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Building an AI-Native Patient Access Platform for NHS GP Practices

Industry

Healthcare

Overview

The client is a UK digital health company building patient access technology for NHS general practice. GP practices across England face a daily surge of phone demand that overwhelms reception teams, delays care, and leaves practices unable to evidence the access improvements NHS commissioners now expect. The client engaged Sigma Solve to design and build Toni Assist: an AI-powered digital front door that triages patients safely, books appointments directly into GP clinical systems, routes eligible conditions to community pharmacy, and gives practices, PCNs and ICBs data to prove it works.

Challenge

NHS GP practices were facing a fundamental patient-access problem: demand was arriving faster than reception teams could safely and efficiently manage it. Every morning, patients flooded phone lines, creating long queues and putting pressure on already-stretched reception teams. Because appointments were often allocated to whoever got through first, rather than by clinical need, practices struggled to prioritize demand. The problem extended beyond phone congestion:

  • Reception overload Teams were consumed by repetitive triage and appointment booking tasks.
  • Misused GP capacity Appointments went to conditions that could be managed elsewhere, including Pharmacy First conditions.
  • Inconsistent escalation Manual triage created variation and the risk of missed red flags.
  • Disconnected booking Digital intake was separate from booking, so staff re-keyed information.
  • Clinical system constraints Any solution had to work within EMIS Web and TPP SystmOne via IM1.
  • No access evidence Practices could not demonstrate improvements against CAIP requirements to commissioners.
  • AI safety boundary Clinical safety could not be delegated to an AI model; AI needed a hard architectural limit.
  • Regulation and scale The platform had to meet UK GDPR, NHS DSPT, DTAC, DCB0129/0160 and WCAG 2.2 AA, and scale across practices, PCNs and ICSs.

The Solution

Sigma Solve designed and built Toni Assist, an 11-module, AI-agent-native patient access platform delivered in 13 to 14 weeks. The architecture draws a hard line between AI and clinical safety: AI handles language understanding and summarisation, while every safety-critical decision runs on deterministic rules that AI cannot override. The platform has three faces: a patient widget (an embeddable chat on each practice's website that handles consent, NHS login, triage, booking and Pharmacy First), a practice portal (a triage board, bookings, pathway builders, reports and settings for practice teams), and a super-admin portal (practice onboarding, NHS geography, global pathways, AI governance and platform-wide reporting).

Key initiatives included:

  • Digital front door A secure chatbot captures patient consent, NHS identity and structured symptom information before any booking.
  • Deterministic safety engine Red-flag symptoms send patients straight to 999, A&E, NHS 111 or urgent mental-health support. The check runs on every message before any AI step.
  • Clinical pathway engine A graph-walking engine runs condition-specific pathways with scoring, age bands and red-flag gates. Practices can edit pathways in a visual builder, and AI can draft new ones from guidance documents.
  • AI as an assistant AI turns free text into structured answers, writes anonymized clinician summaries, suggests SNOMED CT codes and re-ranks cases only within their fixed red, amber or green tier.
  • GP clinical system integration Patient matching, GP record reads and write-back to EMIS Web and TPP SystmOne, with live slot checks and practice-specific booking rules.
  • Pharmacy First and BaRS Eligibility is assessed within the triage flow, the nearest community pharmacy is found by postcode, and a BaRS referral is sent. Patients fall back to a GP booking when needed.
  • Multi-tenant administration Practices are onboarded from their ODS code, with PCN, Sub-ICB and ICB derived automatically. Practices manage booking rules, staff, pathways and AI settings.
  • Reporting and evidence Real-time reporting covers demand, bookings, Pharmacy First referrals and safety events, with CAIP-aligned exports for commissioners.
  • Automated communications Booking confirmations, 24- and 48-hour reminders, SMS cancellation and rescheduling, and NHS App messages.
  • Resilient cloud platform Containerised services on AWS London region, multi-AZ Aurora databases, durable SNS/SQS workflows and horizontal scaling.

Outcome

Toni Assist is live, and practices have moved from a phone-first model to a digital front door. Patients no longer queue on the phone every morning. They describe their problem online, at a time that suits them, and are seen in order of clinical need rather than who got through first. Reception teams no longer triage and book every request by hand. Requests arrive on the triage board already sorted by urgency, with a summary and a response deadline, and appointments go straight into EMIS Web and TPP SystmOne with no re-keying. Patients with minor illnesses are sent to a community pharmacy in the same conversation, which keeps GP appointments for those who need them. Clinicians stay in control of every outcome, and red-flag symptoms are escalated the same way every time. Practices now have live data to show commissioners how access has improved. Delivery continued after go-live. At the client's request, Sigma Solve added bereavement support, social prescribing, dental routing, test-results enquiries, PSA/haematuria assessment and per-practice transcript retention.