By Dr Sheikh Mateen Ellahi (Mateen.ellahi@nhs.net) Elm Tree Medical Centre
Administrative workload for GPs has increased substantially over time: by 2019, administrative work accounted for ~29.6% of GP workload (up from ~16.3% in 2005), noted: trends in clinical workload in UK primary care 2005–2019: a retrospective cohort study – PMC
Administrative burden is linked to dissatisfaction among GPs and is consistently cited as one of the major pressures in general practice. Highlighted: Lost In The System: The Need For Better NHS Admin | The King’s Fund.
Introduction
During 2024, Elm Tree Medical Centre in Teesside embarked on a mission to remove staff time spent on low value work. By listening to staff, they identified three activities that advanced medical practitioners and general practitioners wanted to minimise:
- Digital clinical administration
- Home visits
- Being on call
By listening to the team and implementing innovative solutions, the practice has successfully reduced digital drag, improved staff satisfaction, and maintained high standards delivering reliable patient care.
The Centre has adopted a protocol-based system according to NICE guidelines for blood test interpretations. Elm Tree Medical Centre, with over 18,000 patient list size, receives roughly 200 bloods daily, with average blood test result filing process taking more than 85 seconds to file. Now, the automated protocol-based system takes less than 22 seconds per filing, saving £100,000+.
An AI expert was hired, costs also included training, audits, and product development.
What was done
We use a SystmOne integrated protocol to file normal blood results quickly. These protocols are safe, fully auditable, and checked regularly by our internal team to make sure patient safety is never compromised.
For a typical list of 200 blood tests, a single click can now process follow-up actions for more than half of them automatically. The remaining cases, usually around 90, are flagged for clinical review by the hub team, reducing their admin to a single choice in most situations.
The system keeps the clinician fully in control. All clinical decisions remain human-made, and the tool simply helps launch the appropriate SystmOne protocols before results are filed.
About the tool
The clinician manually chooses which function (protocol) to run using a simple GUI with pre-built options. When a function is selected, a pop-up explains exactly what it will do, and the clinician must confirm before it continues.
Each function carries out a specific administrative step, for example:
- Sending a text message to the patient, then marking the blood result as satisfactory, borderline, or abnormal with an explanatory note.
- Adding a read code, followed by the above action.
- Sending a task to reception for patient contact.
- Prescribing medication.
In prescribing scenarios, the tool pauses so the clinician can manually review all SystmOne safety alerts. It only continues if the clinician presses “continue”. The same pause appears when read codes are added, allowing the clinician to check accuracy before anything is actioned.
In short, the tool automates appropriate clicks within SystmOne to run pre-built protocols and complete the admin steps of blood result handling. Before any result is filed, it stops and requires the clinician to press “OK” to confirm they are satisfied with the actions taken.
Establishing hub teams
To address the challenges, the partners created dedicated hub teams comprising advanced medical practitioners and general practitioners. These teams took responsibility for on call duties, home visits, and the bulk of digital administrative work, centralising these tasks to improve efficiency and allow clinical staff to focus on patient care.
It also allowed the practice to more easily automate those administrative tasks, having them done at higher volume in a smaller team. Protocols have also enabled Elm Tree to standardise the results filing
Automating blood tests
One major area that was high volume and rules based, was completing blood test follow-up activity.
Using protocol based automated solution, Elm Tree Medical Centre invested time in developing clear, clinically sound rules for following up on blood test results. This included distinguishing between normal and abnormal results, and applying specific actions based on the diagnostic order set and a patient’s problems.
Impact and achievements
The outcomes from Elm Tree Surgery’s approach have been significant:
- Practice growth: The surgery has grown, using increases in capacity and reliability to significantly grow their patient list
- Staff satisfaction and retention: Staff report greater enjoyment and fulfilment in their work, with more time dedicated to direct patient care and less spent on repetitive admin tasks.
- Patient experience: Rated Highest in the UK on Google reviews and Top 10 in the country for a large practice on NHS Patient survey results published 2025.
Looking ahead: Spreading the benefits
Elm Tree Medical Centre’s experience demonstrates the powerful impact of listening to staff, defining the digital clinical admin tasks in detail, then leveraging technology and processes in the practice to remove that burden from clinicians.
Dr Sheikh Mateen Ellahi and fellow partners have played a central role in developing the clinically robust algorithms and rules that underpin the system. It’s important to be brave in adopting technology to save time, funds, and enhance healthcare workforce well-being through AI-enabled decision-making. After all, sludge gets us all down! It’s critical that we keep up to date with the regulation of AI and the national commission.
The next challenge is to explore how further administrative activity can be automated, and how these solutions might be scaled and shared with other clinical teams across the NHS.
We also need to be honest about the barriers. Most of us are burnt out and carrying more work than ever. If we don’t protect some headspace to think and innovate, we’ll stay stuck in the same cycle of constantly firefighting, clearing sludge, and never getting to work that actually adds value.
Want to learn more?
If you’d like to learn more about the tool, you can reach Dr Sheikh Mateen Ellahi at Mateen.ellahi@nhs.net or connect with him on LinkedIn.
