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INTRODUCTION In 2018, the English National Health Service Long Term Plan proposed significant increases in virtual consultations over the next 5 years, setting out an ambition to deliver a third of all hospital appointments virtually. This was a direct response to the rise in demand over the past decade from 54 to 94 million outpatient appointments, at an estimated cost of £8 billion. This plan was dramatically accelerated with the declaration of the COVID-19 pandemic in March 2020. In order to eliminate all nonessential facetoface patient contact, NHS England recommended that virtual consultations were implemented for all secondary care outpatient appointments, except those ‘which meet local defined exception criteria’—and even for those they advised an initial virtual triage appointment. Many paediatricians have welcomed this change and feel that the pandemic has broken down many barriers to innovation. While children and young people have specific needs and vulnerabilities, this generation of ‘digital natives’ is a potentially perfect candidate for widespread digital healthcare delivery. However, there is limited research in the routine use of virtual consultations among children and young people. While there have been successful pilot programmes that have improved patient experience and engagement and even demonstrated some clinical outcome benefit, most have been limited to specific conditions or adult populations. 5 This article aims to explore the benefits and risks of the rapid and extensive deployment of virtual consultations for children and young people and explores the implications for planning of healthcare delivery. WHAT IS A ‘VIRTUAL CONSULTATION’? ‘Virtual consultation’ is a broad term that can be used to describe different scenarios. For clarity, this article focuses on the definition used by NHS England—‘synchronous, non facetoface consultations that takes place between a patient and a clinician over the telephone or through video technology’. Note that even this tighter definition still encompasses both telephone and video consultations, which can have very different characteristics, challenges and opportunities.