An Appt Solution
Appt has a mission to minimise avoidable ill-health, by making it easier for patients to access care. We interview founder, Hector Smethurst.
Screening programmes, vaccinations, and other public health appointments across the NHS are failing to meet their desired targets. This failure means there are missed chances to save lives, by catching and treating disease early. Hector Smethurst, an alumni from 2016/17, saw an opportunity to digitise and automate this process, and Appt was born.
YH: When did you develop the idea for Appt?
Hector Smethurst: It was during the placement phase of my Year Here Fellowship, I was placed at a GP practice in East London, in a particularly deprived part of Tower Hamlets. My role was pretty unusual for someone working in the health sector: I spent half of my time in the reception team, carrying out the patient service and administration tasks that help to keep a practice running, whilst the other half of my time was spent on the other side of the desk working with the Communities Team. That gave me what I think is a pretty unique perspective of the barriers that are unknowingly thrown up between the public who oftentimes need help to understand and access the services they need to stay healthy, and the staff who face such pressure just getting through the day. I thought that the use of accessible digital communications tech could help break down these barriers, making it easier for the public to stay healthy and the nature of the Year Here placement allowed me to put this idea into action.
How could we further use tech as a society to address other problems?
I expect there are almost infinite ways for technology to be applied in society to help solve the problems many of us face on a day to day basis. But, my concern is much more focused on the way that we implement this technology. So often, I worry that the use of technology serves to strengthen the advantage of those who already have a leg up. Digital exclusion is something I’ve always been concerned about. It is something that was clear to me when I was placed in the Tower Hamlets GP surgery, as a patient in need, if you had the ability you could book via an app, or use an online triage system which allowed you to explain your condition with the promise that someone in the practice would respond to you the next day. If you didn’t have the ability, either because you don’t have the tools, the skills or the knowledge, then you had to take your chances on the phone lines at 8am, or queue outside until the practice opened.
We know that this ability (or lack thereof) is closely related to deprivation, there is a poverty premium attached to access to mobile data and there is a digital skills gap at the sharp end of society. I think that further uses for tech has great potential to solve some of society’s most difficult problems, but I think that we need to think carefully about whether this technology is equally empowering. We need to build equity into this technology if we are to achieve its potential to improve society.
What’s been the biggest reward in running your own social business so far?
For me, the biggest reward from running a social business is the daily connection I feel to the contribution I am making to society. I can draw a clear line between my day-to-day activities at Appt and the way that we are contributing to solving a tricky social problem. I haven’t had any other job where I found so much meaning in my role.
What’s something unexpected you’ve learnt in lockdown?
I wouldn’t say that it is a lesson I’ve fully learned, but one that I am in the process of learning. I’m learning to accept things that I can’t control. I think in some ways lockdown has a huge opportunity for me to sit with a situation that I can’t try and change, shouldn’t try and change. The lockdown has been a bit of a forcing function for me to slow down a bit and not try and change something just because its uncomfortable.
How do you plan to scale?
Since I started Appt I’ve been excited about its capacity to scale. Our plan really hinges on integration with existing NHS software. I have a strong belief that if you want anyone to do anything, you have to make it easy. That means that Appt’s service needs to be closely compatible with the way that GP practice staff currently do their job. We are pretty close to launching our first scalable product and we’re putting together a plan to get in front of GP practices and drive towards scale.
Advice for people wanting to apply to Year Here?
I’d advise anyone wanting to apply to Year Here to commit yourself fully to the process. There is no other programme that I know of that gives you the opportunity to dive so deeply into important social issues, to really get to grips with them and understand their causes and effects. This process is fundamental, in my opinion, to building solutions that can actually contribute to meaningfully solving these problems.
