Real time urgent and emergency care waiting times

WaitLess is an app from Transforming Systems that uses real-time information about waiting times for A&E and urgent treatment centres, which is combined with current traffic and travel information and route guidance, showing patients the fastest place to access care for minor emergencies.

Now live across east Kent and Northamptonshire, WaitLess is helping patients to choose venues of care which can see them faster, reduce pressure on busy accident and emergency departments and also saving money for commissioners.

How was it developed?

The app was commissioned by Canterbury and Coastal Clinical Commissioning Group as part of the new models of care vanguard initiative. WaitLess was designed by a collaborative of patients and GPs, led by Dr John Ribchester and the Encompass Federation of GPs. It was launched in east Kent in December 2016.

Research undertaken with the behavioural insights team - into whether providing information to patients about where to access care could help reduce avoidable A&E attendances - identified that patients accessing urgent care services commit quickly to a venue of care, even with relatively minor conditions. WaitLess enables patients choose venues of care with lower waiting times and that are less pressured. This is expressed in a simple view, accessible in under 10 seconds. WaitLess also links to route guidance and provides useful information about the services that are available at each facility.

It has been used as a showcase by NICE for its digital health technology standards and is being supported by the National Innovation Accelerator programme as best practice. The app has also been accredited through the NHS apps beta testing process.

Who is using it?

In its first year, WaitLess was used 125,000 times; last year it clocked up 250,000 uses. Currently in use in East Kent and Northamptonshire, WaitLess is now live in Dorset and will shortly go live in Hertfordshire and across West Middlesex, Chelsea and Westminster (as part of the Testbeds programme).

Transforming Systems is continuing to develop WaitLess in coproduction with its service users and commissioners, such as a web view giving WaitLess information to 111 call handlers and screens in A&E and minor injury units that will show current waiting times. New pathways are currently being developed and will show the nearest open pharmacies.

Outcomes

While WaitLess is a benefit to people who need to use a minor injury unit, the advantage to the local health system is that it automatically distributes pressure across A&Es, urgent treatment centres and minor injury units, acting as a load balancing tool. An analysis was carried out by York Health Economics Trust based on observational data for East Kent for a six-month period in 2016-17. Data were collected on the rate of A&E minors’ attendances in A&E Departments and the overall rate of minors’ attendances across A&E Departments and MIUs.

The potential benefits, observed by carrying out a time series analysis over a 6-month period, were:

• reduced minors’ profile across all sites of 5%
• 11% reduction in minors’ attendances at A&E Departments
• 3% to 4% reduction in proportion of minors’ attendances out of all attendances in A&E Departments and MIUs - the observed reductions vary dependent on the day of the week

Academic Health Science Network (AHSNs) research found that diverting people away from A&E through use of the App could save up to £150,000 a year for each of the CCGs involved in the East Kent pilot.