"A&E is creaking at the seams. It's not broken, but it's struggling" said Professor Sir Bruce Keogh, NHS Medical Director at the publication of the Urgent and Emergency Care Review in November 2013. Accidents & Emergency has become a hot political topic over the last years, often used as the ultimate measure for how the coalition runs the country's health service.
At the heart of the problem lies exploding demand for A&E services where attendance has risen by 50% in the last decade. It is widely assumed that 25% of patients who turn up do not need A&E care and instead could be treated in other settings.
Proposed solutions for solving the A&E crisis range from improving out of hours care by finally making the 111 phone service work to charging for A&E visits - a proposal supported by 32% of GPs polled by the Press Association earlier this year. Many of these proposals are radical and most are expensive and difficult to implement at the scale required to meet this national challenge.
While the political blame game continues, iPLATO has been quietly addressing the central issues in close partnership with some of the 800 GP practices and over 6m patients that use its patient communication platform.
In 2013 the Hammersmith based team added a new Patient Auto Cancellation feature to the iPLATO service. This free upgrade allows the patient to quickly and without any effort cancel booked GP appointments from a mobile phone thereby freeing up the appointment slot for someone else possibly with an urgent medical concern. The result was stunning: Within months most iPLATO practices had switched on Patient Auto Cancellations showing that GPs embrace technology and change if it safe, easy and the benefits are clear to all the stakeholders within the local health economy.
Based on patient reply the iPLATO service communicates with the GP IT system and eliminates the need for practice staff to intervene in the appointment cancellation process. iPLATO's mobile system automatically frees up non-needed appointments making them available for more needy patients and allows surgery staff to concentrate on fielding incoming calls and provide better service.
In the NHS year 2013/14 iPLATO practices together used the system to free up 181,474 urgent appointments through patients cancelling their appointments via text message. Patients need not waste time calling surgeries to listen to 10 minutes of Vivaldi to cancel appointments. Based on feedback this mobile service could carry itself on patient satisfaction alone but the business case is equally attractive. The productivity gain is equivalent to the entire annual appointment capacity of 12 average sized GP practices. But, of course, it is better than building 12 new practices, because the service improves productivity of existing units in a way that does not increase the cost to the NHS.
With an average cost per GP appointment estimated at £43 iPLATO practices saved the NHS £7.8 million last year in appointment productivity. If this best practice service was expanded across England the annual savings would reach £171 million using a proven system and deployment methodology.
While longer term measures to address the structural issues in A&E are being implemented it is clear that adding 4m urgent GP appointment slots - the annual capacity of 267 GP practices - would go some way to alleviate the immediate stress on urgent care in this country.
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About iPLATO
iPLATO Healthcare is British innovation company dedicated to mHealth and Analytics since 2006.
iPLATO's evidence based mobile health solutions have proven to improve patient access to healthcare, to enable powerful health promotion targeted at people at risk and to support people with long term conditions.
Serving millions of patients and thousands of healthcare professionals every day iPLATO has emerged as the leader in mobile health. Across this network the company is running campaigns to promote smoking cessation, weight loss, childhood immunisation and pandemic awareness as well as mobile disease management services for people with diabetes, hypertension, epilepsy and HIV.
iPLATO Healthcare's mission is to, in partnership with clinicians, help healthcare commissioners transform patient care through cloud based mHealth and Analytics.