NHS rolls out the robots to tackle 7million-strong backlog

‘There is a risk of errors... automated responses will not be able to deal with the subtleties of healthcare’

ROBOTS will be deployed to help clear NHS waiting lists and decide which patients are seen first.

Pilot schemes are using automated calls to assess patients waiting for operations and prioritise their urgency.

One company said the NHS was looking to use automation in about 100 areas, including helping to clear backlogs and speed up handling of referrals. More than 100,000 NHS staff could now be trained in coding and bot creation to reduce the bureaucratic burden.

There is concern about how the public will respond to the automated calls, in particular the elderly on the 7millionstrong waiting list. Health officials are also aware there may be errors, after almost 2,000 patients were accidentally wiped from lists in one pilot scheme because the robot’s memory was full.

Yesterday Dr Adrian Boyle, president of the Royal College of Emergency Medicine, said that NHS 111 was sending too many people to A&E because its computer algorithm was “too risk averse”, heaping extra pressures on services.

Hospitals in Lancashire and South Cumbria have started using robots to assess those on waiting lists, with 30,000 patients due to be contacted by March. Early trials found that 15 per cent of those on the lists no longer needed the treatment they had been waiting for. Ten per cent were found to require more urgent care, allowing medics to attempt to fast-track them.

The pilot scheme in Morecambe Bay and Preston will be followed by trials in Blackburn, Blackpool and other areas. It comes amid mounting chaos across the NHS, with the biggest walkouts planned for next month when ambulance staff and nurses combine strikes.

Official figures show excess deaths in England and Wales are the highest for nearly two years, with senior medics warning that delays for A&E and ambulances have had an “terrible” impact.

Public concern about the NHS is at its highest since before Covid. Polling by Ipsos found that 42 per cent of people view the NHS as a major issue, above inflation, the economy or immigration, up from 27 per cent last month.

Experts say automation could greatly assist NHS efforts to tackle record backlogs, with waiting lists littered with errors and duplication. But some early schemes have introduced major errors.

Last year, 1,800 patients were deleted from Barking, Havering and Redbridge University Hospital NHS trust’s waiting list, without their GP being informed or the trust even being aware. According to internal reports, the error occurred because of a mistake in the handling of a “robotic process automation” programme. The trust’s chief executive apologised for the error, promising greater staff oversight.

Dennis Reed, from Silver Voices, a campaign group for the elderly said: “I really do worry about the risk of errors, and the fact that automated responses will not be able to deal with the subtleties of healthcare. I think for a lot of

older people getting these kinds of automated calls can be confusing and frightening, many will fear it is a scam, and be at a loss to what to do about it.”

Trusts piloting the schemes say that those who do not pick up the calls would not be penalised, and would be contacted by a member of staff.

The chief executive of one leading automation company said robots will be used to clear Covid backlogs, speed up referrals and improve care.

Mihir Shukla, chief executive of Automation Anywhere, said the NHS was already using 3,000 of its robots to handle referrals and pay. He said health chiefs were examining plans to teach up to 100,000 NHS workers how to code and create bots. He said: “There are about 100 different areas in which the NHS is looking to do this.”

Rishi Sunak has urged trusts to modernise their practices to bring down waiting times, calling for a “bold and radical approach”.

Yesterday, Dr Boyle, the country’s leading A&E doctor, told MPS that December was the “worst ever” in A&E with waits of more than 24 hours in most departments.

He said the reliance on NHS 111 algorithms meant too many patients ended up in hospital. “In terms of how we manage people who could be looked after elsewhere, the key thing to do is to improve NHS 111,” Dr Boyle told MPS.

“There is a lack of clinical validation and a lack of clinical access within NHS 111 – 50 per cent of calls have some form of clinical input; there’s an awful lot that are just people following an algorithm.”

Dr Boyle said where clinical input is lacking “it becomes risk averse and sends too many people to their GP, ambulance or emergency department”.

In December, 44.7 per cent of calls to NHS 111 were assessed by a clinician, NHS England provisional statistics show, down from 51.5 per cent in December the year before. Almost one in 10 calls was referred to the ambulance service, while the same proportion was recommended to attend A&E.

An NHS spokesman said NHS 111 had dealt with “exceptionally high” call levels this winter.

Sir James Mackey, NHS England national director of elective recovery, said: “It is right we use digital systems to contact patients where safe and appropriate to do so – two thirds of all outpatient appointments are follow-ups, and validating the waiting list enables hospitals to prioritise those patients who need to be seen quickly, and means people who no longer need to be seen can be removed from the list.”