New AI initiative to reduce demand on urgent and emergency care in North East London

By Integrated Care Journal

Thousands of patients across North East London are set to benefit from new initiative, using artificial intelligence (AI) and personalised clinical coaching, easing pressure on NHS services.

NHS North East London Integrated Care System, in collaboration with Health Navigator and UCLPartners, this week (Thursday 12 December) launched a new, three-year programme, providing preventative care for patients with long-term conditions. This comes as urgent and emergency care services in North East London are facing unprecedented pressure and all-time high demand.

Through advanced AI screening technology and targeted, phone-based clinical coaching, patients at high risk of needing unplanned emergency care will be identified and offered personalised support from healthcare professionals trained in delivering preventative care and self-management techniques.

The initiative is designed to identify and better support people with long-term conditions, like asthma, by taking a proactive and preventative approach to healthcare delivery.

Forecasting models estimate that the programme will save 26,673 unplanned bed days in North East London hospitals across the three years of the programme, with an anticipated reduction of 13,000 A&E attendances annually.

Dr Paul Gilluley, Chief Medical Officer at NHS North East London, said: “More than 15 million people in England live with one or more long-term conditions, accounting for 50 per cent of all GP appointments, 64 per cent of outpatient visits, and over 70 per cent of inpatient bed days. This new approach represents a landmark step in harnessing technology for preventative care to better support these patients before they reach crisis points.”

Supported by the largest randomised controlled trial to date on AI-assisted preventative care, the initiative has shown significant impact when piloted in Staffordshire. Notable results include a 46 per cent reduction in deaths among men over 75, a 34 per cent reduction in emergency attendances and 25 per cent reduction in bed days, and a 26 per cent reduction in GP referrals to secondary care, further supporting sustainable healthcare delivery.

Tim, who benefited from clinical coaching when it was piloted in Staffordshire, said of the programme: “If you are brave enough to take control with the help of the coach, you truly can make a difference to the immediate crises as they turn up. In my case I went from being an asthmatic, to someone who happens to have asthma. I went from six admissions to hospital to none within a couple of months.”

Waltham Forest will be the first area to receive this new initiative through Barts Health NHS Trust and Barking, Havering and Redbridge University Hospitals NHS Trust, with plans to expand across North East London in the coming weeks. The AI technology and clinical coaching will then be implemented throughout the rest of North East London in the coming months.

Shane DeGaris, Group Chief Executive at Barts Health NHS Trust, added: “As winter approaches, the pressure on A&E services is rising. By predicting demand and providing earlier interventions, we can improve patient outcomes and reduce the burden on the NHS.”

Dr Chris Laing, Chief Executive Officer of UCLPartners, said: “This project provides a template for how the NHS can use modern technology to deliver predictive, proactive and preventive care that is customised for local communities and prioritises those most in need of our help. Our collaboration with Health Navigator and NHS North East London will not only enhance the lives of at-risk patients but will also relieve critical pressure on our healthcare system too, aligning with the government’s prevention priority.”

Dr Simon Swift, Chief Executive of Health Navigator said: “Our AI-driven technology, combined with personalised clinical coaching, has consistently demonstrated its ability to improve patient lives and shift care, allowing hospitals to be more productive. This collaboration represents a major step forward in proactive, preventative healthcare. We’re confident that this program will enhance the quality of life for patients and contribute to a more efficient and sustainable healthcare system.”

There is no integrated care without cross-sector data sharing

By Hannah Barnett

Integrated care systems strive to provide seamless, equitable healthcare by coordinating services, but fragmented data sharing remains a major challenge. Strong data partnerships are vital for continuous care, addressing health inequities, and optimising resources. Yet, technology, governance, and collaboration gaps hinder progress, disconnecting patients and providers.

Why data sharing matters in integrated care systems

The success of integrated care systems (ICS) relies on robust, strategic data sharing across multiple care settings. Effective data partnerships enable more coordinated and continuous care, empower population health management and self-care, tackle health and access inequalities, and drive informed resource allocation.

In today’s diverse, fragmented healthcare system, patients often navigate multiple providers across sectors. However, their data does not always follow, and this is disempowering as much as it is frustrating. Many ICSs still lag in adopting comprehensive data sharing practices and infrastructures, posing a significant barrier to achieving greater system efficiency, transparency, and supporting patients effectively.

Current limitations in data sharing practices

When data sharing does occur, it often flows in one direction. For example, NHS commissioners frequently rely on activity and service-user data provided by Voluntary, Community, and Social Enterprise (VCSE) organisations or primary care network (PCN) systems data to evaluate the impact of funding. This narrow focus excludes data on service users’ interactions with other health and care services, creating blind spots in patient outcomes and hidden needs, while undervaluing how these services reduce pressure on the broader system.

Comprehensive data sharing partnerships could transform this dynamic, enabling full tracking of patient pathways and better identifying access inequities across services and sectors. This shift would not only improve service delivery and resource allocation but also foster shared purpose and cross-sector accountability, while promoting consistent data collection and truly evidence-based evaluation practices.

Overcoming barriers to consistent and effective data sharing

Achieving this vision requires overcoming several cultural, technological, operational, and legal challenges. Patient data remains fragmented across multiple management systems, complicating access, aggregation, and sharing. While some advocate for a unified data capture system, the diversity of digital maturity across delivery partners makes this impractical. Instead, ICSs should prioritise system interoperability and shared care platforms, the latter being widely considered the cornerstone of integrated data sharing. When anonymised and aggregated, these shared databases become invaluable resources for population health management by enabling healthcare leaders to identify and anticipate care gaps across geographies and demographics.

All technical advancements, including the integration of artificial intelligence (AI), must be accompanied by centralised guidance on data collection, coding standards, and sharing agreements. Currently, many providers hesitate to share patient data due to confidentiality concerns and unclear information governance, GDPR or AI guidelines, which often vary across contracts and care settings. Clear protocols and governance structures are essential to balance privacy requirements with healthcare planning needs, ensuring both patient confidentiality and system efficiency. A cohesive system with transparent data processes would not only build public trust in data use but also reduce the frustration and fatigue patients often experience when navigating multiple disconnected care providers. Such structures must be clearly communicated to patients as the primary owners of their data.

Relationships, capacity, and power diffusion

Despite government mandates, limited progress in ICS investment in data infrastructure reveals the persistent barriers posed by entrenched organisational cultures and practices. As the King’s Fund observed in a 2022 report, “Good technology is not enough for interoperability to succeed; relationships between staff and organisations are vital for success.” Persistent power imbalances within ICSs can undermine enthusiasm for data sharing partnerships, especially when the benefits of integration appear unclear or unevenly distributed.

To foster trust and collaboration, health, social care, and voluntary sector leaders must work as equal partners in planning and delivering services. By setting, understanding, and contributing to shared priorities and agendas, all sectors would be mutually recognised as key contributors to progress. This approach would also increase buy-in for data collection at the local level, ensuring that digital infrastructures are viewed as enablers of collaboration rather than isolated technologies.

Many health and care providers currently lack the capacity or funding to dedicate staff time to data collection. Short-term contracts further limit incentives to build data sharing capabilities or use data beyond immediate funding requirements. Longer-term contracts would support consistent delivery, sustainability, and capacity building across sectors, while substantially reducing data fragmentation. Building a sustainable ecosystem requires trust and ongoing investment through collaborative, long-term partnerships, rather than transactional, repeated contracting cycles.

The NHS must lead this transformation by embedding information technology, governance, AI, and analytics at the heart of system implementation while supporting partners with varying levels of digital maturity. This includes equipping the workforce with the technical skills required to effectively collect and utilise data. Recognising the current strain on workforce capacity, the NHS must leverage resources and time for upskilling (including from its own suppliers), and ensure the transition is backed by ongoing investments in accessible analytics.

Conclusion

As patient pathways become increasingly dispersed across care settings, robust and proportionate data sharing infrastructure grows more essential for tackling health inequities, streamlining cross-sector resource allocation, and empowering the system to better empower patients. A sustained commitment to technological and cultural innovation, coupled with workforce upskilling will reshape how providers collaborate and deliver care, enhancing population health outcomes and building a more responsive, equitable healthcare system.

Local authorities join initiative providing digital support to carers

By Integrated Care Journal

1 million carers across England are benefiting from tech-powered support, as 1 in 4 (25 per cent) local authorities across the country have joined an initiative providing essential, digital services for all those who look after loved ones in their communities over the course of this year.

Nine local authorities across Cheshire and Merseyside have become the latest to join a new initiative aiming to provide digital support to carers. The service is being delivered by carer-led digital community, Mobilise, and can be accessed remotely via Mobilise’s online hub by anyone caring for a loved one in regions where local authorities are participating in the initiative.

Under the Care Act 2014, local authorities have a duty to promote and provide services to unpaid carers in their area, to put support the wellbeing of carers and reduce the risk of carer burnout.

The digital support services include:

An online peer community of thousands of fellow carers from across the UK – with the chance to share advice and experiences through a community forum and during regular events, such as the ‘virtual cuppa’
Easy-to-use, self-service tools outlining the different forms of support which carers may be entitled to – including Carer’s Allowance – and guidance on how to navigate eligibility criteria and access various benefits
Tailor-made support guides on everything from how to balance caring with full-time work, to managing personal health and wellbeing while looking after someone else
Information on carers’ rights and relevant social care law, in line with the latest government guidance

An AI-powered ‘assistant’ is also available to help carers quickly and easily find the specific information, resources or support that they need.

Cheshire and Merseyside is home to some of the UK’s highest density areas of unpaid carers, with more than one in ten residents living in St Helens, Knowsley and Halton providing some form of unpaid care.

“It’s reassuring to know that my experience as an ‘unofficial’ carer for my husband is valued, and that there is support and advice available from Mobilise if and when I need it.”

Sheila Walsh, a carer in St. Helen’s

Chair of the Adults and Health Committee at Cheshire East Council, Councillor Jill Rhodes, said: “By joining this initiative, we’re taking a significant step towards recognising and supporting the invaluable contribution of our local carers. The Mobilise digital tool will empower unpaid carers to access the help they need, when they need it.”

Cheshire and Merseyside councils follow thirteen local authorities in the North East, who joined the same initiative earlier this year through a similar collaboration. This saw over a quarter of a million carers living in the North East alone gain access to additional digital support. The North East is home to the largest proportion of people supporting relatives or loved ones in any region across the UK.

With Cheshire and Merseyside onboard, a total of 38 local authorities across England have provided added support for carers so far this year as part of the tech-enabled initiative with Mobilise, on top of existing provision. The free on-demand services are aimed at supporting individuals across the UK with the day-to-day realities of caring.

Suzanne Bourne, Co-Founder and Head of Carer Support at Mobilise, commented: “It is amazing to see all nine local authorities across Cheshire and Merseyside coming together to harness the power of technology, and widen access to support for unpaid carers. They join many other local authorities across England in this mission. And, with Cheshire and Merseyside onboard, a quarter of all local authorities across England are now providing additional, digital support for carers. We can’t wait to see the impact for all those who provide care across Cheshire and Merseyside, and beyond.”

Councillor Del Arnall, Cabinet Member for Adult Social Care at Knowsley Council, said: “Through joining this initiative, carers in Knowsley can use Mobilise to easily access a range of support services on-demand and link in with their peers across the UK to share advice and reduce isolation.”

For more information about the support now available in Cheshire and Merseyside, see here. To start accessing support today, the Mobilise app can be downloaded via the Apple App Store or Google Play, with more information available on Mobilise’s website.

London’s Universal Care Plan recognised for support to care for sickle cell disease

By Integrated Care Journal

Use of digital care plans for sickle cell disease hailed for giving healthcare providers visibility of patients’ unique medical history and preferences, enabling more compassionate and personalised care.

The introduction of the Universal Care Plan, OneLondon’s shared care planning solution powered by Better, has been hailed as a key improvement in the care of sickle cell patients, a group historically disadvantaged by misconceptions and poor-quality care.

The personalised care plan is designed to address individual patient needs, ensuring that preferences are documented in advance, which is particularly crucial for those who may experience severe pain and struggle to advocate for themselves.

Dr Subarna Chakravorty, Consultant Haematologist at King’s College Hospital NHS Foundation Trust made the comments during a recent event in London for Better’s user community. Dr Subarna, added: “What matters to the patient should be just as important as the medical diagnosis itself.”

The Universal Care Plan facilitates seamless access to essential patient information for healthcare providers, ensuring that critical details, such as oxygen saturation levels, are readily available during treatment. Developed with input from patients, the plan employs the ACT acronym—Analgesia, Compassion, and Trigger Testing—to guide providers in delivering appropriate care.

While currently available only within London, there is a drive to extend digitalised care plans for people with Sickle Cell Disease nationally, supported by training programmes for healthcare professionals to ensure effective use of the system. The project represents a collaborative effort to enhance the quality of care for sickle cell patients and sets a precedent for similar improvements in other areas of healthcare.

During the event, Solome Mealin, a PhD student and patient advocate, shared a deeply personal account of her battle with sickle cell disease, emphasising the vital role technology can play in improving care. “All I’ve known is pain, every day,” she said, recalling her experiences where, in the midst of a sickle cell crisis, her only lifeline was an off-duty nurse who understood her condition. Desperate and in agony, Solome had to rely on this nurse to call her colleagues at the hospital to ensure she received the correct care.

“One of the hardest things is not always being listened to by healthcare professionals. They say things like, ‘it can’t be that painful,’ leaving you feeling alone and helpless,” Solome explained, highlighting the emotional and physical toll of constantly having to advocate for herself.
Solome stressed the importance of personalised digital care plans, which give doctors immediate access to critical patient information, even in unfamiliar settings. “Every time I move or even go on holiday, I have to think about whether there will be a hospital nearby that understands my condition,” she explained.

With accessible digital care plans, healthcare providers can offer more consistent, compassionate care by understanding her unique medical history and preferences. “I believe that with better care plans and universal support for conditions like sickle cell, we can truly transform patients’ lives,” Solome said, her message clear: better systems mean better futures for countless people like her.

Dr Subarna and Solome were joined by the Head of the Universal Care Plan programme, Nick Tigere, during a panel discussion on the plan which highlighted the importance of collaboration between clinicians and digital systems, particularly in prioritising care needs for conditions like sickle cell disease. The panel stressed the necessity of incorporating clinician and patient feedback into the Universal Care Plan pathways to enhance usability and effectiveness and the plan’s utility, particularly during urgent care scenarios.

Looking forward, Nick Tigere confirmed plans to measure the UCP’s impact on patient outcomes, aiming to continue learning and sharing insights with integrated care systems (ICSs) throughout the UK.

New study underway on joint clinical trials between health tech and primary care

By Integrated Care Journal

A groundbreaking feasibility study in Northumbria is exploring the potential of collaborative clinical trials between health tech providers and primary care, with early results showing significant lifestyle and self-management improvements.

A first-of-its-kind randomised control trial in Northumbria is exploring the feasibility of cost-effective collaborative clinical trials, using digital interventions to support people with hypertension and depression and/or anxiety. Over a 12-week period, the Innovate UK-backed research project is involving patients by using Holly Health’s digital coaching service at home, emulating the real-world use of the service.

Cardiovascular conditions are the biggest cause of early deaths worldwide and over 19 million UK adults are affected by hypertension. However, as stated in the NHS Long Term Plan, “cardiovascular disease is largely preventable and the single biggest area where the NHS can save lives”.

Managing and preventing hypertension through lifestyle changes, including an improved diet and increased exercise, is critical. However, for many patients, self-managing the required changes becomes more challenging when combined with conditions such as anxiety and depression. For this reason, the need for innovative and integrated solutions that address both physical and mental health aspects is paramount.

Holly Health’s digital tool has the transformative potential of addressing the challenges posed by the comorbidity, enhancing self-management, reducing NHS costs, and improving national health outcomes.

Dr Justine Norman, Clinical Director for Quality and Research at Northumbria Primary Care, expressed excitement about participating in this unique feasibility study, highlighting the team’s interest in understanding how patients engage with and benefit from an innovative digital approach that address both physical and mental health conditions. Dr Norman added,

“The response from patients to take part in the research has been really encouraging. Now, we’re looking ahead to the study which has concluded this month and analysing the outcomes which will form a bigger six-month trial to measure the longer-term impact for our patients.”

The main outcomes of the study indicate strong patient engagement and positive lifestyle impacts. After using Holly Health for 12 weeks, 64 per cent of patients found the service useful, 69 per cent said they benefited from the service and 92 per cent found it acceptable as a digital health intervention. The app has helped improve participants’ lifestyles in the following ways, including:
●      Changes to eating habits
●      Reduced alcohol intake
●      Increased physical activity
●      Using the app to prompt better behaviours/habits

One participant finds the app very valuable and has become an integral part of her daily routine. She finds the ‘discovery’ resources and the notifications extremely useful. She also enjoys the reward feature and being able to tick off/complete a “habit” once she has done it. As an exploratory analysis, the study will look into changes in GP appointments and prescriptions after six months of using Holly Health. As an exploratory analysis, the study will look into changes in GP appointments and prescriptions after six months of using Holly Health.

Daniela Beivide, Chief Science Officer at Holly Health pointed out that prior studies for isolated conditions have demonstrated the positive impact of digital interventions, including a reduction of demand on services. She commented,

“We’re just as excited as our study partner, Northumbria Primary Care, to be investigating whether the same impact can be applied to supporting people with physical and mental health comorbidities.

If successful, there is huge potential to efficiently and cost-effectively scale the service for large populations to reduce strain on NHS services and create significant change in the economy of the country. We’re proud to be part of this cutting-edge approach where digital health companies and the NHS can partner to research and implement solutions at low cost and an accelerated pace”.

Holly Health’s intuitive app provides intelligent AI-powered coaching, habit reminders, education, and in-the-moment support to encourage regular actions for blood pressure and mood management, which empower individuals and improve self-management abilities.

The feasibility study is part of a Future Economy 12-month project funded by Innovate UK that has also enabled Holly Health to develop innovative features within its app, such as the Ecological Momentary Assessment (EMA) feature that gathers real-time user data for current mood and stress levels which can then be used to provide a more relevant and personalised coaching experience.

Digital Implementation, News November 18, 2024

From innovation to application: How healthcare must adopt an AI approach to patient engagement

By James Neal

Healthcare systems can learn vital lessons from other sectors further along the AI implementation transition, writes James Neal, Chief Revenue Officer at EBO.

Artificial intelligence and machine learning are already mainstream tools in many sectors, helping to automate manual tasks, accelerate processes, and drive innovation. In healthcare, the adoption of this technology will make today’s practices seem outdated in just a few years.

However, as we scale up these innovations, we must look towards other sectors that are further along in their AI journeys to absorb lessons that are prime for application in the NHS.

Meeting patient expectations in healthcare

Across multiple industries, AI is revolutionising user experience, setting new standards that healthcare providers should aspire to meet. Patients, accustomed to seamless digital interactions in other areas of their lives, now expect the same from healthcare. They seek easy access to care, free from bureaucratic hurdles and inefficiencies.

“Embracing AI is not just a choice — it’s a critical step for the NHS.”

As IBM’s Senior Vice President, Paul Papas, has observed: “The last best experience that anyone has anywhere becomes the minimum expectation for the experiences they want everywhere.” This is particularly true in healthcare, where outdated systems can no longer meet modern demands. Lord Darzi’s review has highlighted that many NHS processes remain clunky and inefficient, causing frustration for both patients and staff.

The imperative to adopt advanced technologies is clear. In an era of rising demand and limited resources, embracing AI is not just a choice — it’s a critical step for the NHS to deliver sustainable care.

Taking a leaf out of the financial services playbook

The NHS can learn from the financial services sector’s focus on user experience, innovation, and its shift from one-way communication to interactive, user-centred dialogue. All of these are crucial to the financial sector due to high customer demands and volumes – which are also acutely present in healthcare.

Automating user journeys to dynamically interact with customers 24/7 – in any language, on any channel, at any time – ensures that accurate information can be accessed immediately and at the user’s own convenience.

With the ability to complete thousands of repetitive tasks and workflows simultaneously, AI automation reduces 60-80 per cent of repetitive inbound enquiries from public-facing teams. This saves staff precious time and increases capacity.

Take Exinity, for example. This trading and investing fintech is having great success using EBO’s AI automation technology to process over 80,000 conversations a month across five languages (English, Farsi, Russian, Chinese and Arabic) around the clock.

By adopting AI automation technology, Exinity aimed to automate 40 per cent of incoming requests within the first year, but impressively, surpassed this goal within just three months. Today, 50 per cent of all conversations are fully managed by AI, leading to greater efficiency, enhanced satisfaction, and reduced operational costs. This has also freed up service agents to focus on more value-driven tasks, further enriching the overall experience.

In the context of healthcare, the same technology is empowering patients to have more visibility and control over their healthcare journey, improving the patient experience while reducing the administrative burden on healthcare providers.

How a private hospital is showing the way

Saint James Hospital is setting a remarkable example of AI adoption within the private healthcare sector, significantly boosting productivity, enhancing patient experiences, and reducing staff workloads. With over a million appointments each year and a rapidly growing patient base, the hospital’s patient services teams were struggling to manage appointment bookings, especially during peak hours. The increasing communication bottlenecks led to inefficiencies in workforce coordination.

“The solutions now handles over 12,000 appointment bookings each month.”

Through EBO’s AI-powered Virtual Assistant (VA), the hospital has provided a two-way communication channel which is available on the hospital’s website and via Facebook Messenger. The tool is the first use of AI by the hospital, which integrates directly with its hospital management system and EPR. Today, the VA interacts with patients and service users via two-way automated human-like conversation, answering questions 24/7, and managing appointment bookings from start to finish. Patients can book, cancel or reschedule their appointments without the need for human intervention. Thanks to its AI context and sentiment awareness, the VA identifies customer’s emotions and adjusts the dialogue accordingly.

The results have been transformative. The solution now handles over 12,000 appointment bookings each month, with 93 per cent of interactions being completed end-to-end by the AI tool. At peak times, it absorbs 40 per cent of the call workload, allowing staff to focus on more complex tasks. Patient satisfaction has soared, with a 96 per cent approval rating—demonstrating how AI can dramatically improve both operational efficiency and patient experience.

Shifting from analogue to digital

Adopting AI automation isn’t just about appealing to the ‘modern’ patient and being there 24/7, on any device and available in any language. It’s about making experiences patient-centric, increasing patients’ access to healthcare and enabling patients to navigate their pathways easily and efficiently.

Shifting patient engagement from an impersonal one-sided interaction to a patient-friendly, conversational, and inclusive model promotes a more accessible and natural way for patients to interact with their healthcare provider. By automating repetitive administrative tasks and streamlining processes, AI automation technology makes patient journeys more convenient and engaging – enhancing choice and empowerment.

It’s not just about focusing on technology and moving from analogue to digital. Virtual Assistants are sophisticated enough to foster meaningful conversations and understand patient needs. Engaging patients through two-way conversations simplifies complex inaccessible processes into universally adaptable communication channels that cater to individual patient needs. It’s about using data to turn the currently reactive processes into proactive and predictive models by using the volumes of data captured to forecast scenarious and outcomes in real-time.

Nearly 20 NHS trusts and health boards across the UK are already using EBO’s solutions and are seeing exceptional results helping to reduce workload, increase efficiency, and improve patient satisfaction.

Time to work smarter, not harder

By adopting AI, we can create a more seamless and patient-centred experience. AI can help automate routine tasks, allowing patients to book appointments, access their health records, and manage their healthcare with ease. These innovations aren’t just about efficiency, they’re about making the NHS more accessible, responsive, and patient-centric.

It’s time to work smarter not harder to help the NHS reform and non-clinical AI innovations are going to be a key enabler. AI is the productivity tool the NHS is crying out for, and we have it in the palm of our hands. Now is the time to apply it.

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NHS-backed study shows 73% reduction in GP waiting times using AI triage system

By Integrated Care Journal

An independent, NHS-funded evaluation has validated the transformative impact of an AI-powered Smart Triage system on primary care delivery in England.

The Groves Medical Centre, a leading family GP practice in Surrey and South West London, has achieved unprecedented improvements to patient access, practice capacity and sustainable staff working patterns after implementing Smart Triage.

Smart Triage, an AI-powered autonomous patient triaging system developed by health technology company Rapid Health, was implemented at The Groves Medical Centre in October 2023. The system has transformed patient access, enabling equitable and safe care based on clinical need rather than on a first-come-first-served basis.

An independent real-world evaluation, funded by Health Innovation Kent Surrey Sussex – one of 15 health innovation networks across England – and conducted by Unity Insights, has measured the impact of autonomous patient triage between October 2023 and February 2024. The evaluation assessed the system’s acceptability, implementation, effectiveness, and impact on health inequalities.

Key findings of the evaluation include:

Patient waiting times reduced by 73 per cent, from 11 to 3 days, for pre-bookable appointments
The practice had 47 per cent fewer phone calls at peak hours, with a 58 per cent reduction in the maximum number of calls, all but eliminating the “8am rush”
Same-day appointment requests fell from over 62 per cent to 19 per cent, significantly expanding the capacity for pre-bookable appointments
70 per cent fewer patients needed a repeat appointment, having received the right care on their first visit
85 per cent of appointments booked via the new system were delivered face-to-face, a 60 per cent increase compared to the pre-implementation period
Only 18 per cent of all patient requests were initiated over the phone after the system was implemented versus 88 per cent prior to it being implemented
91 per cent of appointments were automatically allocated without staff or clinical intervention

These changes have culminated in a better overall experience for patients at The Groves Medical Centre. GPs now spend 15 minutes with patients, rather than 10 – a 50 per cent increase. Additionally, the practice has achieved an 8 per cent increase in the number of appointments delivered per working day without hiring additional staff. Patients now have a wider selection of appointment slots to choose from, with an average of 61 slots available per patient appointment request. This has resulted in a 14 per cent reduction in patient no-shows, despite the practice already maintaining low DNA (did not attend) rates.

In contrast to traditional online consultation and triage tools that only collect information, Smart Triage fully automates the patient navigation process from the initial contact with their GP practice. Whether requesting care online, by phone, or in person, patients are guided through a series of questions based on their concerns. The system then assesses their symptoms and directs the patient to the most suitable care, even enabling immediate self-booking into the right appointments. This streamlined process empowers patients to access care at their convenience while relieving the practice from direct involvement in each request. This is the first time a study has proven an autonomous clinical system is safe and effective in doing this process end to end.

Dr Andrea Fensom, GP Partner at Groves Medical Centre, remarked: “Smart Triage has completely changed how we work. It has not only optimised our resources but increased patient access. Feedback shows that patients find it easy to use our online tool and it’s convenient for them, giving them multiple options for appointments where safe to do so and booking them with the most appropriate clinician for their problem. We are all very proud of these results.”

Jake Kennerson, Group Manager at Groves Medical Centre, added, “The positive outcomes we’ve seen in such a short period are a testament to the effectiveness of this innovative system. There’s been a significant decrease in the number of patients requiring same-day appointments and wait times have been drastically reduced. All of this change was achieved during the peak winter months and without any additional staff. If others were to adopt a similar approach, it could lead to transformative results for patients and the NHS as a whole”.

Carmelo Insalaco, CEO of Rapid Health, expressed his pride in the system’s success: “We’re really proud to see the extraordinary impact of autonomous patient triage at The Groves Medical Centre. These results reflect what we consistently observe with our customers across the country – the remarkable potential for Smart Triage to dramatically enhance patient access and choice, while solving the persistent challenges of lengthy waiting lists and disruptive morning bottlenecks. We look forward to further collaboration and expansion across the wider NHS to benefit more patients and healthcare providers”.

By implementing the software, GP practices and Primary Care Networks (PCNs) can improve patient access, reduce workload, unlock capacity and manage patient demand more effectively. With better access for patients online, call volumes are reduced and peaks in demand can be smoothed out, eventually eliminating the ‘8am rush’. This ultimately enhances and automates the Modern General Practice Access Model which was introduced by NHS England last year.

Universal Care Plan breaks usage records with new integrations and sickle cell care plans

By Integrated Care Journal

More than 5,000 people with sickle cell disease now have a plan on the integrated care platform, covering nearly all of those receiving care for the disease in London.

The Universal Care Plan (UCP), OneLondon’s shared care planning solution powered by Better, has in the last year integrated with the NHS National Record Locator (NRL) and the NHS App, while also extending the care plan support for people with sickle cell disease.

These latest developments within the solution, which spans five integrated care boards across the whole of London and has recently marked two years of existence, are helping to further integrate care, improve patient outcomes, and drive up engagement, in some cases at record-breaking levels.

Introduction of sickle cell care plans

Expanding the UCP to support individuals with sickle cell disease is an important step, following the No One’s Listening report, calling for major changes in sickle cell care. Sickle cell disease affects approximately 15,000 people in the UK. Approximately 60 per cent of people diagnosed with the disease have their treatment in London. With symptoms ranging from anaemia to severe pain episodes known as sickle cell crisis, managing this condition effectively requires comprehensive care planning and prompt treatment interventions.

Since the launch of the care plans, 5,000 people with the disease now have a plan on the integrated care platform, meaning the service is close to supporting everyone who is cared for in the capital.

“I think this is a real game changer for people with sickle cell disease,” said Nick Tigere, Head of the UCP Programme. “They are now able to confidently seek the medical attention they need while in crisis, knowing fully that the services they attend, wherever they attend in London, will be aware of consolidated key information on diagnosis, symptom management, and treatment options.

“Supporting healthcare professionals with immediate access to this critical information is facilitating timely interventions and improved care. It really has been transformative for people’s care pathway.”

National Record Locator integration

With the new National Record Locator (NRL) integration in place, London and out-of-London urgent care services are now able to view a UCP en route to responding to a patient in need. This means that a patient’s care plan, particularly their symptom management requirements, can be delivered immediately as the paramedics make contact with the patient, even when they are away from London. Following the go-live, the number of plans accessed by the Ambulance Service has increased by 20 per cent due to the increased access the integration is providing.

The NRL is an NHS service that allows health and care professionals to find and access patient information shared by other health and care organisations across England to support the direct care of a patient.

NHS App integration

Patients can now also access their UCP in the NHS App, which is another step towards putting patients at the heart of their care planning. It means patients can easily share their plans with healthcare professionals as they move around London and across the rest of the country.
In an emergency, patients may not be able to articulate or communicate their wishes and preferences, in which case they can defer to showing clinicians the plan on the app. The increased accessibility is also empowering patients to take a more active role in managing their information and ensuring it is up to date.

In four months, the app has seen 20,000 jump-offs to care plans, and if a plan isn’t in place, it’s helping to initiate conversations with clinicians to create one, which is in turn contributing to an increase in overall care plans created. During July, the service celebrated a record-breaking 4,200 care plans being generated on the platform.

Concluding on the new integrations and sickle cell care plans, Nick Tigere added: “The UCP platform has become a well-established tool for health and care professionals and is helping to ensure people have their care wishes and preferences respected. Our role is to enable all parts of the system to quickly access relevant patient information at the right place and right time. I am proud that we continue to enable this for people and our health services with these latest developments.”

Darren Ransley, Managing Director UK & Ireland at Better, said: “By expanding access to patient data through the NHS National Record Locator and NHS App, we are advancing interoperability and making healthcare data available anywhere, anytime. These integrations mark a significant step forward in delivering person-centred care and ensuring equitable access to healthcare services.

“By leveraging innovative technology and a person-centred approach, the UCP continues to redefine care delivery standards, setting a new benchmark for integrated healthcare solutions.”

At the end of 2024, the UCP will be transformed into a personalised care and support plan with the introduction of new forms and data fields to create a richer picture of the person receiving care. The new information will cover the PRSB ‘About Me’ standard, living arrangements, medical devices, communication and accessibility requirements, and daily activities and support needs.

Social care monitoring tech could free up two million bed days and save over £1.2bn for the NHS, new report finds

By Integrated Care Journal

New report highlights major potential of lifestyle monitoring technology to address immediate system-wide crisis across health and social care, finding that thousands could avoid hospitalisation from earlier detection of illness, avoiding more expensive residential care.

The NHS could save more than £1.2 billion through widespread use of new non-intrusive lifestyle monitoring technology in social care according to a new independent report. More than two million hospital bed days could be saved, and the extra capacity created in social care able to fund the equivalent of 10,000 additional full-time carers in the system by 2035.

These findings are part of new analysis commissioned by health-tech company Lilli to make the case for urgent digitisation across the health and social care sector. The report uses data from multiple local authorities across the UK who are currently using the AI-driven monitoring technology to address the growing care deficit and mounting social care crisis.

Entitled From passive to proactive: How monitoring technology can help to solve the health and social care crisis, the report follows recent social care promises from the new government to accelerate the adoption of technology in health and care and highlights the ‘domino effect’ that proactive monitoring employed in social care can have not just on council resources but also the NHS and patient outcomes.

It identifies hospital discharge as a key area that can see a significant impact from the technology. Earlier discharge would amount to 2.3 million additional bed days and almost £1.2bn in savings for the NHS, due to reduced costs of providing beds for patients over the next ten years – enough to pay the salaries of 2,000 nurses over the period. It would also lead to better health outcomes for the many thousands of people experiencing delayed discharge every day, with extended stays linked to higher risk of infections, adverse drug reactions and readmissions to hospital.

The report also finds that adopting monitoring technology now would save councils £3bn by 2035 by supporting people to live independently at home for longer and preventing thousands of people entering more expensive care settings, such as residential care. The productivity benefits would help to address the workforce crisis in care, by generating additional capacity equivalent to 94 million hours of carer time across the UK, or to having 10,000 extra care workers. These productivity benefits would be worth an estimated £1.8bn to councils, allowing vital resources to be redistributed to where they are most needed.

Lifestyle monitoring technology works by tracking patterns of behaviour and key indicators of health, such as movement, eating and bathroom activity, and alerting carers to any changes. This allows care professionals to quickly make accurate care assessments, and safely monitor people’s health at home remotely, while being on the front foot to proactively spot signs of health decline before conditions require hospital treatment. Urinary tract infections (UTIs) have been identified as a key area where monitoring technology can help prevent hospital admissions, and the report estimates that the NHS could make savings of £1.8m each year through reduced hospital admissions from UTIs, due to earlier intervention, which could pay for half a million hours of nursing time.

Rebecca Andrew, Service Improvement Manager from Nottinghamshire County Council, said: “The rollout of remote monitoring technology across Nottinghamshire allows our social care staff access to real time data, giving insights into a person’s behaviour over a period of time. This helps them to build a clear picture of what is going on in a person’s life and draw their attention to any potential change in their social care needs. This ensures we can put appropriate care and support in place that is personalised to the individual, and respond quickly to prevent crises, meaning fewer ambulance call outs and hospital admissions.”

According to the report, produced by economists at Policy Points, “there is strong evidence that lifestyle monitoring technology can generate essential, big-ticket savings for both the NHS and for social care, creating a digital dividend by protecting scarce hospital resources at the same time as boosting the productivity of carers”.

Kelly Hudson, Chief Executive Officer at Lilli, said: “Right now, the people who need care are not getting the help that they should, and the problem will only get worse as the population ages. The numbers in this report speak for themselves. The savings and productivity figures highlight the profound difference that an investment in technology now would have not just on the system but on the lives of people up and down the country.”

Lifestyle monitoring technology from Lilli is currently being used by multiple councils across the UK, including Islington, Nottingham and Reading, to enable people to live safely and independently at home.

The report goes on to explain how over the next ten years, the older population will ‘grow by millions’, increasing demand for its services, and for the health and care system to be sustainable, a commitment to overhauling the system at pace and scale is urgently needed. The alternative is a broken system that will continue to be reactive and is unable to meet the care needs of those who need it most.

Kelly Hudson adds: “We are supportive of the new Health Secretary’s ambition for a ‘different politics on social care’ and we urge the new government to tackle the current crisis proactively as they have pledged, by addressing the root cause of the issue. We are urgently calling for more support for the sector to adopt a technology led approach to better support the people in need, reduce wasted costs and deliver better outcomes.”

EHR roll-outs need strategies to mitigate clinician overload

By Dr Dominic Pimenta, Jasmine Balloch, Dr Ellie Asgari; TORTUS

Clinicians are increasingly subject to cognitive overload, and recent studies suggest that without mitigation strategies in place, poor implementation of EHR systems can exacerbate the problem.

In April, a narrative review paper was published in the JMIR Medical Informatics titled Impact of Electronic Health Record Use on Cognitive Loads and Burnout Among Clinicians. My fellow authors and I applied cognitive load theory to explore the impact that routine EHR use has on clinicians and to suggest how the risk of negative effects could be minimised.

It’s important to preface the discussion of our conclusions by acknowledging that EHR systems are essential for the delivery of efficient, joined-up patient care: they allow for improved communication between clinicians, remote access to clinical records and to a high volume of clinician data for research and audit purposes. Rightly, years of effort and significant investment have led to widespread EHR implementation across the NHS: 87 per cent of primary, secondary and community care staff surveyed by the Health Foundation reported using EHRs as part of their work, and in the 2024 Spring Budget, the Chancellor pledged that they would be rolled out across all NHS Trusts by 2026.

However, only 57 per cent of respondents in the same Health Foundation survey chose EHRs as the technology saving them the most time, and their rapid review of 72 studies about EHRs and related tools identified that 44 per cent found no time savings delivered. This indicates that the potential of EHRs is not yet being fully realised.

As our new review concludes, taking a considered, evidence-informed approach to the design and implementation of EHRs makes all the difference when it comes to unlocking their full potential, while mitigating significant potential risk. Importantly, by acknowledging and proactively addressing the relationship between EHRs and cognitive burden, organisations can successfully reduce rates of clinician burnout and minimise risks to patient safety.

EHRs and cognitive overload: examining the evidence

Cognitive load theory explains that human capacity to process information is limited to a few elements in working memory at any given time. When this capacity is overwhelmed by an excessive quantity of information, the resulting cognitive overload can impair decision making, interfere with mental performance and elevate stress levels. Clinicians are typically at high risk of cognitive overload, as they must navigate complex patient data, integrate new information rapidly, and make critical decisions under pressure on a daily basis. The transition to digital records has compounded this challenge by significantly increasing the volume and complexity of data clinicians must handle during patient care.

Recent studies indicate that poorly designed EHR systems can exacerbate cognitive load. The factors contributing to this include inefficient user interfaces, excessive documentation requirements, and the need to navigate through cumbersome electronic systems to access relevant patient information. In addition, dealing with overly-frequent pop-up notifications has been shown to cause distraction and alert fatigue, both of which can lead to clinicians missing important information and result in poor patient outcomes.

Experiencing regular cognitive overload is a major risk factor for burnout. In 2023, 55 per cent of surveyed NHS workers had experienced burnout in recent years, a condition characterised by emotional exhaustion, demoralisation, and a reduced sense of personal accomplishment, which not only affects individual health professionals but also the quality of care they provide. Although burnout has multiple root causes, addressing the design and implementation of EHRs to reduce the cognitive load they place on clinicians is a necessary and important step towards tackling the rise in burnout cases.

Practical recommendations:

Improving EHR user interfaces: Simplifying the user interface of EHR systems can reduce unnecessary cognitive effort. This involves designing more intuitive menus, reducing the number of steps to complete tasks, and organising patient data more logically.
Streamlining information presentation: Tailoring the presentation of information to minimise extraneous load is crucial. This could mean displaying critical patient data in a summarised form, with the option to expand details as needed, thus preventing information overload.
Reducing documentation burdens: Automating routine data entry and employing natural language processing can decrease the time clinicians spend on documentation. This not only frees up cognitive resources but also allows clinicians to devote more attention to patient care.
Incorporating decision support tools: Advanced decision support tools can aid clinicians by providing contextually relevant information at the point of care, reducing the need for extensive data retrieval and analysis.
Training and support: Continuous training and real-time support can enhance EHR proficiency among clinicians. Tailored training programs that address the specific needs of users can alleviate stress and improve their interaction with the technology.

Importantly, emerging artificial intelligence and machine learning technologies offer promising avenues to manage cognitive load by automating routine tasks and predicting patient risks through advanced analytics. However, the integration of these technologies must be handled carefully to avoid adding to the cognitive burden – evidencing a need for user-friendly design and time-saving clinical integration.

In summary, clinician burnout is complex and has multiple causes – such as overall workload, inflexibility of rostering and organisational culture – which is why it could never be fully eliminated even by the ‘perfect’ design and implementation of an EHR. However, by scientifically assessing the impact of different EHR technologies and models, it becomes possible to paint a more complete picture of how they alleviate or exacerbate burnout. In turn, this understanding can be used to ensure that clinicians are equipped with the best EHR systems –and the best integrated technologies – that improve their efficiency and improve patient outcomes.