The company using AI to keep workers away from NHS waiting rooms
Simplyhealth has pledged to be a solution to the UK’s productivity crisis, linking rising corporate sick leave, which costs Britain’s economy an estimated £150bn annually, to the NHS’s long backlog of treatments.
The health insurer is turning to agentic AI to scale its services, hoping to keep employees healthy and at their desks rather than waiting for NHS appointments.
“The average sick days per employee per year have spiked to 9.4, nearly two full working weeks”, Simplyhealth chief customer officer Claudia Nicholls told CityAM.
“If you think about it, that’s nearly two whole working weeks… that’s not good for productivity, and if you add that up, that’s not good for the UK as a whole”.
Simplyhealth provides everyday healthcare, GP appointments, physiotherapy, mental health support, and diagnostics, targeting minor issues before they escalate into long-term absence.
The company argues that health cover should be universally accessible, not just a perk for executives.
“It should be the working folk who have it… all of those key workers who help the economy run”, Nicholls said.
AI as a productivity lever
Aiming to meet this growing demand, Simplyhealth has automated large parts of its customer service by partnering with software giant Salesforce.
Director of customer service Dan Eddie told CityAM that 80 to 90 per cent of queries were routine administrative cases, which AI now handles.
“Two years ago, we could serve 25 members a day. Now we serve 50”, Eddie said. “We’re doing more than we’ve ever done, across more channels, with fewer people as we grow”.
Claims automation now reaches 82 per cent, with reimbursements often hitting members’ accounts the same day.
Email response times have dropped from 12 minutes to just 1.5 seconds when AI drafts the reply, slashing operational costs.
While the AI deployment has reduced human involvement in routine interactions, Nicholls confirmed the company doesn’t mind if humans aren’t in the loop in some cases.
“In theory, with generative AI checking itself, you don’t need a human”, she added.
Job displacement
AI adoption has prompted a 40 per cent reduction in customer service roles.
The remaining staff have received a 30 to 35 per cent pay increase, reflecting upskilling to handle complex queries requiring empathy.
“The human side to healthcare for us is the single most important thing”, Nicholls claimed.
However, this shift underscores the tension between efficiency gains and workforce displacement.
While some employees gain higher-value roles, others are effectively replaced by automation.
According to McKinsey, up to 30 per cent of tasks in the UK workforce could be automated by 2030, highlighting a broader economic challenge.
Measuring impact
Simplyhealth has reported high customer satisfaction, 99 per cent of claims resolved to satisfaction, and low complaint volumes, down from 650 four years ago to just 25.
Employee engagement scores have also remained strong, measured at 8.3 out of 10, suggesting that careful change management has mitigated some workforce risks.
But despite the improvements, AI solutions may only partially address the productivity deficit, given that wider structural factors like long-term NHS underfunding and chronic disease prevalence, also drive absenteeism.
“We see ourselves as a marketplace connecting supply and demand for healthcare”, Nicholls said. “Technology plays a key part, but it won’t replace the empathy and strength of our people”.