The NHS is at a crossroads. Demand for primary care has never been higher, while workforce capacity and funding remain under intense pressure. Every year, new contract requirements aim to improve access. But without fundamental change in how patients navigate services, the system risks becoming more complex rather than more efficient.
The Tony Blair Institute (TBI) paper Preparing the NHS for the AI Era defines this problem precisely and offers a blueprint for solving it. It calls for the creation of an AI Navigation Assistant, providing a consistent, intelligent and always-on route into healthcare. According to the Institute, smarter triage and AI navigation could release 29 million GP appointments a year and generate £340 million in productivity gains.
This vision is not speculative. The technology already exists. At X-on Health, Surgery Assist has been delivering patient navigation to primary care since 2022, managing over two million patients across the UK. What the TBI describes as a necessary reform, Surgery Assist demonstrates in practice: scalable, compliant automation that supports safe access, reduces administrative burden and ensures clinicians spend their time where it matters most—with patients.
Smarter triage through AI navigation
The TBI paper highlights that the NHS’s current navigation model is fragmented and inefficient. Patients are met with multiple entry points that each use inconsistent tools and processes. The result is duplication, delay and rising pressure on staff: up to 40% of A&E attendances could be managed in primary care, while one in six GP appointments are deemed unnecessary.
Surgery Assist directly addresses this problem. Acting as a digital front door, it enables patients to describe their needs at any time, via text or voice. The AI-powered chatbot then uses local practice logic and time-based criteria routing to guide them safely to the right place, first time. This might mean a community service, PCN service, self-service, or where appropriate, a GP service.
Where an issue is clinically urgent, the system recognises red-flag symptoms and prompts the patient to book or seek urgent help immediately. For routine or administrative needs, the patient is guided through a simple, structured process that can resolve or redirect up to 30% of patient-led, inbound demand before it reaches the reception team. Within 4 months of deploying Surgery Assist at Chawton Park Surgery, their digital assistant ‘Charli’ handled 11,000 online queries, processed 1,600 prescriptions and saved 3 admin days.
This is the smarter triage the TBI paper describes, not replacing clinical decision-making but automating low-risk, high-volume tasks that consume valuable time and resources. By embedding this layer of smart patient navigation first to manage demand better, Surgery Assist ensures every patient request is safely managed, and every member of staff can focus on higher-value care.
24/7 access and GP contract compliance through AI navigation
The GP contract 25/26 requires practices to keep their Online Consultation (OC) tool open during core hours and to offer same-day online booking for routine appointments where no triage is required. Without automation, this is another administrative load on an already stretched system. Surgery Assist eliminates that risk by building these capabilities directly into the navigation process.
Through the digital assistant, patients can now:
- Book routine appointments such as smear tests, reviews or flu jabs directly into available slots safely and without calling the practice
- Submit OC requests for non-urgent symptoms or queries, verified through NHS-compliant checks and flagged as new or existing conditions to support continuity of care
- Be automatically redirected to the correct pathway when a triage assessment is required, ensuring urgent or complex needs are never routed through a routine channel
This automation does more than tick a compliance box. It reduces waiting times, empowers patients to self-serve and removes unnecessary administrative steps for staff. By keeping access open beyond the traditional phone queue and enabling patients to interact digitally 24/7, Surgery Assist realises the very principle behind the TBI’s proposed AI Navigation Assistant: a system that scales, never sleeps and manages navigation safely at any time of day.
As this technology evolves, routine GP Appointment Booking and Online Consultation features will also be available through voice, delivering equitable access for patients who prefer speaking over typing.
Data-driven insight from AI navigation tool for sustainable capacity
The TBI paper stresses that AI navigation must not only direct patients safely but also inform system improvement. Automation should generate actionable insight on where demand is coming from and how capacity is being used, so that healthcare leaders can design better services and target resources effectively. This is built into Surgery Assist that integrates seamlessly with Surgery Insights, a centralised dashboard that aggregates data on call volumes, appointment trends, online consultations and workforce activity. Practices, PCNs and ICBs gain a clear, real-time view of demand and performance, benchmarked against local and national averages.
By turning navigation data into operational intelligence, Surgery Assist supports evidence-based decision-making. Practices can see which patient queries are being resolved digitally, identify peak periods of demand and measure the impact of digital access initiatives. This visibility moves primary care from reactive firefighting to proactive planning—a foundational goal of both the TBI’s recommendations and the NHS’s wider digital transformation agenda.
AI navigation delivers a scalable model for modern care
The case for change is clear. The NHS cannot meet growing demand simply by adding more staff or infrastructure. It must modernise how patients are guided through the system so that every contact is managed efficiently, safely and in the most appropriate setting.
The AI Navigation Assistant envisioned by the Tony Blair Institute represents that future, and Surgery Assist delivers it today. It provides a scalable, NHS-approved solution that integrates seamlessly with existing systems, aligns with contract requirements and reduces the administrative load that drives staff burnout.
By embedding AI navigation at the heart of access, X-on Health is helping practices achieve what the TBI describes as the defining transformation of our time: an NHS that is smarter, more efficient and available whenever patients need it.