Author: Alison Griffiths

We have previously reported on the growing impetus towards shared health and social care initiatives; moving healthcare away from specialist settings and into the community. That move has been generally welcomed by clinicians and patients alike; with prevention and early interventions seen as helping to improve health outcomes.

However, as with any new system there are still some issues to iron out. One of these is the role which medical specialists will play in the future. This uncertainty has been highlighted by a report by the Royal College of Physicians (RCP) which revealed that 48% of clinicians were either not very clear, or not clear at all, about how their specialist role could integrate with a neighbourhood health team. Moreover, 42% of respondents were concerned about the way in which a move to neighbourhood health would affect their clinical work. Key areas of concern here include the impact of virtual or remote consultations, including whether consultations outside of a hospital base could lead to a reduction in timely diagnostic procedures. Responders were also concerned about escalation routes available for patients with complex needs.

In response to the concerns raised, the RCP has made a number of recommendations aimed at providing integrated pathways and training. These include the need for integrated systems which include electronic patient records to enable “joined-up care and shared decision-making across traditionally siloed teams.”

This call from medical specialists to deliver integrated health systems may also go some way towards solving administration and communication issues identified by patients. A report by The King’s Fund has revealed a level of concern about health communications and the way in which poor communication can impact patient outcomes. And whilst the headline rate of 66% of patients and carers experiencing at least one administration problem in 2025 is unchanged from the previous year, other results are even less encouraging.

For example, whilst in 2024 52% of people thought the NHS was good at keeping them informed about their appointments and test results, in 2025 this had fallen to 43%. Similar falls were seen in the communication of care and treatment plans; whilst a significant 23% commented they had received appointment communications after the appointment date had passed. And sadly, those with long-term health conditions seemed to be experiencing the worst level of service, with 45% of those with long-term healthcare needs reporting poor communication levels compared with 36% of those with more short-term healthcare needs.

Summarising the report The King’s Fund commented that “The results overall make for difficult reading.” In response they have put together a ten-point action plan starting with making admin a national priority. As with the RCP report, The King’s Fund also highlights the potential benefits of a digital process recommending that when designing digital processes all potential users are considered and supported and that digital pathways are straightforward, easy for patients to navigate and enable two-way communication. Prompt referral confirmations should also be given including an indication of expected treatment waiting times and with patients being offered a choice of time and date for appointments.

“Across GPs, dentistry, mental health, elective care, and social care, people face persistent difficulties getting timely appointments, referrals, treatment, and support.” That’s the top finding from a recent report looking at the state of health and social care in 2026 in England. The report was compiled by Healthwatch, a statutory committee set up under the Health and Social Care Act 2012 as a part of the Care Quality Commission (CQC) responsible for monitoring and reporting on user experiences in health and social care.

The report also revealed that inequalities in healthcare persist, in some cases being little changed from three years ago, and that waiting for care takes a toll on wellbeing. In a bid to tackle delays the government has announced a plan to invest a further £237m in the community diagnostic programme. The funds will go towards expanding and enhancing 32 existing centres, with plans for new centres to open in the coming year in Gorton, Luton, Boston and Bideford.

According to the government announcement, this expansion of the community diagnostic programme will enable people to receive faster and more convenient tests, checks, and scans. Given that the report highlighted the fact that just 35% of people were confident of receiving timely healthcare, that expansion of the programme may well be welcomed by patients. Commenting on the programme Dr Bernie Croal, Royal College of Pathologists’ President, said: “From monitoring heart disease to checking kidney function or diagnosing diabetes, the centres bring diagnosis and treatment into community settings. These centres are also instrumental in tackling health inequalities, delivering improved access to diagnostic testing, reduced waiting times and earlier diagnosis for patients.”

Increasing access to fast diagnostic programmes is only one part of the healthcare story. The Healthwatch report also highlighted the importance of digital transformation in delivering access to care. When done right, digital transformations can help to speed up treatment plans; for example, the digitisation of patient records enables fast access to and transfer of records between health providers. However, the report also cautioned that digital exclusion and poor system integration could lead in some cases to unequal access to care.

Administration and communication failures were also signalled out as potential pathways to poor patient experiences. In particular the report highlighted problems such as missing records, lack of updates and failure to meet accessibility standards. Here again the digitisation of patient records could go some way towards tackling the problem of missing records, whilst systems such as appointment notification could help to improve attendance.

Having said that, the report’s authors say there is a need to offer both technological and traditional care options. This includes offering dual access to services such as the ability to either book appointments online or via a phone call; as well as offering face to face, telephone, or online consultations. This will help to ensure that patients have more choice in the way they interact with their health provider whilst ensuring that individuals who do not have access to fast internet services or who lack confidence online are not excluded from health provision.

On 7^th March 1876 Alexander Graham Bell picked up his telephone and issued the immortal words “Mr Watson come here I want to see you.” In doing so he changed the face of communications forever. What is perhaps remarkable is the speed with which this new invention took off. Within two short years Bell was demonstrating his phone system to Queen Victoria and two years after that the first UK phone book was published.

In the early days telephone callers had to be connected via switchboard operator. It was not until 1912 that the first automatic switchboard was introduced in the UK but the roll-out was slow and it was not until the early 1960s that the last manually operated switchboard was closed down. By then, either installed in our homes, offices or on street corners, the telephone had become a familiar staple of life.

Fast forward to today and the idea of a static phone in every home is slowly disappearing, as mobile phone coverage becomes more universal. At the same time, the roll out of fast fibre to the premises is accelerating, with Ofcom announcing on 16^th March 2026 that 78% of homes now have full fibre connectivity. But however the telephone network is accessed, nothing can take away from the profound impact which Alexander Graham Bell’s invention has had on our lives.

This is particularly true in the field of healthcare where the phone rapidly became a lifeline for those in poor health. In the early days, the ability to phone for the doctor undoubtedly helped to save lives. And as phones became more universal, the idea of phoning to book health appointments or to ask for answers to simple health questions rapidly became an intrinsic element of health care.

Of course, nowadays telephone contact with health services has been supplemented by online services; perhaps enabling us to book appointments online or to send queries electronically to health providers. However, online services cannot provide solutions in every case. Knowing that we can still pick up the phone and ask for help is still a vital part of the patient/ healthcare contract.

So much so that the Government’s latest announcement on the neighbourhood health framework issued on 17^th March 2026 acknowledges the part which phones have to play in delivering healthcare. The announcement includes the ambition to “organise services around the person with more convenient, personalised and joined-up care” including improving access to care “by phone, online, or in person.” Other planks of this revised health framework include the integration of services and making full use of digital opportunities. This move towards a more integrated and local service will help to deliver improved health and care outcomes, focusing on prevention and proactive care management across multiple care pathways.

When Alexander Graham Bell picked up his new telephone those one hundred and fifty years ago he may have been excited by the opportunities afforded by his invention. But he may well not have envisaged quite how transformative the phone would prove to be in so many aspects of our lives, livelihoods and healthcare.

When we think about health and social care delivery in the UK, one of the perennial themes which underpin any discussion is the ever rising demand for health appointments from a growing and aging population. That demand has been the catalyst for numerous initiatives including an online hospital, home monitoring and increased screening for conditions such as cancer. These and other initiatives aim to speed up diagnosis and treatment times whilst enabling more people to manage their conditions from the comfort of their own homes.

Despite all of these initiatives, the day-to-day pressure on health services continues to stretch resources. On the one hand figures released on 22^nd January 2026 revealed that, at 73.8%, the number of patients admitted, transferred or discharged in December 2025 was the highest for five years. On the other hand, the week ended 18^th January 2026 saw the highest general and acute bed occupancy levels (94.5%) since January 2020.

So the pressure is on to find more ways to smooth over the treatment pathways; delivering fast and effective treatments as quickly as practicable. And whilst progress is largely driven by health professionals, patients too have a part to play. One area in which individuals can make a measurable difference is by making sure that they either attend their healthcare appointments or let the healthcare provider know in good time if they are unable to attend.

Appointment no-shows represents a perennial problem for healthcare providers. Back in 2012 we highlighted the cost to the NHS of the one in ten hospital appointments which had been missed the previous year. At the time we commented on the way in which some health providers had started to use texts and emails to send appointment reminders to their patients.

In the intervening years reminders such as these have become part of the mainstream; built into diary management software and sent out automatically as required. Despite this, reducing appointment no-shows is still a challenge for health services. For example, in the year to September 2025 over three hundred thousand GP appointments were missed in Nottingham and Nottinghamshire alone. This has led health services in those areas to issue a call to patients to make sure they attend or cancel appointments. Calling no-shows a “significant drain on NHS resources and precious GP practice time,” Dr Dave Briggs, Executive Director of Outcomes (Medical) at NHS Nottingham & Nottinghamshire said: “whatever the reason for an appointment no longer being needed, or you can no longer attend, it’s vital you contact your practice to either cancel or rearrange.”

A similar message is being sent out by the NHS in Cumbria with their spokesperson saying: “We completely understand that life happens and plans can change but when appointments aren’t attended and the practice isn’t told, that time can’t be reused for someone else who may really need it.” They went on to highlight how: “A quick call or message means your slot can be offered to another patient, helping reduce waiting times and keep care running smoothly.”

There’s nothing new about the phrase ‘prevention is better than cure,’ particularly when it comes to healthcare. First coined in its current form by Erasmus in the 1500s, the origin of the phrase can be traced back to early an early Chinese proverb from some two thousand years ago. That proverb runs to the effect that: ‘The superior doctor prevents sickness; The mediocre doctor attends to impending sickness; The inferior doctor treats actual sickness.’

Irrespective of its origin, the idea of proactive healthcare is one which is very much in evident within today’s health services. Take the ‘Healthier you’ programme being run in England which has seen over one million people sign up since its launch in 2016. Or what about the fitness scheme run by the Welsh Government as part of its ‘Healthy weight: healthy Wales’ programme which has delivered more than ten thousand weight and fitness sessions to over 60s over the past five years.

Both have been successful in helping people to live more healthy lifestyles, thereby preventing or delaying the onset of life limiting conditions such as diabetes. This has led Colette Marshall, Chief Executive at Diabetes UK, to say: “The NHS Healthier You Diabetes Prevention Programme has a pivotal role to play in tackling the rising number of people developing type 2 diabetes.” She went on to comment that those completing the programme could: “reduce their risk of developing type 2 diabetes by more than a third, in turn helping people avoid the serious complications associated with the condition.”

Whilst some proactive healthcare measures can be delivered and practiced on a day-to-day basis, from time to time other circumstances crop up which may require more short-term targeted interventions. Take the amber cold health alert which, at the time of writing, runs from the 2^nd to the 9^th January 2026. Issued by the UK Health Security Agency, the alert is designed to highlight the possible impacts of the current spell of cold weather on health and social care.

These include the potential impact of staffing issues due to factors such as travel delays as well as possible knock-on impacts across a wide range of sectors including transport and energy. Lower outside temperatures can also cast a spotlight on heating issues across both healthcare settings and private homes. This potentially could result in a greater health risk, in particular for vulnerable individuals.

Adding to the mix is, according to the UK Health Security Agency, a likely increase in demand for health services. Some will arise as existing conditions are exacerbated by the cold weather. Indeed, the Health Security Agency warns that cold weather brings an increase in deaths for those aged 65 and over with existing health conditions; another reason which proactive healthcare measures are so important.   But the increased risk of slips, falls, and accidents which cold weather, and particularly ice and snow, brings can also lead to an increase in demand for specialised health services. As a result, not only might hospitals see an increased demand from those with broken bones, for example, so too might the demand for associated healthcare services such as those provided by physiotherapists or osteopaths. That’s when services such as those provided by Clinic Appointments can come in handy, relieving some of the pressure by helping with services such as phone answering and booking  appointments.

When is a health emergency not a health emergency? That’s the question which NHS England is trying to make us all think about this winter. They’ve issued a short film which is designed to highlight the various treatment pathways available including visiting your local pharmacist, re-ordering prescriptions via the NHS App, sending online messages to GP services, or calling 111.

The underlying message is that whilst there are some conditions which will still need a 999 call or urgent visit to A&E, there are also a range of more common conditions which can be treated elsewhere. In particular, NHS England wants to draw attention to some of the more than two hundred thousand visits to A&E last winter which could have been avoided had other avenues been considered. These included 384 visits for hiccups, 83,705 visits for earache, and over ninety-five thousand visits for sore throats.

Now it is true that some of these conditions could have underlying factors which point to a more serious health issue. However, by skipping the interim steps and going straight to A&E patients may not only have to sit for hours in crowded waiting rooms as they look for treatment which they could have received quicker elsewhere, they also prevent or delay treatment for those with more serious conditions.

Commenting on the campaign GP Dr Ellie Cannon said “Every winter, NHS services face a surge in demand, and this year is no different. Knowing where to get the care you need can make all the difference.”

There is also another reason why the NHS has launched its campaign at this time. This flu season is proving to have hit harder than in recent years. With no signs of the current wave of flu abating, figures released on 4th December reveal that on average 1,717 patients were hospitalised in the previous week due to flu. That’s more than 50% up on the same time the previous year and more than ten times higher than in 2023. This despite the fact that nearly seventeen million individuals have taken up the flu jab, up 350,000 on the previous year.

As National Medical Director for Urgent and Emergency Care, Prof Julian Redhead said: “Today’s numbers confirm our deepest concerns: the health service is bracing for an unprecedented flu wave this winter. Cases are incredibly high for this time of year and there is no peak in sight yet.”

Despite all of the patient pathway options there are going to be times when an individual just wants to pick up the phone to their health provider, perhaps to book an appointment or to ask a simple question. There may well be times when that health practice is, for one reason or another, unable to answer the phone in as speedy a manner as they would like. That’s where a service such as that provided by Clinic Appointments comes into play. Answering the phone in the name of the relevant health practice, our trained receptionists can book appointments, answer pre-agreed queries or take messages. Calls are recorded and with over 97% of calls being answered in three rings patients can receive a swift and reassuring response; starting them on the pathway towards treatment for their health conditions.

One in five UK adults of working age are currently out of the workforce due to health reasons. That stark headline statistic from the Keep Britain Working review which was released in November 2025 underlines the challenge facing individuals, employers, and the country.

The review, headed by Sir Charlie Mayfield, could not be clearer in setting out the challenges and consequences which arise from long term sickness. With unemployment due to ill health up by 800,000 since 2019, the impact is felt across society. For example:

• A 22 year old individual who falls out of work due to ill health could lose up to £1million over their lifetime, impacting not only their health but also their mental wellbeing.
• UK employers lose £85billion each year due to employee sickness impacting turnover and lost productivity.
• For the country as a whole the cost of ill health that prevents work equates to 7% of GDP or the equivalent of nearly 70% of income-tax receipts.

The rate of long term sickness seen in the UK is higher than comparable countries. So much so that an additional two million individuals would need to be returned to long term work just to bring the UK in line with the OECD average. Why is this? Well, partly the review’s authors identified three key barriers to managing health and disability in the workplace. They are:

• A culture of fear which prevents employees and line managers from feeling that they are able to discuss and address challenges at an early stage.
• A lack of effective or consistent support, compounded by a ‘fit note’ system which the report’s authors believe is not working as intended.
• Structural challenges for disabled individuals which leave them disproportionately excluded from the workplace.

In the light of the report, Sir Charlie Mayfield has been asked to lead a three-year initiative which is designed to identify changes within the workplace which could both prevent those with health issues from falling out of work and to help those already out of the workplace to return to employment. The Vanguard Taskforce will bring together employers, the disabled, work representatives and health experts. Commenting on the initiative Sir Charlie Mayfield said: “Employers are uniquely placed to make a difference, preventing health issues where possible, supporting people when they arise, and helping them return to work. If we keep Britain working, everyone wins – people, employers, and the state.”

More than sixty employers ranging from global brands such as British Airways to smaller SME organisations have already signed up to the initiative. Organisations across the health sector have also signalled their support. For example, the Chartered Society of Physiotherapy, which itself contributed, to the report commented: “This is a huge opportunity for employers and healthcare systems to recognise the power of rehabilitation in keeping people well and working. A significant part of that success depends on employers playing their part by harnessing the full expertise, experience and capacity of the independent physiotherapy sector, alongside NHS services, to create healthier, more supportive workplaces.”

Healthcare management has come a long way since the days of paper and manual processes. This writer well remembers a parent being handed their X-Rays to be carried from one health provider to another in order to speed up diagnosis and the development of a treatment plan. Nowadays, those X-Rays and associated patient records can be digitised; available to be transferred or retrieved at the touch of a button.

With digitised data comes the opportunity to deliver something more than a simple linear treatment plan. Quite simply, moving patient information online opens up the pathway to integrated healthcare delivered by multi-disciplinary teams; in the process potentially transforming health management in particular for those with multiple or lifelong conditions.

Two examples of the way in which online access can open up integrated healthcare hit the headlines in September 2025. The first, saw the launch of neighbourhood health services in forty-three areas of the country. The areas chosen to benefit from the first wave of these services are those which have traditionally seen the lowest life expectancy and longest treatment waiting times in the country.

By linking healthcare, the voluntary sector, and the wider community the new programme aims to move services such as diagnostics, mental health, outpatients, rehab, nursing and social care away from specialist centres and closer to home. Trials in one area in London saw a lowering of A&E admissions by 7% and hospital admissions by 10%.  In Cornwall another trial lowered unplanned GP appointments by 7% whilst increasing vaccinations by 47% and cancer screening and NHS health checks by 82%. As Rachel Power, Chief Executive of the Patients Association, said: “Locating services in more convenient places for patients can mean earlier support, quicker diagnosis and fewer barriers to accessing vital treatment.”

The second example, announced at the end of September, comes in the form of an ‘online hospital’ to be known as NHS Online. This service is not expected to be rolled out until 2027 and with a gradual introduction may not be fully operational until some time after that. However, the new scheme is expected to deliver the equivalent of up to 8.5 million appointments and assessments in its first three years.

The idea behind the NHS Online offering is to digitally connect patients to clinicians who may be based anywhere in England. Using the NHS App as the focal point of contact, the service will enable integrated healthcare; with patients being able to book not just GP appointments but also follow-up scans or hospital appointments at a time and place which best suits them. Not only that, depending on the nature of the condition, it is expected that patients will also be able to have an online consultation with their chosen specialist from the comfort of their own home.

Commenting on the new scheme Dr Jeanette Dickson, Chair of the Academy of Medical Royal Colleges said: “This is a novel and potentially game changing way of improving equity and speed of access to NHS services, which would reduce health inequalities.”

On Sunday 7^th September 2025 mobile phones across the UK will leap into life as a second nationwide test of the Government’s emergency alert system gets underway. The alert is due to go out at 3pm and be received simultaneously on all compatible 4G and 5G phones and tablets across the UK.

The last nationwide test was not an unqualified success; with some phones and indeed areas of the country not receiving an alert at all, whilst other phones delivered the alert several hours late. Since then, some tweaks have been made which it is hoped will deliver a more universal alert service. In fact, since that initial test, the alert service has already been deployed on a number of occasions. For example, in February 2024 an alert was sent across the city of Plymouth, containing information about the transportation of a World War II bomb from where it was found to a nearby ferry terminal. And in January 2025 red alerts about the potential dangers of strong winds were issued in Scotland and Northern Ireland.

In the future it is envisaged that the emergency alert system will be used for genuine life-threatening emergencies such as flooding, extreme storms, and wild fires; all of which could constitute a danger to life. The Government is at pains to point out that such alerts will only be sent out by the emergency services or by authorised government departments, agencies and public bodies so they won’t be used or available for more mundane matters.

Using mobile phones to deliver emergency alerts in this way shows just how far our acceptance of this type of technology has come. When the first mobile network was launched in January 1985, who would have envisaged that forty years later we would be using mobiles not just for voice communications but also as recording devices, calendars and diaries, as conduits to a world wide web of information, and now as potential life savers.

Whilst it is hoped that emergency alerts appearing on our phones will be few and far between, mobile phones can also act as delivery points for other alerts which may be less important in the overall scheme of things but equally of importance to the individual.

The health sector, for example, has been successfully delivering appointment reminders via SMS text for a number of years. Delivered automatically as part of an online booking system, SMS text messages can be a simple way of helping to improve attendance rates for health and other appointments. Not only do SMS texts act as a visible reminder of the appointment, the receipt of the reminder can also act as a prompt for individuals to cancel if they are no longer able to attend. This in turn enables the health practice to fill vacant appointment slots rather than have them go to waste.

Optimising appointment scheduling in this way could help health practices to run more efficiently; making the best use of available resources for the benefit of both patients and the practice.

According to the UK Health Security Agency (UKHSA), in 2024 there were 1,581 laboratory confirmed cases of tick borne Lyme disease in England. That’s a slight fall on 2023; but as the UKHSA say, as some cases go unreported or untested, laboratory confirmed cases are known to be an underestimate of the true total.

Awareness of Lyme disease has risen in recent times, partly thanks to a number of high profile individuals who have revealed that they were suffering from the condition. For example, in an Instagram post at the end of July 2025 the pop star Justin Timberlake commented that following his diagnosis: “at least I could understand why I would be onstage and in a massive amount of nerve pain or, just feeling crazy fatigue or sickness.”

In the UK, ticks are more prevalent across the south, south east, and south west of England. The recent mild winters have meant that ticks have not died off as they might usually do. As a result, and as any dog walker in a tick-prevalent area will readily testify, there has been a growth in tick numbers. And whilst larger ticks are easier to spot, young ones can be as small as 1mm, making them hard to identify.

It is important to note that the majority of ticks don’t carry Lyme disease. However, any individual who has been bitten is encouraged to monitor their health and contact their GP if they develop any symptoms. These, according to NHS Inform, can include:

• a pink or red rash
• a temperature of 38°C (100.4°F) or above
• other flu-like symptoms, like a headache or joint pain
• swollen lymph nodes

And don’t be misled if the “traditional” marker of a bullseye around the bite wound doesn’t appear. It won’t do so in about a third of cases but if other symptoms arise and are suspected to have been caused by a tick bite then the sooner antibiotic treatment starts the better.

Left untreated, Lyme disease can lead to the development of long-term symptoms including chronic fatigue syndrome, fibromyalgia, heart problems, brain fog, nerve problems and ongoing joint pain.  

Little wonder then that the UKHSA has launched a campaign to be more tick aware. That awareness message is as important for health providers as it is for those who are venturing outdoors into wooded areas or areas of long grass. If individuals present with a collection of vague symptoms including exhaustion and/or joint pain then Lyme disease is one option which should be considered in tandem with other potential causes.

Commenting on the tick and Lyme disease awareness campaign Christina Petridou, Consultant Microbiologist at UKHSA, said:

“It’s really important that people continue to be tick aware this summer to protect themselves against Lyme disease. The disease is usually acquired when spending time outdoors in green spaces, which people do more of in the summer months. After spending time in nature, people should take precautions such as checking for ticks and promptly and safely removing them which will reduce chances of infection.”