“Covid-19 is the best thing that could have happened to fast forward innovation of the healthcare system”, Hannah tells me, due to its ability to cut through legacy process and provide an unarguable incentive for change. Covid has undoubtedly brought about decades of innovation in the NHS in the short 6 months since lockdown began in March. As a proportion of total consultations, virtual meetings have reportedly grown from ~9% to 90% during this time; a framework bringing together 11 telehealth providers was achieved in 48 hours; and the digital systems for Nightingale Hospital at ExCel London were built from nothing to fully functioning within three and a half days.
But for Hannah, the NHS is not changing fast enough, particularly in women’s health where there has historically been “no real pressure” to digitise this space. That’s why, in 2016, Hannah left full time general practice, joining the Babylon AI team and, more recently, co-founded Tinto, the app that provides mums with fast, credible and personalised advice at the touch of a button.
We speak about the role of healthtech and industry in relation to the NHS, and in particular how Tinto complements our healthcare system by providing prophylactic, holistic and personalised care.
Tinto was born from Hannah’s “burning desire to change the women’s health industry and create something really meaningful”. So, in 2019, she joined forces with Idia Elsmore Dodsworth – women’s health advocate, lawyer and mum – to create the motherhood app that’s “Flo meets Hinge meets Google”.
Tinto is quiet, clean and calm, and a far cry from the cognitive overload of homogenous digital platforms such as Mumsnet or Netmums , or the depressing pamphlets of a family-planning clinic waiting room.
Using bleeding edge data science, the app creates each mum a personal Tinto – a visual representation of you – from unique, identifying tags and a psychometric personality assessment. When you ask a question, you’re matched with a mother whose Tinto is similar to yours. One-to-one discussions between mums are supported by experts who are on-hand if needed: “information is personalised for you and your journey, whether that’s from peers, experts or tech-driven guidance.” Tinto isn’t simply a digital community, “it’s about a hybrid model of human and technology, that enables you to have that sense of belonging and lead a really fulfilling life”.
“Nearly 1000 women die every day from treatable illnesses in the UK, whether in pregnancy or postnatal” – Hannah Allen
In Hannah’s experience, primary care has become a reactive system that measures success by ‘patients seen’ rather than ‘patients cured’ due to the strain of so many patients. Hannah describes treating countless women with chronic yet preventable illnesses, including endometriosis and postnatal depression, in her 8 years as a GP: “Up to 35% of women have urinary incontinence postnatally – mostly a preventable condition if given the right exercises and care pre and post-birth”. Postnatal depression has also become increasingly common amongst new mothers, with a shocking 30% now suffering from it.
Hannah tells me one story of a consultation with an isolated woman who had been extradited for keeping a baby conceived from a one-night stand: “It was immediately obvious that she had postnatal depression but not one person had flagged it, even those who had visited her at home. They just ticked the boxes.”
However, last year, the NHS set out its “Long Term Plan” (LTP) to make themselves fit for the future, with preventative care signaled as being a key focus area for the next 5 years. Recognising that a one-size-fits-all approach is no longer working, the LTP hopes to introduce personalised care for all, making it “business as usual” for 2.5 million people by 2024.
A recent LSE study cites that perinatal mental health problems carry a cost of £8.1bn per year to the UK economy. According to Hannah, if we took a more prophylactic approach to post-natal depression, we would save £1600 per patient, but doctors just do not have the time or resources to deal properly with each patient, “we simply don’t have the research into contraception, fertility and pregnancy to support women’s wellbeing”.
Tinto tackles the issue of pre-emptive care by providing that sense of belonging and holistic support to mothers in a time of extreme change, be it physiological, psychological or social, before they get to the point of needing clinical care: “if we can get enough data analytics and great tech in Tinto to create that safety net and pre-empt problems, I’ll die happy!”
Hannah and Idia launched Tinto after a “do or die moment” in March 2020 when their NHS and corporate pilots were pulled: “if you can’t succeed with a digital offering for shielding, isolated, pregnant women in a pandemic, then what’s the point?” It’s been a long road, but for Hannah every day since has been worthwhile: “being able to give women who have no support network a lifeline through this pandemic has been an incredible experience.”
This lifeline has never been more necessary. Post-natal depression has become increasingly common amongst new mothers, with 1 in 10 suffering within a year of giving birth. Another article cites that loneliness is associated with a 50% increase in mortality from any cause, making it comparable to smoking 15 cigarettes a day, and more dangerous than obesity.
As well as being fatal, our individual and, often, isolated living arrangements mean we don’t have helping hands to physically or psychologically help. Women too often face motherhood alone. As Hannah puts it, “Years and years ago you’d be living in a village with someone just like you – now you’ve got to go through everything with a forensic lens to find information from someone you trust.” We speak of Blue Zones, places in the world where the average life expectancy is over 100. On an analysis of these 5, seemingly disparate communities, ‘multi-generational living’, was cited as a key contributing factor to longevity. Hannah asks ‘where is that village in 2020?’, and in response has created Tinto to provide that sense of community that supplements isolated motherhood.
Covid-19 has accelerated change in the NHS at an unprecedented rate, particularly in terms of GP visits and blood tests. We can only hope that the impetus for change remains, and spills over into underserved areas such as women’s health. “I believe in the system and principle [of the NHS]”, Hannah clarifies, “but it was created in 1948 for a completely different population and demographic. I always wanted to push, innovate and question things, and I couldn’t do that at the NHS”. For the time being, Hannah believes the digital space is the perfect companion to practioners. Health-tech start-ups have the ability to reduce the strain by removing those unnecessary doctor appointments where women really just need a support network.
Hannah hopes that, in 10 years’ time, we won’t be approaching care in the way we are now, and instead will be operating on a much more patient-centred model. To finish, we discussed what changes the NHS could make tomorrow to improve women’s health immeasurably:
- Healthcare professionals need to empower women to learn and inform themselves to better understand the data and their bodies
- Have readily available, comprehensive information for women making life-decisions as young as they are
- More testing of contraception and fertility as we just don’t have the answers currently
- Find an alternative for pregnant women to be included in trials as no pregnant woman will put themselves forwards, but it is essential that they can take medicine during pregnancy and understand the consequences