right.” She said: “It’s a big improvement from the loose requirements set for earlier providers.

“There is some evidence that services delivering care remotely attract GPs back into work, and by steering them to the right place this could improve access to care in some of the most deprived parts of England.

“However, there are other issues to consider. People with complex health problems require an ongoing relationship with the same professionals to get the best outcomes and avoid onward.”