Chatbot vs NHS111 trial cancelled as patients game the system

Tuesday lunchtime saw a lively discussion in the staff room at Middle Street Surgery. Dr Puddle, iPhone in one hand and sandwich in the other, proclaimed that everyone’s job was safe!

Well, for a little longer at least.

He had just heard via Twitter that the North London trail to replace NHS111 call handlers with Babylon’s artificially intelligent chatbot symptom checker had been abandoned.

It seems, he went on… That patients, who have to wait days or even weeks for a GP appointment, might deliberately game the symptom checker if they think it will get them a quicker appointment.

Dr Puddle looked up and around at a room of knowing looks and unsurprised faces.

The staff room had a number of thoughts about why the trial may have failed…


1. Wrong solution for the wrong problem? Efforts to improve access when capacity is the problem will not help

There are a finite number of GPs, nurses and appointments and a seemingly unquenchable demand. Getting an appointment can often feel like a competition. When systems change, patients wise up quickly and soon learn how to maximise their chance of getting an appointment. Call earlier, ring at certain times of the day when slots are released, drop in as the surgery opens. A new equilibrium is quickly reached.

New ways of booking an appointment don’t change things for long if the problem is that there aren’t enough appointments in the first place.

Attempts to improve capacity by simply improving access can backfire and overwhelm already over stretched services.

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