Author: Alison Griffiths

Is the increased availability of online patient access allied to upgraded telephone systems ushering in the end of the 8am health appointment rush? It certainly seems so if the experience of one Leeds surgery is anything to go by. According to NHS England, the Lingwell Croft surgery deploys a mix of online contact forms, phone requests and walk-in options in order to provide an appointment service which best fits the needs of their patients.

The practice says that this has resulted in the receipt of some 350 e-consult requests each day, albeit it says mainly from younger patients. Those who still prefer to telephone in order to book an appointment have the option to either speak to someone or to leave a voicemail which is transcribed using voice recognition software. All requests, no matter how received, are triaged by two GPs and two care navigators with patients directed to the most appropriate member of the practice team, whether that be doctors, nurses, paramedics or physiotherapists.

NHS England says that thanks to GP practices making best use of technologies such as improved phone systems and digital records they have been able to offer 31.4 million GP appointments in March 2025. That’s an increase of 6.1% on the previous March and nearly 20% higher than in pre-pandemic times.

However, Dr Amanda Doyle, National Director for Primary Care and Community Services urged healthcare practices not to become complacent, commenting that: “there’s still more to do to make it easier for patients to contact and see their local GP, which includes making even better use of new technology to improve patient care”.

That caveat was born out by a British Social Attitudes survey published in April 2025 which revealed that just 31% of people in the UK were satisfied with their GP service, compared with 68% in 2019. Over the same period the percentage of individuals who saw their GP had fallen from 80% to 66%. However, what the survey didn’t show is whether that fall in GP visits was matched by a targeted increase in the use of other health professionals such as physiotherapists or mental care specialists.

The move towards prevention rather than post-condition treatment allied to more targeted health delivery may also impact these numbers and therefore patient satisfaction levels going forward. Interestingly, a report published by the UK Health Security Agency on 2 May 2025 highlighted the correlation between deprivation and health needs. For example, the report showed that those living in deprived communities are twice as likely to be hospitalised for invasive infections or respiratory diseases and 1.7 times as likely to be hospitalised for gastrointestinal diseases. This led to the findings that inequalities in emergency infectious disease hospital admissions cost the NHS between £970m and £1.5b in 2022-23 as well as accounting for some 20% of hospital bed use.

Commenting on the report Dr Leonora Weil, Deputy Director for Health Equity and Inclusion at UKHSA said: “These health protection inequalities – where there are poorer health outcomes based on where you live, your socio-economic status or ethnicity are avoidable, pervasive, and preventable. That is why it is so important to shine a light on these findings to increase action to support communities to live longer and in better health.”

The idea that prevention is better than cure has long been one of the central planks of health provision in the UK. And it’s certainly an idea which has gained traction in recent times. Put simply, the earlier that health problems, or the likelihood of problems developing, can be identified; the greater the chance of a cost-effective and efficient solution.

Now there is nothing new about some of the solutions; such as vaccinations to prevent certain diseases, or public information campaigns to highlight areas of concern. Where we have seen a development of these approaches is in the use of more targeted campaigns allied to a greater effectiveness in measuring outcomes. For example, a breast cancer screening campaign in February 2025 saw 32,432 visits to breast screening advice pages in the first week, an increase of 145% over the previous weekly average. Similarly, a Covid immunisation information campaign in March 2025 resulted in over half a million booster jab appointments being made in the first week.

These more targeted and measured campaigns can have a beneficial effect across the broad population stream, but new approaches are also having an impact on the health of individuals. We have previously reported on the deployment of ‘at home’ monitoring in order to avoid the necessity for regular hospital visits for long term conditions. This approach has now been taken one step further with the development of an artificial intelligence tool which can help to predict the likelihood of a patient suffering a fall.

The tool, which is said to be 97% accurate, requires patients, carers, health visitors and family members to input a range of data on an app which also is able to monitor vital signs such as blood pressure and heart rate in real time. This enables the AI tool to identify those at high risk of a fall, enabling preventative measures to be taken and preventing an estimated 2,000 falls leading to hospitalisation each day. The AI tool’s functionality is also planned be expanded in due course in order to identify illnesses such as Covid or norovirus; enabling early intervention to reduce recovery time.

With falls and fractures in those aged over 65 accounting for four million bed days and a cost of £2billion each year, it is hardly surprising that AI technology such as this is being hailed as a game changer. Commenting on the app, Dr Vin Diwakar, National Director of Transformation at NHS England said: “This AI tool is a perfect example of how the NHS can use the latest tech to keep more patients safe at home and out of hospital.”

Less technical but no less preventative, the idea of expanding the role of peripheral healthcare workers in order to undertake regular home visits is being evaluated. An early pilot scheme in Westminster saw a 10% drop in hospitalisations and a 7% drop in visits to A&E.

Adding these new initiatives into an existing mix of technological initiatives such as the use of digital patient records or the ability to outsource patient appointment bookings can further help to free up resources and streamline a healthcare delivery focused on prevention first.

Once upon a time, far from advocating a good brisk walk, the standard treatment for pack pain was bed rest. Lots and lots of bed rest. So much so that a study from 1992 started with the observation that the recommended treatment for lower back pain varied from two days to two weeks. Interestingly that study found that in ‘relatively young and motivated patients’ there was little difference in outcome between three day’s and seven day’s bed rest. As such the study concluded that shorter durations are preferable, bringing as they do psychological and economic benefits.

Fast forward to current times and the latest thinking is that for many types of back pain, rather than bed rest, exercise is best; as long as it is the right type of exercise. For example, an Australian study from 2024 called WalkBack looked at the effects of individuals undertaking a progressive walking, education and physiotherapy programme.

The results showed that, whilst the programme didn’t completely eliminate back pain, those on the programme experienced a substantial reduction in low back pain recurrence as compared to those in the control group. It further concluded that “By encouraging active self-management using health coaching principles, the WalkBack intervention might be able to reduce the prevalence of recurrent low back pain and associated burden on health-care systems.”

The results of this study and others like it demonstrate the important role which physiotherapists and other health professionals can play in re-mobilising individuals who have been suffering from work-limiting back pain. Add in the benefit of education in helping people to understand how exercise, even a gentle walk, can help to prevent back pain from occurring in the first place and it is easy to see how a combination of prevention and intervention through walk and exercise programmes could not only help to boost individual health outcomes but also benefit the workforce and greater society as a whole.

To this end, the NHS has just entered an agreement with Nuffield Health to offer the Nuffield’s Joint Pain Programme to NHS employees in certain areas of the country. The six-month programme offers a combination of lifestyle advice, exercise and rehabilitation. Lifestyle topics covered include pain management, eating well, and mental health, whilst the exercise programme looks at a combination of strength, flexibility and stability training as well as yoga.

 Within the NHS, back and musculoskeletal problems are the second highest cause of absence, leading to over 314,000 lost days in the past year. It is not surprising therefore that the NHS see this programme as a potential game changer. Commenting on the new partnership, Health and Social Care Secretary West Streeting said: “NHS staff cannot treat patients if they’re in debilitating pain themselves. This partnership with Nuffield Health will help get thousands of NHS staff back to work, improve their quality of life, and allow them to continue to cut waiting lists.”

It’s a bit like the old saying ‘physician heal thyself.’ It doesn’t matter what contribution an individual is making within the health sphere. From answering phones and booking appointments to delivering hands on health treatments every individual has their part to play. And if they can do so while they themselves are pain free, they have the potential to help so many others to also live in a pain free manner.

In 2021 our article “It’s good to talk” highlighted the more than 600,000 individuals who had completed a talking therapy course in the previous year. That article also commented on the NHS’s ambition to help 1.9 million people with talking therapies by the year 2023/24 in addition to those who were receiving talking and other therapies outside of the NHS banner. Fast forward to 2025 and new figures reveal that, whilst the ambitious target hasn’t been fully met, over the past year 1.8 million talking therapy referrals did lead to 1.2 million individuals starting treatment.

The talking therapies programme has though moved on from those early days. An ONS survey revealed that talking therapies not only had an immediate impact on an individual’s ability to find paid work in the year immediately following the therapy, the effect could be seen for a number of years after the treatment had completed. 

This has resulted in an enhancement of the programme with those who are struggling to find work as a result of their mental health issues receiving additional work-related assistance. This might take the form of help with applying for jobs such as completing application forms or writing a CV, or in-work advice such as setting and meeting goals. Over the past year over 67,000 individuals received this work-related advice alongside their talking therapies.

Commenting on the programme, NHS National Director for Mental Health, Claire Murdoch, said: “The NHS has heard for many years from patients struggling with their mental health that working and having a purpose can have a hugely positive impact. This is why I’m thrilled that NHS staff have helped more than 67,000 mental health patients with employment advice, because for many, having the right job and support is crucial in their mental health journey.”

Continuing on the theme of mental help for individuals, at the beginning of February 2025 the Medicines and Healthcare products Regulatory Agency (MHRA) set out new digital mental health technology guidance. This guidance aims to ensure that digital technologies which are used to diagnose, prevent or treat conditions are effective, reliable and acceptably safe. This, it is hoped, will help to ensure that individuals who use mental health apps can do so with confidence.

The guidance covers:

• How to define and communicate the intended purpose of a digital mental health technology

• When a digital mental health technology is considered a medical device under UK law.
• How risk classification is determined, ensuring proportionate regulation for different types of technologies.

Commenting on the guidance Rob Reid, Deputy Director of Innovative Devices at the MHRA, said:

“Effective and acceptably safe digital tools have huge potential to improve mental health support, making help more accessible than ever.”

Echoing these thoughts, Mark Salmon, Deputy Director of Science Evidence and Analytics at NICE, said: “Providing more detailed guidance to the developers of digital mental health technologies helps us to ensure that technologies being considered for NICE assessments have received an appropriate level of regulatory scrutiny to assure their safety. There are many types of technologies available, and it is important people can understand how regulations apply to different products.”

 “You book a table in a restaurant these days—or even an appointment at the hairdresser—you’ll get a text message 24 or 48 hours in advance to remind you. Why doesn’t the NHS do this?”

Speaking on the BBS’s Laura Kunessberg show, the Health Minister, Wes Streeting, highlighted SMS text messaging as one element of a new NHS programme which aims to cut waiting lists and increase convenience for patients. Now there is nothing new in the idea of SMS text reminders. As far back as September 2012, our article “Reducing no shows” commented on the way in which some health providers were already sending appointment reminders to patients by text or e-mail. And indeed, the ability to send appointment reminders is one feature of the Clinic Appointments diary management service alongside other features such as onscreen consent signature forms, the ability to manage clinical notes online, and the management of multi-attendance events such as fitness classes or meetings.

But perhaps it is the combination of an expansion in SMS texting with other technologies which the Government hopes will cut down on no-shows and smooth out the patient experience. According to the Government announcement, one of these technologies looks to deploy Artificial Intelligence algorithms in order to identify where appointments are more likely to be missed in order that preventative action can be taken. This might include arranging for patient transport or chaperones, or simply providing reminders in a form which the patient can identify with.

Another plank of the new drive to cut waiting times is the recognition of the part which private health care providers can play in delivering patient care. Two areas specifically targeted in the initial phase are gynaecology with more than 260,000 women waiting more than eighteen weeks for treatment and orthopaedics where more than 40% of patients are waiting longer than the set time period. This drive to partner with independent providers is underpinned by an agreement between the NHS and the independent sector dated 6^th January 2025. The agreement not only covers referral and payment processes, it also looks at aligning NHS and independent sector digital systems, encouraging long term contractual relationships, and working together to develop the elective workforce.

Set alongside community diagnostic centres and surgical hubs the inclusion of private providers aims to both increase choice and speed up the pathway from diagnosis to treatment.  An expansion in the functionality of the existing  NHS App is also expected to enable people to self-refer in some circumstances as well as being able to monitor the progress of their treatment pathway.  As Wes Streeting commented this new approach should help to put people “in control of their own healthcare.” He also commented that: “The NHS should work around patients’ lives, not the other way around. By opening community diagnostic centres on high streets 12 hours a day, seven days a week, patients will now be able to arrange their tests and scans for when they go to do their weekend shopping, rather than being forced to take time out of work.”

Whether looking at quality and outcome, cost-effectiveness, or safety; the value of patient partnerships as a means of healthcare delivery cannot be underestimated. As the Patients Association comments: “In a well-resourced system, patient involvement enhances services and drives them towards excellence.”

Key to that partnership are approaches such as shared decision making, actively seeking patient input, and integrated patient-centric services; all of which can be enhanced by the appropriate use of technology.  And it does seem that scarcely a week passes by without some new announcement on the deployment of new technology within healthcare provision.

At a high level, systems such as the NHS Federated Data Platform are being used to provide an overview of resources, thereby enabling better planning on patient throughput. In the year since its release 87 NHS acute hospital trusts and 28 integrated care boards in England have signed up to the system. Notable successes include one trust reporting a 37% reduction in the number of days patients stayed in hospital, whilst an average increase of 114 inpatient theatre treatments per month have been seen across those trusts which have signed up to the new system. Commenting on the system Ming Tang, Chief Data and Analytics Officer at NHS England, said its many benefits include: “the ability to identify those on waiting lists for longest, highlighting issues that could lead to on the day cancellations of procedures, showing when operating theatres are lying empty and speeding up discharges so patients get home faster.

So technology can help healthcare organisations to provide better and more targeted treatments, thereby potentially positively impacting waiting lists and patient health. But technology can also help on a more patient-centric level. A recent report on the BBC online service looked at whether wearable tech could help the patient-healthcare provider dialogue. This followed on from the current Health Secretary’s announcement of a review into whether wearable smart tech could help patients to track existing health concerns and feed data back to their healthcare providers.

The BBC report concluded that whilst including wearables in the healthcare mix could be of benefit in some instances, there is a danger that relying solely on wearables could result in patients either developing hypochondria or at the other extreme not acting on symptoms which should have resulted in a healthcare visit. Commenting to the BBC Pritesh Mistry, digital technologies fellow at the Kings Fund, said that whilst there is “a good case to be made” for including wearables in the healthcare mix it may be a challenge, “without that underpinning foundation of technology enablement in terms of the infrastructure, and supporting the workforce to have the skills, knowledge, capacity and confidence.”

Amidst all of the discussions about the way in which future technologies could benefit patient-clinician healthcare partnerships, we should not sideline existing technologies which have been benefitting the relationship for years. The deployment of simple online appointment booking services can help both patients and healthcare deliverers; particularly if delivered in tandem with SMS text reminders. Even the ability for healthcare providers to outsource call handling as required to a specialist provider can free valuable clinical time whilst enabling patients to receive a more personal response at a time when they need it most.

Electronic scanners, virtual hospital beds, digitised patient records….: no matter how technological the health solution, every journey towards recovery often starts with a simple phone call. And that’s never more the case than when the call is an emergency.

And yet, there are still far too many instances when that phone call is delayed. Alarmingly a recent analysis of NHS data has revealed that when it comes to strokes, the average time delay between the first onset of symptoms and a 999 call for help was eighty-eight minutes. For a condition in which every minute of delay reduces the chances of recovery, that’s an alarming statistic. Particularly so when you consider that some 100,000 people in the UK experience a stroke each year with 38% going on to lose their lives as a result. 

So what is the problem? Are people so used to making routine health appointments online or via an app that they are reluctant to pick up the phone? Alternatively, are people just not aware enough of the early symptoms of a stroke that they don’t even think of calling for help in the first instance?

Helpfully another new survey might have the answer. Following a number of campaigns there does seem to be a reasonable level of awareness about the FAST (face, arms, speech, time*) mantra for stroke recognition. However, 57% of those surveyed believed that an individual should display two or three signs of a stroke before a call should be made. As a result, despite each one of the face, arms, speech symptoms being enough on their own to signify an emergency, 64% of people for example wouldn’t dial 999 if someone was struggling to smile.

In a bid to overturn this perception, the NHS has commissioned a new advertising campaign which will run across TV and radio. The campaign, which will run until December, illustrates each of the face, arms, speech stroke signs and underlines the importance of acting on just one of these indicators. The campaign launch also features a film which shows stroke survivors listening back to recordings of the calls which saved their lives.

It is hoped that boosting awareness of something as simple as being unable to smile at the TV, not being able to lift a paint brush, or suddenly struggling to read a bedtime story, might trigger an earlier 999 call and thereby improve the chances of a fuller recovery.

Commenting on the campaign Dr David Hargroves, NHS national clinical director for stroke and consultant stroke physician, said: “When someone has a stroke, it’s estimated they may lose around two million brain cells a minute, which is why rapid diagnosis and treatment is critical – the first sign of a stroke might not seem like much, but face or arm or speech, at the first sign it’s time to call 999.”

   *

Face – One side of the face may start to droop, and/or it may become hard to smile

Arms – One or both arms may feel week and it can become hard to lift the arm and hold it aloft

Speech – Words become slurred or confused

Time – The quicker you phone 999 the better

Is a work life balance simply a matter of finding the time or energy to switch away from work and embrace home time? Well not entirely if a new report by the Royal Society for Public Health (RSPH) is anything to go by. The report has spotlighted some of the challenges which an aging workforce will place on health providers.

Over the last forty years, the number of people in England aged over 50 has increased by 47% with those aged over 65 increasing by 52%. Not only does this aging population place a strain on existing public health resources, with the aging demographic also reflecting in the workforce the challenge facing health providers is that of finding ways to ensure that their people can stay as fit and healthy as possible in order to continue to provide a good level of service.

As the RSPH comments “With an ageing workforce comes more workers who require support with long term health conditions, and potentially reduced levels of mobility.” And with over half of workers having a long term health condition by the age of 60 and with a quarter of those aged over 55 considering leaving work due to their health, that challenge is considerable.

One solution proposed by the RSPH is to provide early access to preventative and targeted occupational health services alongside workplace and working pattern adjustments as required. In other words, resetting the work life balance in order to help people to stay in employment for longer.

Interestingly this approach ties in with a new NHS health check initiative which is being rolled out to workplaces across the country. Over sixteen million people are eligible for an NHS health check but just 40% of those eligible actually participate in the programme. The hope is that by rolling the checks out into workplaces, those at risk of cardiovascular and other diseases might be identified earlier. This in turn will enable early interventions which could help people to bring their work life and health balance back on track.

Commenting on this programme Jaguar Land Rover Chief Medical Officer, Dr Steve Iley, said:

“Health checks are a fundamental part of prevention and therefore feature in many of our programmes. Our collaboration with Solihull Metropolitan Borough Council on the workplace cardiovascular disease checks pilot presents a unique opportunity to work together on providing awareness and signposting for our employees.”

Even with programmes such as these, the pressure on health practitioners and health services will continue to grow unless technological patient management and treatment solutions are adopted. One solution for those with mental issues is the integration of digital therapies within mainstream treatment plans. It is estimated that in the 2023/24 year the demand for talking therapies reached an all-time high with 1.82 million referrals. Enabling people to use digital therapies under the supervision of a trained practitioner could save around 6,000 therapist hours per 1,000 people currently receiving talking therapies. Similar results are anticipated for those with depression or PTSD.

Aside from being able to provide a more flexible treatment plan, the saving in therapist hours means that more individuals can be seen and helped in a short time frame; again helping individuals back into the workplace whilst relieving the pressure on health practitioners.

Whether providing consultations or referrals, interventions or ongoing treatment plans; for all health professionals the prime consideration is to act in the best interests of their patients. Those best interests also extend out from the treatment rooms and into the day-to-day practice areas, from reception and administration to the security of patient data.

When carrying out duties such as booking appointments or providing follow-up information, the important part played by health practice administrators was illustrated recently in the 2023 National Cancer Patient Experience Survey. The cancer workforce plan acknowledges the key role played by administrators. And this is reflected in the survey, with 87% of patients commenting that the administration of their care, which the survey defines as “getting letters at the right time, doctors having the right notes/tests results, etc” was either very good or good.

So timely correspondence and the efficiency of patient notes management is important in helping to provide patients with the reassurance which they need when undergoing treatment. And the knowledge that their data is being kept in a secure environment also helps to provide additional reassurance. Particularly so in a time in which the National Crime Agency (NCA) has highlighted high levels of cyber-crime; in particular the danger of ransomware and supply chain attacks alongside compromised social media, business and personal e-mail accounts.

The NCA recommend an initial three step approach which consists of:

• Protect your accounts by using a strong and different password for your email using three random words and by turning on 2-step verification.
• Protect your information when using social media.
• Select online providers and retailers which offer good protection for you and your data/information.

In addition, the NCA recommend that organisations follow the cyber aware advice and framework which can be found on the NCSC Cyber Aware Website. Recognising the importance of data security, on 3 September 2024 the National Data Guardian (NDG) and NHS England announced a plan to change the way in which health organisations assess their data protection and security capability and preparedness. This change will require the gradual phasing out of the current model in favour of the one promoted by the NCSC Cyber Awareness framework (CAF). Initially the change will only affect a few larger organisations but the intention is for all health providers to transition in due course.

According to the announcement, the CAF will benefit organisations in two ways. Firstly, it helps organisations to develop a long-term roadmap of yearly incremental improvements. And secondly, as the CAF focuses on achieving outcomes it enables organisations to apply strong governance and cyber security principles. As a result, health providers are empowered to implement flexible data protection measures which best serve their organisation, patients, and service users. This flexible approach also helps to change their model as new threats arise.

Commenting on the change Dr. Nicola Byrne, the National Data Guardian, said that the transition to the Cyber Awareness Framework: “represents a positive evolution, offering organisations a more current framework for evaluating and improving their data protection and cyber resilience.”

On Wednesday 28th August 2024 the Paralympic Games open in Paris. Since its inception in 1948 as a small event for war veterans, the Paralympics has grown to be a major force in promoting and highlighting disability inclusion. The first competitors only had archery and netball to choose from. In 2024, athletes will compete in 549 events across 22 different sporting disciplines.

In Paris, the ParalympicsGB squad will be made up of more than two hundred athletes, between them aiming to beat the Tokyo total of 124 medals. But the Paralympics represents far more than simply a desire to ‘go for gold.’ ParalympicsGB has three aims: to provide equitable access to sport, to champion disability inclusion, and to transform understanding of disability.

To this end over the last year more than forty thousand young disabled people have been helped to be physically active with over ten thousand people each month being helped to find inclusive sport opportunities near them. Perhaps most importantly ParalympicsGB promotes the Social Model of Disability, which says that “disability is caused by barriers in society, not by a person’s medical condition.”

Removing those barriers requires input and awareness from society as a whole with every aspect from infrastructure to communication potentially having an impact on inclusivity. However, it is also true that helping disabled individuals to optimise their talents can also require a strong input from health professionals and others in related disciplines. And we should also remember that individuals may require a multi-disciplinary approach. For example, those with physical disabilities may also require mental health support; particularly if they are facing inclusivity battles.

The publicity surrounding the Paralympics may also encourage those who would not normally see themselves as disabled but might be struggling with some aspect of their lives to pick up the phone and seek help. Whether that is something as simple as a sprained ankle or something far more complex, the positive impact of seeing those with disabilities competing on the world stage can act as a catalyst for individual change.

Admittedly, in the same way that not all individuals across society can look to participate in the Olympic games, not all disabled individuals will be able to, or want to, take part in Paralympic competitions. But as one South African Paralympic physiotherapist commented in 2021: “The Paralympic Games is an exciting opportunity for rehabilitation professionals to get knowledgeable about different sports in their area and how their patients can get involved. While there are avenues to get classified and participate at a national and international level most people only need help to get past the barriers keeping them from participating locally.”

Research has also shown that the success of Paralympic athletes can have an impact across society. One survey by ComRes revealed that 84% of UK adults saw the achievement of ParalympicsGB athletes as having a positive impact on society with 74% seeing the team as inspirational.

Commenting on this research Nick Webborn, Chair of the British Paralympic Association, said: “This research is the strongest proof yet of the direct link between the success of our talented Paralympic athletes and its wider social benefit.” He went on to say that: “We believe that the success our Paralympic stars achieve on the field of play can be turned into meaningful, long-term action – turning the nation’s cheers into change and those medals into a movement.” ​