More patients are turning to chatbots for medical advice. The NHS App is about to meet them there

At a glance

England’s 10-year plan calls for AI triage embedded in the NHS App by April 2028, and NHS England has awarded IBM a £160.1 million contract to support the app’s development. Fewer than 10 percent of patients currently book appointments through the app while 54 percent call their GP, yet one in seven people already consult chatbots for medical advice before contacting their practice. Early pilots are promising. A Sussex practice group using AI triage reports a 29 percent drop in patients queuing for the GP, and Rapid Health’s triage tool now covers close to 300 practices and around 80 percent of ICBs. Panelists at the HETT show in London cautioned that the Sussex pilot served affluent, largely English-speaking communities during core hours, that AI triage may shift work onto patients and that alternative routes to care must remain. For developers, speakers said England’s depth of healthcare needs data creates a significant opportunity.

People reach their GP in different ways: through the NHS App, a phone call, an AI triage tool or a walk into the practice. Which route they take depends on preference and location. One of those routes is about to get a significant boost. If the 10-year plan and the discussions at the recently concluded Health Excellence Through Technology (HETT) show in London are any guide, the NHS App will soon carry AI-powered triage.

That creates a real opportunity for developers. Whether patients benefit, and where the workload lands, is less certain.

Most patients still pick up the phone

Over the last three years the share of people booking appointments through the NHS App has climbed steadily but remains below 10 percent. Fifty-four percent still call their GP to book, according to the latest national survey results.

Even so, the app sits at the heart of the 10-year plan, said Mark Davies, chief health officer for IBM. The plan calls for AI software embedded in the app to triage patients in England and route them to the most appropriate service by April 2028. Australia has already rolled out AI triage nationally and offers a point of comparison, Davies added, but England has its own particularities to work through. Earlier this year NHS England awarded IBM a £160.1 million contract to support development of the NHS App.

Patients are already asking chatbots

Patients are not waiting for the NHS to catch up. One in seven people in England already turn to chatbots for medical advice before contacting their GP, said Matea Delieu, CCIO at Bromley Healthcare and associate CCIO at Guy’s and St Thomas’.

The market is moving. “We’re putting many more decisions into the hands of the consumer. This is us getting into the consumer and their experience,” said James Friend, who works on digital adoption and digital access for NHS England in London.

The same report Delieu cited found that people still trust a clinician’s opinion over a chatbot’s. An AI tool offered by a trusted source could meet patients where they already are.

It could also cut waiting times. “We know that 40 percent of the people that show up at A&E, into a GP practice don’t necessarily need to have gone there,” Helen Clifton, executive director for products and platforms at NHS England, told an audience of healthcare professionals, practitioners and private vendors. AI triage could shorten the wait for the people who need care most, she added.

Sussex pilot cuts GP queues by 29 percent

Pilots are already producing results. Surgeries run by Wealden Ridge Medical Partnership in Sussex use an AI triage system built on a “probabilistic engine that would give you differential diagnosis and also prioritization,” said Ragu Rajan, GP partner in Sussex and digital lead for Sussex Primary Care Collaborative. “But the clinician is in the loop to make the final decision.”

The NHS says the system has cut the number of patients queuing for the GP by 29 percent.

The caveats matter. The pilot communities are “fairly affluent” and largely English-speaking, and most patients were triaged during core hours, Rajan said.

“You probably want to see what happens when you do it 24/7. What hospitals can treat you? What happens when people don’t use English as their first language, when they have struggles to use English? And then what happens when you integrate other bits into the system?” Rajan said. “Triage is not just for general practice, but also for out of hours and emergency care. So in those situations, how does it all work, and what does it do for the system?”

Two triage models, different trade-offs

Rapid Health’s AI triage is another system the NHS already hosts. Patients can use it at any hour, and it directs them to the right GP appointment. The company now covers “close to 300 practices now across the country, covering around 80 percent of ICBs,” said Carmelo Insalaco, cofounder and CEO at Rapid Health.

The two models take different approaches. Sussex assesses “what is wrong with a patient and then assign an urgency,” Insalaco said. “We’ve taken a different approach, which is we built a triage model from the ground up to look at presentation, and ultimately how soon and who should you see. With the diagnostic decision always left with the human.”

Each model carries advantages and risks, he added. “What we see across the country right now is by reducing the triage workload on clinicians, clinicians can focus on delivering care.”

That relief for clinicians may shift burden onto patients, several panelists noted, so other ways to get triaged and book appointments need to remain in place.

Given the government’s ambitions and the problems still to be solved, Friend sees an opening for developers and innovators. “You have more access to the healthcare needs data in this country than in most of those other international examples,” he said.

Siddhant Pusdekar is a scientist-turned science journalist and communicator with a Masters in Neuroscience and a Ph.D. in ecology evolution and behavior. He writes about health, neuroscience and the environment. He can be reached at [email protected].