Not too many people had heard of Attend Anywhere before March 2020 but since then the video consulting capability has been offered to all, and adopted by most, NHS trusts across England.

Chris Ryan, whose mother worked in the NHS, founded Global Telehealth (now called Attend Anywhere) in 1998. The solution was developed over many years in the same building as the Alfred Hospital in Melbourne, Australia and first used for direct patient access in 2010.  It was not until 2016 however that it was introduced across Scotland after the company won a pilot via a competitive process.

Then in March 2020, the company was awarded a £4.8m one-year contract to help trusts bolster their remote consultation capacity in England during the Covid-19 pandemic.

Ryan explained to Digital Health News the company had originally won, through a competitive process, a pilot that involved between 35 and 40 trusts. The pilot had been due to run until December 2020 but when Covid hit, the company was given a contract to build a platform for NHS England and make it available for all NHS trusts.

This meant the Attend Anywhere model, which had previously been rolled out in planned stages and at comparatively low volumes, was “thrust onto the big stage with scale in England”.

“It was a very challenging few weeks as we added something like 65,000 news users across the UK and Ireland,” Ryan added.

“It meant our nice 18-month steady increase that we had planned had to be compressed into 12 weeks.”

Teething problems

In light of this increase, Attend Anywhere was hit with some initial teething problems early on.

“It was literally like riding a very big wave that was getting bigger and bigger as we scaled up,” Ryan explains.

“Scaling the actual video call part wasn’t the main issue – that is relatively easy – the challenge was the messaging volumes at peak time, for example displaying the real-time status of patients waiting and how long for, who they are being seen by, messaging between clinics and patients, not to mention the system constantly checking under the hood that only authorised clinicians or staff are in consultations with patients.

“One thing we didn’t adequately cater for in the early days, as an example, was the fact that clinicians would begin video consultations all at the same time – on the stroke of 11am or 2pm were peak times.

“We did have three outages, two of them were reasonably unavoidable and technical ones which resulted in around 7,000 consultations being lost, which when you put it in the context that we will have delivered around 5.5 million consultations across our NHS sites doesn’t seem too much, but still one person missing a consultation is one too many.”

Over the last eight months the service had been stable, but in February 2021 Attend Anywhere was caught up in an Amazon Web Service (AWS) outage that affected the London region and meant the NHS England and NHS Scotland sites were affected for around three hours.

Though there have been challenges, Ryan says he has been “proud” of Attend Anywhere’s contribution during Covid-19.

Video as the norm

But does he think video consultations are here to stay?

“I am completely convinced it will continue – that might sound self-serving but the reason why we have been doing this for such a long time is because we are totally sold on the human, social and systemic value of video call access to health services,” Ryan says.

“Online alternatives to established health care pathways have demonstrated the huge consumer demand and acceptance, but of course being in a video call has limitations and isn’t for everyone.

“And now there is the option of having your cake and eating it – so being able to see your doctor via video but also then being able to see them physically, if you need to – I think the jury has delivered its verdict in terms of the value of video as one part of a continuum of care delivery options.”

You can hear more from Ryan at Digital Health Rewired 2021 where he will be speaking as part of the Cloud and Mobile Summit on 17 March. 

Get a flavour of Rewired 2021 from the video below. You can book your place here