The case for Seenly: the evidence behind what we're building

1 · The people

Who carries the load

Behind most patients there's someone keeping track: a spouse, a grown-up child. In the UK, that unpaid workforce is enormous and stretched thin.

The 2021 Census counted around 5.7 million unpaid carers across the UK¹. The census question is narrow, though. Polling for Carers Week found that one in five UK adults, an estimated 10.6 million people, are supporting a relative, friend or neighbour because of illness, disability or older age⁵. Carers UK estimates that 12,000 people become unpaid carers every day⁶.

The value of that care is hard to overstate: £184.3 billion a year, nearly the entire combined NHS budget of £189 billion for the same year. Unpaid carers are, in effect, a second NHS⁷.

In the middle of it sits the "sandwich generation": the ONS estimates 1.4 million people aged 16–64 in the UK are raising a dependent child while also caring for a sick, disabled or elderly adult. Most are women; around half say caring limits how much they can work; and 31% show signs of depression or anxiety, against 24% of all adults⁸.

The pattern is global. In the United States, 63 million adults (nearly one in four) are family caregivers, up 45% since 2015; among caregivers under 50, nearly half care for a child and an adult at the same time⁹.

£184.3bn⁷

the yearly value of UK unpaid care, nearly a second NHS

1.4m⁸

UK "sandwich carers" looking after children and adults at once

12,000⁶

people in the UK become unpaid carers every single day

2 · The appointment

An appointment asks a lot

Prepare beforehand, absorb complex information under stress, remember it afterwards: the evidence says every step fails routinely.

Before the visit

More than 15 million general-practice appointments are missed in England every year without enough notice to offer the slot to someone else. The 7.2 million missed GP appointments alone cost over £216 million a year¹⁰. In hospital outpatient clinics, 7.6% of the 103 million appointments booked in 2021/22 ended in a "did not attend", roughly 650,000 missed slots a month¹¹. And many who do attend arrive without organised questions or an up-to-date medication list.

In the room

43% of working-age adults in England can't fully understand health information written for the public, rising to 61% when numbers are involved³. In the US, only 12% of adults are considered proficient in health literacy¹³. Medical conversations are conducted in a language most of the room doesn't fully speak.

Afterwards

In a study of specialty-care visits, patients freely recalled just 49% of the decisions and recommendations made; even with prompting, 15% was remembered wrongly or not at all. Patients without a high-school education recalled 38%, against 65% for university graduates². Classic research puts the loss even higher: up to 80% of medical information is forgotten immediately, and almost half of what is retained is remembered incorrectly¹².

3 · The consequences

When communication fails, patients pay

These aren't abstract inefficiencies. Communication failure is one of the best-documented sources of avoidable harm in healthcare.

80%¹⁴

of serious medical errors involve miscommunication during handovers between caregivers, according to Joint Commission analysis.
3×¹⁶

patients who face communication barriers are three times more likely to suffer a preventable adverse event in hospital.
$1.7bn¹⁵

in US malpractice costs, and 1,744 deaths over five years, in the cases CRICO Strategies examined where communication failure was a factor.
4×¹³

low health literacy is linked with healthcare costs up to four times higher, hospital stays around two days longer, and up to $238 billion a year in cost to the US economy.

None of this means any individual appointment is unsafe. It means the gap between what is said and what is understood has consequences you can count.

4 · The response

What helps, and how Seenly is built for it

The encouraging part: the same literature points at what works. Seenly is designed around those findings, without claiming to be medicine.

Prepared patients do better

The AHRQ encourages patients to set a visit agenda and bring a question list, and finds decision aids reduce anxiety and increase involvement in decisions¹⁷.

Seenly appointment preparation, symptom timeline, medication list and AI-suggested questions for an upcoming visit. — Symptoms, medications and questions, organised before you arrive.

Before every visit, Seenly puts your symptom timeline, medication list and suggested questions in one place.

Understanding needs reinforcement

Techniques like teach-back (confirming understanding in plain words) measurably improve comprehension¹⁸, and shared decision-making tools integrated into care improve knowledge and reduce decisional conflict²⁰.

Seenly visit summary, a recording player with a plain-language summary of the appointment and an AI disclaimer. — Every visit in plain language, clinical terms, and key points.

Each recorded visit becomes a plain-language summary, a medical paraphrase and a checklist of key points, so nothing rests on memory alone.

The coordination gap is unfilled

A 2024 scoping review concluded that no existing app adequately supports family caregivers coordinating care across providers⁴, while an RCT found a well-designed adherence app significantly improved medication adherence and self-efficacy¹⁹. RAND's policy framework calls for exactly this kind of caregiver-facing technology²¹.

Seenly family profiles, separate health records for yourself, a parent, a child and a partner in one account. — One account for everyone you look after.

One account, a separate profile for each person you care for: built for whoever does the family's remembering.

To be clear about what we are not claiming: the research above establishes the problem and the soundness of the approach; it is not evidence about Seenly itself. Seenly is new. It has not been clinically evaluated, and it is not medical advice or a medical device. It's a tool to help you prepare and remember. Your care decisions belong with you and your clinicians.

Sources

Every figure, referenced

Numbered in order of first appearance above. All links open the original source.

In private testing

Help us close the gap

If this page describes your family, Seenly is being built for you. Join the waitlist for early access, at a price held below the full one. Coming to iOS & Android.

The problem is real, measured, and largely unsolved