While the UK is fortunate to have access to the NHS, we all know that the system is currently under enormous strain, with a huge over demand for its services. London-based startup Appt think that preventative healthcare could be part of the solution. Joining our Future 20 programme last year, Appt have created innovative software which helps patients to easily access preventative healthcare appointments through an automated process. By screening for long-term illness and chronic disease more effectively, this saves the NHS time and money, while improving overall patient health.
So how does it work? We spoke to Appt to find out more:
Could you explain in a few sentences how Appt works?
Appt’s software automates the invitation and appointment booking process for appointments like health screenings, immunisations, or periodic reviews in a way that saves time and reduces practice expenses. It is designed to work for both patients and care providers.
89% of deaths in the UK are from causes considered preventable. That’s an incredible statistic that we feel we must impact
Why is preventative healthcare so important?
Preventative healthcare stops people from becoming ill and suffering unnecessarily. It has the power to help everyone live longer and healthier lives. The more diseases or conditions that can be prevented, the less demand is placed on the NHS. The lack of current resource for preventable ill health is worrying and preventing diseases would save the NHS billions in the next few years. Aside from that, the UK economy sees a huge missed opportunity from avoidable illness, as people take sick days or suffer every day leading to low productivity.
Can you tell us some of the statistics that you hope to impact?
Currently, 89% of deaths in the UK are from causes that are considered preventable. That’s an incredible statistic that we feel we must impact. Across England, just 35% of people who are eligible for an NHS Health Check actually attend. Our randomised control trial in Barking & Dagenham is designed to test what we can do to impact this statistic; we are aiming for at least 65% uptake. From our first invitation we saw a booking rate of 45%, and we still have three rounds left to reach patients. If we can translate this type of uptake to new screening programmes, immunisations, and other preventative interventions, we will be well on our way to reducing preventable ill health.
How many GPs has Appt been used in so far?
Following early pilots in four practices in east London, we are now running a randomised control trial to build out and prove our technology. The trial runs in 17 GP practices in the London Borough of Barking & Dagenham who were willing to test what we could do, offer feedback, and have a solution built around their needs.
We recently also extended our work with the London Borough of Tower Hamlets. Last year we began optimising invitations for the latent tuberculosis infection vaccination offered to people who had a high risk of carrying the infection without knowing it, and we are about to start rolling our service out to all 34 practices in the borough.
All the signs have been very positive so far and we are looking forward to expanding outside of London later this year.
Can you take us through the Appt patient journey?
It depends on the communication method. For our two-way SMS, patients receive a series of SMS messages: an introduction, an invitation, and reminder messages to respond.
Our SMS invitation includes three appointments times they can choose from. The patient simply has to respond with A, B, or C to choose the time that suits them and this books them in to the GP practice’s appointment book. If none of the times offered suit the patient they have the option to reply ‘MORE’ or even to give guidance like ‘I need Tuesday afternoons please’, which allows us to adapt the offer to their needs.
Some patients require a more manual approach or prefer to receive an Appt-crafted invitation letter in the post – which we automate. We’ve also developed an automated telephone booking system in response to GP practice feedback. Patients no longer will have to call the practice to book an appointment, but will have the details for a secure, automated phone line that they can call to book a suitable appointment, included in their letter.
What effect could Appt have on the NHS long-term?
We believe that Appt can transform the way that preventative healthcare is commissioned. By making it really easy to implement a preventative programme, we will no longer need to run programmes that target whole populations; instead you can target smaller, at risk groups. This will be more cost effective for the NHS, will lead to better patient outcomes, and should create a better patient experience.
Regardless of what mechanism is used to identify eligible patients – all of these programmes fundamentally rely on being able to encourage patients to book and attend these appointments in the first place. And that is what Appt does really well.
What’s the feedback been like?
The feedback from general practice staff, NHS and local government officials has been really encouraging so far. When we started our randomised controlled trial in Barking & Dagenham, we saw the huge pressure that practices felt when trying to deliver on their NHS sanctioned prevention targets.
The Public Health team at Barking & Dagenham council have expressed great interest in our results, and they will be presenting Appt’s technology at the Cardiovascular Disease Prevention Conference 2020.
Our clinical users (practice managers and GPs) have continued to give us positive feedback as we send them more booked appointments each week. One practice manager even noted that they were seeing patients in health check appointments they’d never seen before despite years of sending letters and attempting to call them.
Where would you like Appt to be in five years’ time?
In five years’ time we want to be live in over 60% of all English GP surgeries. We want to be helping all those GP surgeries to hit their targets around preventive healthcare and early intervention and we want to be helping commissioners to implement some of the new programmes that Appt’s platform makes possible.
What has been challenging for Appt, and has being part of the Future 20 programme helped?
Innovating within the NHS has been a challenge at times. People have to be very careful about who can access patient data, and ensuring that Appt satisfied all regulations and had all of our documentation in place was a long and difficult journey.
Once we had run some small trials and proved that our idea had merit, the next challenge we faced was integrating with outdated NHS technology. This is a challenge we are still working through, but it is important that we can get data in and out of GP systems without adding to staff workload.
The Future 20 programme has given our team a home where we can all meet and work on tricky problems together, or a place where we can put our headphones on and get stuck into something without being distracted. It’s been so helpful for helping us become a team too.
To find out more about Appt, visit their website: www.appt-health.co.uk/
The Future 20 programme is a bespoke incubator programme run by Allia Future Business Centre comprised of 20 of the very best UK tech for good and social ventures that are addressing the UN Sustainable Development Goals.