Comment by jiaweicli | Hacker News Reader

Comment by jiaweicli | Hacker News Reader

We're Jiawei and Jialu of Tuli Health (https://tuli.health/). We let people get medical diagnostics quickly and safely in a pharmacy close to home, instead of going to a hospital. We're based in the UK.

I have a MD PhD from University College London, and Jialu has been a software engineer for the past 10 years. We’ve lived in London for a decade and while we appreciate the NHS, we also wished for a world where we could walk down the street to get healthcare. This is what we're building.

Instead of travelling a long distance and waiting a long time to receive diagnostic tests, customers can now receive diagnostic tests from their local pharmacies, just around the corner from where they live.

There are 11,000 independent pharmacies in the UK. Our software makes it easy for them to sell and fulfill Covid-19 tests. These same pharmacies have just started selling allergy tests as well.

We offer easy-to-use software for the pharmacies to register and manage patients for diagnostic tests. We are currently used by over 150 pharmacies. The link to the dashboard is https://portal.tuli.health. A user can sign up as an end customer or a pharmacy.

Covid has led to changes in our user behaviour. Many services have now become hyper-localised. Covid tests led to the pharmacies delivering the first diagnostic tests. In the future, other diagnostic tests will also be available: STI, , biochemistry profile, gluten intolerance... Hopefully things will get easier and more accessible. We look forward to your questions and feedback!

This is an interesting idea. I agree with you that going to get a Covid test from a local pharmacy has made me wish that other similar diagnosis were available from pharmacies, rather than requiring a trip to a hospital.

I'm curious as to how you will integrate into the existing UK healthcare system. Will you have access to my NHS records? Will the results of these tests appear on my NHS records? Will these tests be covered by the NHS?

(I'm not in the healthcare profession so please forgive me if these questions are obvious to those that work in the UK healthcare!)

> Will these tests be covered by the NHS?

The marketing copy on the website seems to suggest this is for private healthcare ("All your private healthcare needs in one app")

I will be interested to see how this goes, because the sentiment outlined in the OP can be quite controversial in the UK healthcare market ("while we appreciate the NHS, we also wished for a world where...") - for international context, the NHS employs 1 in 17 people in the UK, and there is an almost irrational love for it. The UK's initial covid lockdown message even featured it as an imperative - "Stay at home. Protect the NHS. Save lives". A push towards private healthcare (at point of use) may well be a challenging sell, though perhaps a primarily-urban market might accept it more.

Over the last ~3 years I've noticed a lot more private healthcare being advertised direct to consumers, particularly in London and particularly targeting busy, high earning professionals.

I'd have expected this to go down pretty poorly because while high earning busy people tend to be more open to spending to fix problems, the idea of paying for healthcare here is nuts – you either use NHS services, or your employer gives you private healthcare.

I wonder if, as London becomes increasingly diverse with more workers from overseas, the acceptance will increase as there are more people who don't have that cultural blocker to paying directly for healthcare (rather than via taxes).

Indeed, I have definitely seen an increase in "convenience" or "time" driven offerings for private healthcare - usually focused around opening hours or "avoiding waiting".

Some seemed to be trying to deliver NHS services (video/remote consultations available by "gig-working" GPs in evenings etc.), but others seemed to be increasingly trying to provide testing or other preventative/diagnostic services (blood tests, 7-day health check-ups booked same-day etc.)

I guess to some extent there likely will (among high earning, time-strapped immigrant workers) be an increased appetite to pay for healthcare directly, but for those who are aware of their immigration NHS access charge, they might well come to adopt the "I already pay for this" view. There's also a scalability question beyond London, where typical incomes mean the only people using any kind of private healthcare will be those with company-paid schemes.

There are some interesting ethical quandaries around what the NHS could do to improve its service (which could potentially hurt private sector rivals) - from some people's perspectives, the NHS could allow people paying privately to get things faster (without compromising on clinical need based priority) if it meant the service was better funded through revenues from those private patients going towards cutting wait times more generally. The British pastime of queueing could negatively impact on perceptions of anything like this though (even though you can already pay a little extra for an expedited next-day passport renewal etc.)

I know some hospital trusts have setups with private wards where NHS staff deliver private care (without bypassing priority by clinical need), and revenues from this are reinvested into regular services.

This is money for convenience trade off. Just like some people pay double for food through uber eats. I use both the NHS and private healthcare. There is definitely an upper limit on this but if I can spend 10 minutes rather than an hour that is probably worth £100 to me.

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