The junior doctor: ‘Patients are put in danger because of the lack of tools we have available. I wanted to change that’

“When you experience IT in the NHS, you feel like you’re walking back into a disorganised version of the 1980s,” says Lydia Yarlott. “People say things like, ‘Oh well, there’s no way of referring this person unless you send us a fax’. Then you end up spending an hour trying to work a fax machine. The amount of wasted time would really shock people.”

It’s not just wasted time – the situation is dangerous for patients, says Yarlott: “Tech gets in the way of caring for your patients. I have 10 logins a day at work. One system will stop working. It makes you feel alone. In what business would you, in a crisis, not be able to contact the person you really needed? That happens every day in the NHS. Patients are put in danger because of the lack of tools we have available.”

It’s just technology that is used ubiquitously across other sectors and applying it to the NHS Lydia Yarlott

So junior doctors have turned to WhatsApp and Snapchat to get around the problem, which raises issues about security and confidentiality. With a team of junior doctor colleagues, Yarlott set about solving some of the tech challenges she faced.

Forward App, which supports complex and secure communications, is the result. The app comprises a directory of contacts so that junior doctors can find the relevant person when they need them, which, says Yarlott, is currently impossible. It also acts as a notebook to replace the scribbled notes that fill doctors’ pockets. “The idea isn’t very innovative at all. It’s just technology that is used ubiquitously across other sectors and applying it to the NHS,” she says.

The app is still in the testing phase but is being rolled out at Medway NHS foundation trust and potentially another two or three trusts in the near future, says Yarlott. However, she says: “The NHS is encouraging this kind of project and there is a sense that there’s a need to change because the system is crumbling. In terms of implementing that, there aren’t the protocols in place. If you want to change something, you’re looking at a five-year procurement cycle.”

The speech and language therapist: ‘There’s a lack of speech therapists trained to work with trans women. I created an app to help’

“NHS IT systems aren’t innovative and don’t allow me to do great practice,” says Sam Brady. “That’s what led me to designing apps to improve [my work].”

One of the five apps Brady has developed, in partnership with her husband, who has a professional background in IT, caters for the growing numbers of transgender patients using the NHS. In the trust where she works, there are two therapists trained in working with trans women. However, there is a nationwide shortage of therapists with the skills to treat transgender voice.



Apps make my time with patients much more effective because things can be done quicker Sam Brady

Brady explains: “Christella Antoni is the leading speech therapist in transgender voice in the UK. She runs courses about once a year, so not many therapists can attend. A lot of trusts are cutting back on funding and so lots of patients won’t be able to access her techniques. They sit on waiting lists that are around one to two years long to have an initial assessment.”

Brady teamed up with Antoni to make her training accessible to a wider audience by including it in the Christella VoiceUp app. Now, patients and therapists can access the training and exercises.

“Before I developed a series of apps, [at my trust] we didn’t use them or recommend them,” says Brady. “Now we can show patients what they can do at home. It facilitates people with their therapy.”

She adds: “Apps make my time with patients much more effective because things can be done quicker. I can also reach other therapists who don’t have the same skills. The apps have all been developed to help me in my work. They make me a better speech therapist.”

The physiotherapist: ‘I developed an award-winning app to help patients but would have given up if I’d relied on the NHS to help’



Myra Robson, who specialises in pelvic health, was talking to a friend who owned a tech company about the most difficult thing in her job, when the idea for her award-winning app was born.

Robson told her friend that getting patients to remember their exercises was challenging: “Pelvic floor exercises are a critical part of what we do in pelvic health. My friend said he could do an app to help with that.”

Had it been up to me, I would have failed. So much of it was a really challenging and expensive process Myra Robson

The pair set about developing a prototype. Although the funding Robson thought she had secured fell through, the company liked the idea so much it created the app for free.

Since then, the Squeezy app has notched up more than 65,000 sales worldwide. It has had excellent reviews, feedback from users suggests that it improves compliance with exercises and it helps spread the word that this stigmatised group of conditions is treatable.

Robson says it would have been impossible to do alone, and that she wasn’t able to develop the idea during work time (she works part-time). It took a member of the tech team one week to fulfil all the requirements to get Squeezy into the NHS app store. “It was a huge piece of work. Had it been up to me, I would have failed. So much of it was a really challenging and expensive process,” says Robson.

She adds: “I think if the NHS wants innovation, the situation has to change. In an individual trust, people can’t get the support they need to put their ideas into action. If I hadn’t been so determined and had the tech company do it for me, I would have given up.”

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