Some years back, a terrible event happened when a young doctor under terrible stress took their own life. To try and prevent such tragedies occurring again, the NHS responded by setting up the NHS Practitioner Health Programme (PHP), which offers GP or GP trainees, as well as dentists, support and help with issues relating to a mental health concern like stress, depression, or addiction.
Until recently, this valuable service was only available, however, to clinicians in London – there was simply no wider coverage. In the words of its Chief Executive Lucy Warner:
Since we started nine years ago, we’ve been 12 clinicians and four admin staff in one London site, servicing London and the South-East only, a catchment area of at most 20,000 possible referrals.
But everything changed last year, when Warner received a brief from NHS England to deliver the world’s first nationally-funded free health service for GPs. The aim was to offer face-to-face general psychiatric assessment and treatment, as well as ongoing support for addiction-related health problems. The focus is on early stage intervention to ensure medics could continue providing patient care for every possible needy user across all of the country.
That’s the good news. The bad, or at least, challenging, news is that Warner got the commission for a national expansion in October last year, which would mean the days of NHS PHP as was were definitely over:
We would be going from 20,000 to more like 80,000 possible users, with potentially a thousand or fifteen hundred appointments being juggled by maybe 60 or more clinicians. There simply wasn’t any way we could see us being able to do that with the diary management system we then had – it just wouldn’t have been able to scale.
In other words, this was a big expansion and it needed to be up and running by the end of January this year. Fortunately,Warner has been able to meet that target, with a new automated online patient booking system as the central plank in her organisation’s new fast, easy and confidential care service for the country’s hard-pressed doctors and trainees.
Built with the use of a so-say low-code development platform from vendor OutSystems, NHS PHP was able to quickly and easily develop both a new mobile app and a fully automated booking system, now potentially one click away for 85,000 health doctor-patient users.
Even better, the system was up and running in just seven weeks, she told diginomica government, being there to help no less than a thousand needy users in the first week after go-live, with 90 treatment clinicians and therapists available on day one. Since January, this has built up to more like 2,000 users, Warner adds.
Another positive was that use of the software prevented Warner having to double her in-house admin team to ensure the service could deliver the expansion out of London, she says.
Available for both Android and iOS, PHP’s resulting ‘NHS Booking App’ is also one of the first apps endorsed by NHS England, too. Warner says:
I don’t know anything about apps, so I talked to NHS England’s Digital Team – who told me they didn’t really know much about apps, either, and that there aren’t really many apps in the NHS at all so far.
Tinder, meet Uber
As it turned out, that wasn’t wholly true. NHS England Digital did pass on a vital lead, with one of the team having recently had a meeting with OutSystems in another context, which led to Warner discussing her problem with the firm.
Again, another small stroke of luck came when it turned out that the vendor had recently worked with an IT consultancy called Truewind, which had in turn done some work for a small regional Portuguese hospital group on a potentially similar sounding application.
Warner decided to seize her chance and work with the two small suppliers in lieu of any stronger guidance from NHS England. She started by offering her refreshingly direct vision of what she felt was needed:
I once used an app that told me where I could get a massage by typing in my postcode. I said our users needed something like that, but also with a bit of ‘Tinder’ – they needed to be able to see a profile of possible local practitioners to be able to pick the one they liked the look of most, and a bit of ‘Uber’ – I wanted it to be as clear and user-friendly as possible in terms of seeing who was where geographically so it would be easy to work out if they were accessible enough.
The system has three user bases – a small team of NHS PHP back office administrators, the therapists and the NHS professionals identified as requiring some structured support. A potential user of the system is assessed to gauge their needs, then offered a URL to discretely download whichever version of the app they want to use. The app allows such registered users to easily select therapists in locations and at times that suit them.
The fact that users can pick and choose is important, Warner points out: a doctor won’t normally want colleagues to know they are seeking out such support, so would prefer not to see peers from University or who they know for other professional reasons, and anonymity and privacy have been absolute priority requirements of the system from the beginning, she stresses.
It also allows them to see a register of booked and previous appointments, the ability to change or cancel an appointment if they want to, and to message any logistical or admin issues they might have.
Available only to NHS staff registered on Warner’s database or with the NHS GP Health Service, ‘NHS Booking App’ seems to be offering a useful service that, regrettably, seems to be increasingly necessary for the NHS in England:
The fact that NHS England has recognised the need to expand the service and make it more widely available across the country shows there is a real need for what we do with the system is more pressured than it ever was and that has an impact on the people that work in it.