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 UK². 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 age⁶. Most of them would not use the word about themselves. Ringing the surgery again for your mother, or keeping your husband's tablets straight, is not something most people would call caring. Carers UK estimates that 12,000 people become unpaid carers every day⁷.

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 NHS⁸.

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 adults⁹.

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 time¹⁰.

£184.3bn⁸

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

1.4m⁹

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

12,000⁷

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 year¹¹. 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 month¹². Attending is only the first hurdle. In a BMJ study of GP consultations, only four patients in 35 raised everything they had come to say, and the items most often left unvoiced were worries about the diagnosis and side effects they were having¹³. A 2025 survey of 2,104 people found 32% had held something back out of embarrassment, modesty or fear of being judged¹⁴.

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 involved⁴. In the US, only 12% of adults are considered proficient in health literacy¹⁵. A review of 96 studies links low health literacy to more hospital admissions, more emergency care, poorer use of medicines and higher mortality among older people¹⁶. And in England's GP Patient Survey, only 56% of patients said they were definitely as involved as they wanted to be in decisions about their care¹⁷. 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 graduates³. 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 incorrectly¹⁸.

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%¹⁹

of serious medical errors involve miscommunication during handovers between caregivers, according to Joint Commission analysis.
3×²⁰

patients who face communication barriers are three times more likely to suffer a preventable adverse event in hospital.
$1.7bn²¹

in US malpractice costs, and 1,744 deaths over five years, in the cases CRICO Strategies examined where communication failure was a factor.
4×¹⁵

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.
21%²²

higher healthcare costs over the following six months for the least activated patients than the most activated, across 33,163 people.
19%²³

higher risk of patients not following their treatment when their doctor communicates poorly, across 106 studies.

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.

Preparing the patient changes the outcome

In a randomised trial, patients given a 20-minute session before their appointment, going through their own records and coached to ask questions and negotiate decisions, reported fewer physical limitations six to eight weeks later²⁴. Run again with diabetes patients, the same approach moved average HbA1c from 10.6% to 9.1%²⁵. Both trials were small and ran in the 1980s. A later review of 33 trials covering 8,244 patients found that helping people prepare questions does increase the questions they ask²⁶, and the AHRQ recommends setting an agenda and bringing a list²⁷.

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 comprehension²⁸, and shared decision-making tools integrated into care improve knowledge and reduce decisional conflict²⁹. A review of studies giving patients a recording of their own consultation found it improved recall and understanding, and helped inform relatives who were not there³⁰.

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 providers⁵, while an RCT found a well-designed adherence app significantly improved medication adherence and self-efficacy³¹. RAND's policy framework calls for exactly this kind of caregiver-facing technology³².

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.

Seenly is not medical advice and is not a substitute for a qualified healthcare professional.

Sources

Where the numbers come from

Numbered in order of first appearance.

In private testing

Be first to try Seenly

The research above shows the scale of the problem. Seenly is our solution. Early access opens before public launch, at a discounted price. Coming to iOS & Android.

600 million NHS contacts a year in England1. Unprepared going in, half-remembered coming out.