Early on in the Covid-19 pandemic, the official NHS mobile app took on a key role in enabling patients to confirm and display their Covid-19 vaccination and testing status by hosting the COVID pass. The app was widely downloaded as a result, and on the third anniversary of the app’s launch, in December 2021, the NHS celebrated the fact that the app had become one of the most-downloaded in the UK, with more than 22 million users.

By January 2023, the app had surpassed 30 million users, and a post by NHS Digital noted that the government had already met its target of having 68% of people in England registered with the app (due by March 2023) and was on track to meet a second target of having 75% of people registered by 2024.

Yet a new report from the Health and Social Care Committee into digital transformation in the NHS has asserted that the health service needs to do more to promote overall usage of the app by patients and “demonstrate [its] continuing value”, if it is to sustain progress in growing the use of digital health services and achieving long-term ambitions for digital transformation that centre on the app.

The report authors write that, “the benefits of using the App over non-digital services are not clear to many existing users”, and that while the introduction of the COVID pass provided “a clear motivation” for patients to download the NHS app, “the current integration of the App with NHS services is limited”, for example when it comes to enabling patients to book GP appointments or manage prescriptions. A well-integrated app would go a long way towards alleviating some of the major pain points in patient interaction with the NHS, such as long waits on the phone, or delays in accessing test results and prescription refills.

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NHS figures from December 2021 clearly show that, at that point, the app’s major use case had been the NHS COVID pass: the app had been used to generate 141 million COVID passes, while just 1.1 million GP appointments had been made using the app, and 10.4 million repeat prescriptions had been ordered.

In oral evidence supporting the digital transformation report, Health and Social Care Select Committee Chair Steve Brine noted, “The truth is that most people have the NHS app because it had the COVID pass on it, but [the Department of Health & Social Care and the NHS] have a potentially diminishing window to use that opportunity.”

In a ‘Delivery plan for recovering access to primary care’, published in May, the Department of Health and NHS England announced plans to “help the public do more for themselves [by] improving information and NHS App functionality”, which would include the ability to access medical records, order repeat prescriptions, manage routine appointments with their GP’s practice or hospital, and see messages from their practice. The Department noted that these ambitions “are already a reality for people registered with around 20% of practices”, and pledged to increase this figure to more than 90% by March 2024.

However, the NHS app faces other limitations in addition to the barriers to integration with NHS services. The report notes that the app is not a true “native” app that integrates with a smartphone (or tablet)’s architecture, but instead functions as a ‘portal’ to the NHS website.

This means that it lacks features that could make it more helpful, such as integration with the user’s phone calendar, or the ability to draw on data collected by the phone to personalise information and services. In oral evidence given for the report, Lord Markham, Parliamentary Undersecretary of State at the Department of Health and Social Care, said that the team behind the app is working to ensure it is “more and more integrated into the fundamentals of both Google and Apple.”

While there is some suggestion that the NHS could relaunch the existing app as a fully-integrated native app, the NHS has previously noted that “Rebuilding the NHS App would require significant time, funding and resources.” Given that the Department of Health and NHS England have outlined plans to continue improving and adding functionality to the existing app, it seems reasonable to infer that they will focus on that instead of a wholly new app launch which, as the digital transformation report also points out, would add friction by requiring users to download it anew.

As the NHS works to drive adoption of its app and digital services, it is also crucial that it ensure those who are less digitally adept or have access to fewer technological resources are not excluded from this evolution. As the report authors write, “As the Government seeks to tackle digital exclusion, it should not forget that there will always be people who need or prefer non-digital channels. … The Government must ensure that it maintains twin-track digital and nondigital services to prevent people from missing out on healthcare that they are entitled to.”

With its 75th anniversary at hand on the 5th July, the NHS is working to prove that it can move with the changing technological times and make use of modern digital infrastructure while ensuring that no patients are excluded from access to information, services and healthcare opportunities.

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