We’ve already set out our case for why booking is critical for transforming healthcare – booking is fundamental to the way healthcare is delivered, and transforming it enables us to deliver more user focused digital services that blend information and services.
Before we can set out a plan to do that, we need to learn more about appointment booking in the real world. We know that appointments exist in a delicate ecosystem, and to really see the effect of designing a booking service we need to get real people really using it.
We’re going to build an alpha of booking with one GP practice that works alongside their existing systems.
What we want to learn
How are services delivered?
In order to direct someone to the most appropriate care, we need to know how services such as blood tests or flu vaccinations are delivered for that person. There is already a directory of services that has data for clinical services in a given area and their capabilities. We are working with the NHS 111 team to open it up as registers so that we can find the right service for people.
Once we can find the right service for someone, we need to provide them with a simple way of booking into it. We need to talk to people that run these services to understand how they manage their appointments and how we can support users to book them.
Finally, we need to learn about how services are commissioned and funded by working with organisations such as Public Health England.
What are the effects of transforming booking?
We can’t tell what the wider impact of transforming booking will be without trying it, and that’s the point of an alpha – to learn these things in a small, controlled trial.
Why do some practices limit the number of appointments they make available online? What’s their strategy? We need to understand these operational realities in order to build something that can actually work for patients.
Above all, we need to learn how a booking transformation would actually benefit patients and GPs, and what the overall effect would be on the wider health system.
How we’ll approach it
Start with one GP practice
We’ll deliberately avoid trying to solve issues like identity and answering questions about scaling up nationally. We know they’ll need answering, but not at this stage.
Our aim is to deliver something real as soon as possible – that means getting some users to book something quickly, without it having to be able to do everything.
We’ll work with the practice to agree what to measure, both qualitatively and quantitatively, and how to tell if things have improved. We’ll collect that data before, during and after our work to paint a picture of the impact.
Start with a handful of services
For 1 in 6 GP appointments the patient would have been better served by being directed to someone else in the wider primary care team. We’ll work with the practice to find out which of their appointments fall into that figure, and what service they were for. We’ll target six or more services that can have the biggest impact.
Some of these services will be delivered by other practitioners in the GP practice, eg a diabetes review with a nurse practitioner. Some of these services will be delivered in another setting, eg a flu vaccination with a local pharmacist.
Start inside the practice, then move out
We’ll start with services offered inside the GP practice by other practitioners. There are fewer unknowns with these services as they are booked, delivered and organised by the practice itself.
Outside of the practice we might be working with flu vaccinations at a local pharmacy or blood tests at a local hospital. We’ll need to work with those service providers to understand how people access their service and how we can integrate with their booking systems.
This is just the first step
We’re building an alpha of booking to learn. As soon as we’ve learned enough, we need to scale up our work.
There are over 8,000 GP practices, each with their own characteristics. We need to work with urban, suburban and rural practices; large, medium and small practices. Patient lists covering young professionals, families and retirees.
Similarly, we won’t learn everything we need to from tackling booking for half a dozen services; we’ll need to cover a broader selection of services, and the local variation in how they’re delivered.