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Background IBD services across the NHS are facing an escalating capacity crisis, driven by rising disease prevalence, increasing outpatient demand, and constrained consultant workforce availability. Specialist nurse-led helplines manage a high volume of clinically active but non-complex patients who require timely consultant input to progress care. Prior to service redesign, consultant access was often ad hoc and delayed, resulting in prolonged time-to-decision, inefficient utilisation of face-to-face outpatient clinics, and avoidable strain on patients and the multidisciplinary workforce.Aim To implement and evaluate a consultant-supervised, nurse-led virtual IBD clinic to reduce delays in clinical decision-making, improve patient flow, and support safe, sustainable service delivery within an NHS IBD service.Methods A protected weekly virtual IBD clinic was established, providing dedicated consultant supervision for IBD specialist nurses managing non-complex but decision-dependent patients identified through helpline contacts and routine monitoring pathways. Cases were discussed in real time, with agreed management plans documented and implemented promptly. Clear governance structures were maintained, with predefined escalation to face-to-face review or multidisciplinary team (MDT) discussion for complex cases, which continued through established MDT pathways. Consultant supervision time was formally incorporated into job plans to ensure sustainability and clinical accountability.Results Prior to implementation, the average time from specialist nurse query to consultant decision was approximately two weeks. Following Introduction of the virtual clinic, 90% of cases received a consultant-supported management plan within five days, representing a substantial reduction in time-to-decision. Over a 12–15-month period, approximately 1,250 patients were discussed through the virtual clinic pathway, of whom an estimated 70% would previously have required face-to-face outpatient review. Specialist nurse feedback demonstrated improved confidence in making safe clinical decisions and recognising appropriate escalation thresholds. Importantly, this model did not increase referrals to complex IBD MDT clinics, preserving specialist capacity for complex disease.Conclusion A consultant-supervised nurse-led virtual IBD clinic is a safe, effective, and scalable service model that significantly reduces delays to clinical decision-making while optimising outpatient capacity. By embedding protected consultant supervision within job plans and maintaining clear escalation pathways, this approach offers a transferable solution for NHS trusts seeking to address IBD service pressures without compromising patient safety.