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NHS AI expansion to tackle missed appointments and waiting times

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The NHS is set to roll out artificial intelligence (AI) to reduce the number of missed appointments and free up staff time to help bring down the waiting list for elective care.

The expansion to 10 more NHS Trusts follows a successful pilot in Mid and South Essex NHS Foundation Trust, which has seen the number of did not attends (DNAs) slashed by almost a third in six months.

Created by Deep Medical and co-designed by a frontline worker and NHS clinical fellow, the software predicts likely missed appointments through algorithms and anonymised data, breaking down the reasons why someone may not attend an appointment using a range of external insights including the weather, traffic, and jobs, and offers back-up bookings.

The appointments are then arranged for the most convenient time for patients – for example, it will give evening and weekend slots to those less able to take time off during the day.

The system also implements intelligent back-up bookings to ensure no clinical time is lost while maximising efficiency.

It has been piloted for six months at Mid and South Essex NHS Foundation Trust, leading to a 30 per cent fall in non-attendances. A total of 377 DNAs were prevented during the pilot period and an additional 1,910 patients were seen. It is estimated the trust, which supports a population of 1.2 million people, could save £27.5 million a year by continuing with the programme.

The AI software is now being rolled out to ten more trusts across England in the coming months.

As part of a focus to recover elective care following the pandemic and bring down long waits for routine care, the NHS is embracing new technology and innovations like AI to reduce hundreds of thousands of missed hospital appointments every month, ensuring that clinical time is used effectively and meaning patients on the waiting list can be seen more quickly.

Published data shows that of 124.5 million outpatient appointments across the NHS in England last year, eight million (6.4 per cent) were not attended by the patient. It is estimated this level of missed appointments has an annual cost to the NHS of £1.2 billion.

Figures for last year also show the highest proportion of missed appointments were physiotherapy – with more than one in 10 appointments marked as DNAs (11 per cent) – followed by cardiology (8.9 per cent), ophthalmology (8.8 per cent), and trauma and orthopaedics (7.9 per cent).

Dr Vin Diwakar, national director for transformation at NHS England, commented: “The NHS has long been a pioneer of innovation, embracing new ways of working so patients get the help they need in a timely way, and the use of AI to help reduce the number of missed appointments is another example of how new technologies are helping to improve care for patients, and ensuring the health service is making the best and most efficient use of taxpayers’ money.

“Not only can these technologies help to free up doctors’ time to treat more patients and reduce waiting times for planned care, it means a significant amount of money can be invested in frontline care rather than lost to missed appointments.

“And the work being done across the country through these AI pilots shows that initiatives like this can deliver results in a short period of time, while also supporting patients to take control over their own care and help to better understand and reduce health inequalities.”

Last week’s budget committed to an additional £3.4 billion of capital funding, so the NHS can double investment in new technology and continue to build on the work already being done.

New initiatives rolled out in the NHS have seen DNAs reduce by about half a million a year, and with the additional investment, it is expected this could lead to hundreds of thousands of DNAs being avoided each month.

Health Minister, Lord Markham, said: “Artificial intelligence is transforming the way we deliver healthcare, and this technology will help cut waiting lists and allow hundreds of thousands more patients to be seen every year.

“Alongside this, it will free up doctors’ time, deliver quicker test results, and save tens of millions of pounds every year.

“These kind of benefits are exactly why AI forms a central part of our £3.4bn plan to boost productivity in the NHS – alongside a wider package to replace outdated IT systems and unlock up to £35 billion in savings.”

Charlotte Williams, chief strategy and improvement officer at Mid and South Essex NHS Foundation Trust, said:  “Reducing wasted appointments, providing a better service to our patients and supporting those who may find it difficult to attend has really shown positive impact.

“Embracing new technologies is something the Trust is passionate about, it also supports better access for people who are disabled and for working women, as a working mum I know how sometimes it can be hard to juggle work and childcare as well as managing your own health needs.”

At University Hospitals Coventry and Warwickshire (UHCW) NHS Trust they been using AI to help improve patient care and pathways through “process mining”, which helps them see how well their processes are working, revealing bottlenecks and other areas of improvement.

Process mining also allows the Trust to look at a cohort of patients who may be being treated by several specialities and whether their appointments can be grouped together at the same time.

During the pilot, they used AI to look at DNAs – which are more common among those with high deprivation scores – and identified a spike in last-minute cancellations after two SMS reminders had been sent. Through this work, they found messaging patients 14 days before an appointment and a follow-up four days before was most effective, as it meant they could cancel earlier and re-book the appointment in plenty of time.

As a result, the trust saw their DNAs in this subset of patients drop from 10 per cent to four per cent, and they are now looking at expanding process mining to theatres to see where they can make efficiencies and improvements there.

Dr Deldar, co-founder of Deep Medical, added: “With a National NHS backlog of six million awaiting outpatient care and over eight million missed appointments each year, Deep Medical could help save lives by offering appointments to help bridge healthcare gaps for faster, more personalised experience without the long wait.

“We’ve already seen how the AI software has helped reduce missed appointments by 30% and gets other patients into the remaining 70% of missed appointments. This means, over time, Deep Medical will allow more and more appointments to be utilised; saving money and providing vital care to the public.”

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