Interview with:
Sonia Neary
MD and Co-Founder
Portasana Patient Engagement Platform (PEP)
By 2030, The World Health Organisation estimates a shortage of 11 million health workers. For health systems like the NHS, already under sustained pressure, the question is no longer how to do more with less, it’s how to fundamentally change the way care is delivered.
As demand continues to outpace workforce capacity, what health systems need is a shift from reactive care to supported self-management at scale.
Evidence consistently shows that when people have the knowledge, skills and confidence to manage their condition, they experience better outcomes and place less demand on services. Research from the Health Foundation suggests that if people who currently feel least able to manage their conditions were supported as effectively as those with the highest levels of confidence, the NHS could prevent 436,000 emergency admissions and 690,000 A&E attendances every year. Studies also show that people with higher levels of supported self-management have 19% fewer GP appointments and 38% fewer A&E attendances.
Engagement, then, cannot be defined simply by how easily someone can access a service. It must be defined by what happens next and whether people are supported to manage their health safely, confidently and proactively.
As a healthcare professional, Sonia has seen first-hand that access alone doesn’t improve outcomes, and it certainly doesn’t solve the workforce pressures facing health systems today.
“The hospital setting is not always the best place to alleviate illness or secure recovery”, Sonia acknowledges. “Most citizens want to stay well, manage their health at home, and live their lives with as much independence as possible. Yet our health systems are still largely designed around reacting to illness rather than preventing it.”
Engagement, then, cannot be defined simply by how easily someone can access a service. It must be defined by what happens next and whether people are supported to manage their health safely, confidently and proactively.
Sonia is clear that this is not about shifting responsibility onto patients. It is about equipping them with the knowledge, skills and confidence to make informed decisions about their health.
“When people understand their condition and feel confident managing it, they use services differently,” Sonia explains. “They attend fewer unnecessary appointments, avoid emergency escalation and seek help earlier when something changes. This is undoubtedly better for patients, better for clinicians, and better for the sustainability of the system.”
“One of the most common questions I hear from health leaders is how do we know engagement is working?” Sonia says. Successful engagement should deliver clear, measurable benefits across three areas:
This includes reduced demand on administrative teams, fewer incoming phone calls, and lower costs associated with manual processes. It also means fewer paper letters, less duplication, and progress toward net-zero targets through digital communication.
When engagement is working, services see fewer unnecessary follow-up appointments, reduced demand for routine diagnostics, and more appropriate use of clinical time. Clinicians can focus on the people who need them most, rather than managing avoidable demand.
In short, clinicians should be able to prioritise time-to-care and the ability to risk-stratify patients, while commissioners focus on operational costs and efficiency.
This is perhaps the most important measure of all. Do people understand their condition? Do they feel capable of managing it? Do they know what to do if their symptoms change?
If the answer to those questions is yes, then engagement is working.
As digital maturity increases across the NHS, the challenge is no longer data collection. It is interpretation, prioritisation and timely intervention.
Healthcare systems are already rich in information. What they often lack is the ability to translate that information into earlier, more targeted action, without increasing pressure on already stretched clinical teams.
This is where guided engagement becomes critical. By embedding structured journeys into patient engagement platforms, services can continuously monitor progress, identify risk earlier, and intervene before escalation occurs.
“And, importantly,” Sonia goes on, “this must be done in a way that supports, not adds to, clinical workload. Intelligent digital care pathways, tailored educational content and automated ‘nudges’ reduce the need for reactive decision-making, freeing valuable clinician time.”
“And we must not forget those who cannot manage digitally at all,” she continues. “Current technologies often struggle with usability, accessibility, and the assumption of high digital literacy. Proxy access (enabling carers, family members or support workers to act on someone’s behalf) is essential for supporting patients with complex needs, disabilities, or low digital literacy”.
Digital transformation is not successful unless it works for everyone. That means designing platforms that reflect the reality of modern healthcare, where patients often move between services, conditions and systems. “Our approach has been to create a multi-condition digital pathway platform, that connects those services into one seamless experience through the NHS App, while ensuring data can flow safely and securely to support timely care,” Sonia concludes.
“What we need are structured journeys that guide and support people through their care, not just connect them to it.” Sonia says.
These virtual pathways, whether for pre-surgical preparation, talking therapies, or chronic condition management, allow the patient experience to be digitised end-to-end. “This will reduce need for in-person attendance, enable patients to be better-prepared and provide more meaningful clinical encounters when face-to-face care is required,” Sonia explains.
In other words, health systems can build and iterate pathways, draw data from multiple Electronic Patient Records into one PEP and give patients a singular joined up digital engagement experience without repeatedly procuring new standalone tools, reducing both cost and operational burden.
The direction of travel across NHS England is that care should be delivered closer to home, with greater emphasis on prevention, education and self-management.
“Our health systems were not designed for the level of demand they are now experiencing,” Sonia says. “We have to move towards models where people are supported to stay well at home for longer, and only escalate into acute services when necessary.”
This requires more than digitising appointments or communications. It requires a fundamental rethinking of engagement itself.
When people are properly supported to manage their health, they don’t just use services differently, they need them differently. Fewer crisis points, fewer avoidable attendances, and better outcomes overall.
By enabling proactive engagement and remote monitoring, Portasana Patient Engagement Platform helps clinicians stay connected with patients between visits, supporting earlier intervention and better outcomes. Get in contact today.