How the Pathways Feature Works: NHS App Routing, SOPHIA Fallback, and Lifeline

Purpose of Document

Pathways is one of the most significant feature introductions in EMMA V12. It is already live for repeat prescriptions and will extend to test results and appointment cancellations in future releases. Support staff, account managers, and onboarding teams must understand Pathways fully to explain it to practices, respond to questions from ICBs, and troubleshoot issues as they arise.

What Pathways Is

Pathways is EMMA's intelligent routing layer for directing patients to digital self-service channels when appropriate, reducing administrative burden at practice level beyond what EMMA alone achieves through form capture and reception transfer.

The core principle of Pathways is simple: some patient requests are better handled through a digital channel than through a phone call or a form submission. Repeat prescriptions are the clearest example. NHS guidance says they should be made in writing. The NHS App allows patients to do this in a few taps. EMMA's role is to identify these requests and route patients to the right digital channel as frictionlessly as possible.

Pathways is designed to align the practice's digital front door with NHS App adoption targets, which are increasingly part of NHS contract requirements and access metric reporting.

The Three Components of Pathways

Component 1: NHS App Deep Link

When EMMA identifies a request that qualifies for a Pathways route, she sends the patient a secure deep link to the relevant section of the NHS App by SMS. The patient receives a single message and can tap the link to open the NHS App directly at the correct screen without needing to navigate the app themselves.

This is not a generic NHS App link. It is a targeted deep link to the specific feature the patient needs, for example the repeat prescription ordering screen.

Component 2: SOPHIA Fallback

Not all patients can use the NHS App. Some do not have it installed. Some are not comfortable with digital tools. Some may be on a landline and cannot receive an SMS. Pathways accounts for this through an intelligent fallback chain.

If a patient cannot or will not use the NHS App, Pathways falls back to SOPHIA. The patient is directed to SOPHIA's web interface where they can complete their request by typing on any device with internet access. SOPHIA is not app-dependent and does not require a login. The practice receives the same structured outcome as any other SOPHIA submission.

If SOPHIA is not available or the patient cannot use it, Pathways falls back further to the practice website or to the reception team, depending on the surgery's per-practice configuration.

Component 3: Lifeline

Lifeline is EMMA's dropped-call safety net that operates alongside Pathways on every call. At the start of every call on V12, EMMA tells the patient that if the call drops or their signal is poor, they will receive a secure link to continue their request. This is Lifeline.

If the call subsequently drops at any point during the Pathways flow, EMMA sends the patient a SOPHIA link to continue their request. The patient can complete the request in writing and the practice receives a structured outcome. Nothing is lost.

Lifeline applies to all surgeries on V12, not only those where Pathways is active.

Current Live Pathways

Repeat Prescriptions (Live, May 2026)

This is the first and currently only live Pathway. When a patient calls about a repeat prescription, EMMA:

1. Explains that repeat prescription requests must be made in writing in line with NHS guidance
2. Offers the NHS App as the fastest route
3. Sends a secure NHS App deep link to the repeat prescription ordering screen by SMS
4. Provides download and access instructions if the patient does not have the NHS App
5. Falls back to SOPHIA if the patient cannot use the NHS App
6. Falls back further to the practice website or reception if the patient cannot use SOPHIA
7. Transfers to reception if the patient insists on speaking to someone

The repeat prescription Pathway was significantly improved on 30 April 2026. Before that date, the flow could stall after the initial acknowledgement in some cases and the approved guidance message was occasionally paraphrased. After 30 April 2026, the flow is reliable and consistent across all surgery types.

Coming Next in Pathways

The following pathways are confirmed as coming in future V12 releases. They are not yet live at the time of this article.

Test Results

EMMA will handle calls about test results through Pathways. Patients will be directed to the NHS App where they can view their test results directly. This reduces the volume of calls to practice staff about results that can be self-served digitally.

Appointment Cancellations

EMMA will handle appointment cancellations through Pathways. Patients will be sent a secure NHS App deep link to cancel their appointment digitally without needing to speak to reception. This is one of the highest-volume call types and is expected to have a meaningful impact on reception workload when released.

Full Per-Practice Configuration

The Pathways release also introduces full per-practice configuration for all Pathways behaviours. This means EMMA can be configured to behave differently for specific pathways depending on the surgery's preferences. For example, a surgery may want repeat prescriptions to always route to reception rather than the NHS App. This will be configurable on a per-surgery basis without requiring engineering involvement.

The Intelligent Fallback Chain in Full

The complete Pathways fallback chain ensures no patient is ever left without a route to complete their request.

No patient is left without a next step at any point in this chain.

How Pathways Supports NHS Contract Requirements

Pathways is directly aligned with NHS contract and access metric requirements that are increasingly important for practices.

From April 2026, NHS access metrics include:

• Call waiting times
• Same-day urgent access
• Non-urgent appointment routing

Pathways supports these metrics by:

• Reducing the volume of calls entering the phone queue for requests that can be self-served
• Supporting NHS App adoption uplift across the surgery's patient list
• Ensuring repeat prescription requests are made in writing in line with NHS guidance
• Providing complete per-patient attribution through Patient ID, meaning every Pathways interaction is tied to a named verified patient record

As Pathways extends to test results and appointment cancellations, its contribution to NHS App adoption and access metric improvement will grow further.

Per-Practice Configuration

Pathways behaviour can be configured per surgery. Support staff and account managers should be aware of the following configuration options.

Standard Pathways flow All V12 surgeries receive the standard Pathways flow as described above. The repeat prescription NHS App route, SOPHIA fallback, and Lifeline are all active by default.

Custom prescription routing instead of Pathways Some surgeries may prefer EMMA to route repeat prescription calls directly to reception or to a dedicated prescription line rather than through the NHS App. This is available as a custom configuration on request and applies to the prescription handling only.

Pathways disabled for specific request types If a practice does not want Pathways active for a specific request type, this can be configured on request. The request type will then be handled through EMMA's standard call flow.

Raise all Pathways configuration requests with the engineering or configuration team, including the surgery name, ODS code, and the specific change required.

Common Questions From Practices and ICBs

"Is patient data shared with NHS Digital when EMMA sends the NHS App link?"

EMMA sends a secure deep link by SMS to the patient's mobile number. The patient then opens the NHS App using their own NHS login credentials. EMMA does not authenticate on the patient's behalf or share any patient data with NHS Digital directly. The patient's interaction with the NHS App is governed by their own NHS login.

"What if the patient does not have a mobile phone?"

If the patient is calling from a landline, EMMA cannot send an SMS. In this case, EMMA falls back immediately to SOPHIA's web interface, the practice website, or reception depending on configuration. Lifeline also cannot send an SMS to a landline, so landline callers receive verbal signposting instead.

"Will Pathways increase the number of SOPHIA submissions in our dashboard?"

Yes. As Pathways routes more patients through SOPHIA as a fallback, the number of SOPHIA submissions in the dashboard will increase. Each SOPHIA submission contains structured patient information and requires the same actioning process as other submissions. On V12, every SOPHIA submission is attributed to a named verified patient through Patient ID.

"Can we turn Pathways off entirely?"

Yes. Pathways can be disabled per surgery on request. However, this means EMMA will revert to the previous call flow for those request types, which typically means reception transfer or medical form submission. The surgery would lose the NHS App adoption benefit and the reception workload reduction that Pathways provides.

Step-by-Step Triage Process

When a practice raises a Pathways-related complaint:

1. Confirm which Pathway is affected (currently only repeat prescriptions are live).
2. Confirm whether the complaint is about the NHS App link not being sent, the flow stalling, or the fallback not working correctly.
3. Check whether the affected calls predate or postdate 30 April 2026 (the repeat prescription flow fix date).
4. Review the call recording to confirm how EMMA handled the Pathways interaction.
5. If the flow stalled or the correct guidance was not delivered after 30 April 2026, escalate to engineering with the call ID and surgery ODS code.
6. If the practice wants a configuration change, raise the request with the configuration team.

What to Tell the Practice

Example wording explaining Pathways:

"Pathways is a new feature in our V12 release that routes patients to the NHS App for requests that are better handled digitally, reducing the volume of calls that need to be handled by your team. For repeat prescriptions, EMMA now explains that the request must be made in writing, sends the patient a direct link to the repeat prescription section of the NHS App by SMS, and provides download instructions if the patient does not have the app. If the patient cannot use the NHS App, EMMA offers our web-based alternative and ensures the request still reaches your team. If the call drops at any point, the patient automatically receives a link to continue where they left off."

Example wording about upcoming Pathways:

"In future releases, Pathways will also handle test results and appointment cancellations through the NHS App. This will further reduce the volume of calls your team receives for these request types while ensuring patients always have a clear next step."

Common Mistakes

• Telling a practice that Pathways is live for test results or appointment cancellations. These are not yet live. Only repeat prescriptions are currently handled through Pathways.
• Not knowing that the repeat prescription Pathways flow was significantly improved on 30 April 2026 and treating pre-fix issues as current bugs.
• Telling a practice that Pathways cannot be disabled or configured differently. It can.
• Not being aware that landline callers cannot receive the NHS App SMS link and are handled through verbal fallback instead.
• Confusing Lifeline (the dropped-call SOPHIA fallback) with Pathways (the NHS App routing feature). They are related but distinct components.

Escalation Guidance

Escalate to engineering if:

• The repeat prescription Pathways flow is stalling or delivering incorrect guidance after 30 April 2026
• The NHS App deep link SMS is not being sent for mobile callers after 30 April 2026
• The SOPHIA fallback is not triggering when the NHS App route is declined
• Lifeline is not sending a SOPHIA continuation link when a call drops during a Pathways interaction

When escalating, always include:

• Surgery name and ODS code
• Consultation tool used
• Affected call ID and timestamp
• Description of what the patient experienced versus what was expected
• Whether the incident predates or postdates 30 April 2026

Last Reviewed: May 2026 Owner: Support and Customer Success