We recently sat down with Max Gattlin and Sharon Hanley of Hanley Consulting, for a chat about their ‘Automated Assistant for General Practice’ EDATT (Enabling Digital Access Through Telephony), their drive to optimise access and experience for patients, and their overall mission to help reduce pressure on primary care and allow them to take back time to work on proactive, preventative measures.
Sharon, as the managing director of Hanley Consulting, has 26 years in primary care and the NHS, having worked in various roles across general practice, community and not-for-profit organisations, primary care trusts and more. She launched Hanley Consulting in 2009 as an independent contractor with the aim of leveraging her knowledge and experience to drive digital transformation and embed change within primary care organisations. Sharon brings a wealth of experience from projects including the national programme for IT, shared care records, GP Connect and the ACE (Access, Choice and Experience) project, which sought to support patients and practices across a London borough in collaborating with each other more efficiently in the digital space.
Max (Sharon’s son) joined Hanley Consulting in 2020 from a background in sales for a London tech start-up. He provided a flavour of the various projects Hanley has been involved in, from procuring, configuring and remotely deploying a cloud-based telephony phone system across 42 sites; to supporting configuration and adoptability of an online consultation systems; to supporting sites with the deployment of Accurx’s Accubook COVID vaccination online booking solutions during the pandemic.
“Ultimately,” said Max, “Hanley is all about digital access, digital efficiencies, patient satisfaction and experience”. It is these drivers that led to the design, development and country wide deployment of EDATT, primary care’s #1 chatbot in England and Wales.
Supporting access to general practice, and EDATT
Since 2022, a key focus for Hanley has been to improve patient experience when accessing health and care services digitally. In early 2022 Hanley was commissioned by a number of PCNs to create and run surveys to gain patient feedback around preferences for enhanced access. The team took the opportunity to explore patient views on the use of digital tools in healthcare, including whether they used them, any barriers, and what support would be required in order to empower patients to self-serve using the digital tools available to them.
“We found that 88 percent of patients are calling their GP surgery and 80 percent of those are having difficulties getting through by phone – 67 percent of those patients who have difficulties getting through by phone said that they would access services digitally if they knew how,” said Max.
“There are so many different tools and platforms for different things, and it can create a real sense of confusion. Resulting in most patients deferring to call the practice causing long delays, with some call queue times exceeding an hour, and in many cases delays to care.”
Working with PCNs to provide enhanced access services at scale, which enables patients to benefit from accessing shared resource across multiple locations, encouraged Hanley to think about how patients should be able to access all services more efficiently at scale, use digital tools to self-serve, and therefore reduce demand coming into general practice and from this can ultimately improve workforce resilience and patient outcomes.
As a result of these findings, the EDATT chatbot was born. Hanley has developed a patient facing chatbot that can be trained to offer patient access to local services at practice, PCN, ICB and local authority level. The chatbot can answer simple and complex queries using multiple choice or natural language processing. Patients are supported through guides and videos within the chatbot to register and use digital tools to carry out self service health admin, helping to reduce pressure on phone lines.
The chatbot data feeds the EDATT dashboard, which Max described as a “one-stop shop for all of GP access data”. It is pre-loaded with data streams from online consultations, the NHS App, telephony, chatbot, workforce wellbeing, deprivation data and more. Max highlighted that the dashboard puts practices “in a much better place to glean insights, because the data is combined – so you can visualise how a reduction in one access metric might have differently impacted another service.”
In addition, the dashboard can produce an EDATT leaderboard which displays seven key metrics from all of Hanley’s partner practices, scoring them against national averages. Each site is automatically linked on a matrix, enabling the Hanley team to see where an individual site may require more targeted support or to deduce trends and correlations in the data. For example, one recent study published by Hanley extrapolated a correlation between levels of deprivation and uptake of digital tools in primary care.
“We are partnering with other companies to provide that support,” Max added. “For example, if a practice is struggling with cloud telephony, we can work directly with that supplier to look into the functionality that the practice has switched on or has not switched on as the case may be. We can find ways for them to improve.”
What benefits and outcomes have Hanley seen from the deployment of EDATT at their partner sites so far?
“We are seeing telephone queue times halving within six months of deploying an automated assistant (chatbot)” Max stated, “and we are seeing a 10 percent increase in NHS App uptake across the board within our practices. A number of our EDATT partners have exceeded 70 percent NHS App uptake within their populations – the highest in the country.”
To ensure access is equitable practices should be offering all their routine appointments online, but the reality is that practices are still reluctant to do this as there is still a hesitancy due to inappropriate bookings. As part of EDATT deployment the Hanley team takes the GP surgery through the patient’s appointment journey via each available channel to ensure access to services are fair regardless of which access route a patient takes. Hanley’s system agnostic integrated approach means that whichever online consultation solution is in use at a practice, the chatbot can surface the correct tool direct to the patient from the call queue.
Other benefits include the chatbot’s ability to support online prescription orders, assisting the patient through the process and leading to “double the amount of prescription orders that come in through the NHS App per month.” Hanley is proactive with this approach; rather than just catching people when they ring into the surgery looking to order a prescription and trying to divert them to digital services, Hanley sends out posters to each individual practice containing QR codes to encourage visitors to the practice to take up the digital route.
“I think it’s important to acknowledge that the more people we help get online, the more benefits we accumulate. Teaching someone how to order a prescription via the NHS App is one thing; but if they grow in confidence with the NHS App there’s other functionality available there too in which the patient can self-serve,” Max noted. “They can cancel an appointment if it’s no longer needed 24/7, for example, without having to wait for phone lines to open, and that means they are then freeing up an appointment slot without adding pressure to the practice. This leads to a reduction of DNAs (did-not-attends).”
The practice and ICB perspective
Sharon and Max highlighted that EDATT is a “wholly patient-focused product”, stating that although ‘patient-centric’ is a phrase that tends to get used regularly, EDATT is “so patient-centric that practices don’t even need to know that the chatbot is there”.
This, and the remote deployment approach, reflects Hanley’s efforts to reduce complexity for staff as much as possible.
There is a financial incentive for ICBs, too. Sharon pointed out that when ICBs are procuring digital tools for primary care, they need to see a return on investment (ROI); but with patient feedback indicating that patients don’t tend to find these tools particularly easy to access or understand, this can pose a challenge. EDATT, therefore, is well-placed to support in this area, by signposting people to the tools and providing information on how to use them, this is having a positive impact on ROI for the ICB, all of which is then reflected in the EDATT dashboard.
Additionally, Hanley can help practices improve their processes through feedback provided by the chatbot; if a patient has not been able to complete their task, then they can share their views through the chatbot. This feedback is then turned into data and presented to the practice as an opportunity for improvement.
“That’s where supporting practices with change management comes into it,” reflected Sharon. “A pathway might have been suitable at the point that it was set up, but digital advancements are being made all the time and we need to keep upping our game. We can help practices as they progress, based on patient feedback.”
One practice told the Hanley team that they had “never seen a reception room like it!” following the deployment of the EDATT solution. The practice manager has allocated call handlers between 8am and 10am, and after 10am reallocated those staff members to work on data quality, preventative care measures and increasing their QOF (Quality and Outcomes Framework) count.
“People often say that they cannot stem the demand coming into general practice. But if we use digital tools and tech to automate processes and support patients to self-serve, then we can free up capacity to work on preventative care and 15 years down the line we will have a healthier population, so there will naturally be less demand,” Max pointed out. “That’s my ethos – it’s all about taking a long-term proactive and preventative approach to health and social care.”
Looking to the future
For Sharon, Max and the wider team, plans for the future revolve around the need to give practices more time to focus on proactive and preventative care by leveraging automation.
From the data collated and presented by EDATT, Hanley – and their partner sites – can see what patients “really want from their telephone calls to general practice,” added Sharon, “and it’s clear that the GP is not always the ultimate answer.” She highlighted the other roles and services that would often be suitable for patient needs, along with the need to ensure that people know how to access them; and ensure that access follows through.
“There’s no point signposting someone to a service by just providing them with a telephone number, because they might not get through,” Sharon said. “Our mission needs to be to help the person actually access the correct service for their needs, using effective digital tools, automation, AI and strong change management ; because that really opens up the services on offer across health and social care.”
Many thanks to Max and Sharon for sharing their insights.
