The new NHS App and patient access

Connie Anker

12 July 2018

Earlier this month, then Health and Social Care Secretary Jeremy Hunt announced the launch of a new NHS App which will give patients secure access to their GP record, allowing them to make GP appointments, order repeat prescriptions and access the NHS 111 service online for urgent medical queries. The Government statement also claims that the app will allow patients to ‘manage long-term conditions’, though what functionality the app will provide to enable this is not yet clear. Patients will also be able to use the app to set their data-sharing, organ-donation and end-of-life care preferences.

Jeremy Hunt commented: “The NHS app is a world-first which will put patients firmly in the driving seat and revolutionise the way we access health services. I want this innovation to mark the death-knell of the 8am scramble for GP appointments that infuriates so many patients.”

Towards digital transformation in the NHS?

Many of these services are in fact already accessible online, but the Government believes that making them available via smartphone will significantly boost use. NHS England National Director of Operations and Information Matthew Swindells said: “The new app will put the NHS into the pocket of everyone in England but it is just one step on the journey. We are also developing an NHS Apps Library and putting free NHS wifi in GP surgeries and hospitals”.

Data from the Office for National Statistics for 2017 do indeed reveal the sharp rise in smartphone use: 73% of adults accessed the internet via phones, up from 36% in 2011. Use is lowest amongst the over-65s, however – this group also typically being the heaviest users of NHS services – though a Deloitte survey in the same year notes that ‘silver swipers’(age 55-75) are the fastest growing user group for smartphones.

Building patient empowerment - and public understanding?

Whilst all moves towards effective digitisation of the NHS and increased patient empowerment are welcome, questions remain that will likely define the success of the NHS App, which is to be made available to everyone in England from December 2018. For example

  • How it will it sit within the NHS Digital landscape? The current NHS Apps library contains around 70 apps, but was only launched in April 2017 and remains a beta (test) site. Only one app is marked as being NHS approved (a self-management tool for chronic obstructive pulmonary disease); a few are said to be being tested in the NHS. Most support self-management of everything from tooth brushing to mental health, healthy cooking to fitness tracking.
  • How will the app integrate with current GP systems? The Royal College of General Practitioners welcomed the initiative, but called for support for GP practices during the rollout.
  • How will personal information be kept secure? Chair Prof Helen Stokes-Lampard also warned that given the confidential nature of medical data, the app would need to meet “the highest international security standards"; the NHS says security will be on a par with online banking.

More positively and related to the last point, could the app assist in wider public understanding of and support for NHS data sharing for research and development? The app will put patients in control of their data by allowing them to manage their medical data-sharing preferences. Combined with assured levels of security, this could contribute to patient support for sharing their health data for health research.

Parliamentary Under Secretary of State for Health Lord O’Shaughnessy recently told the All Party Parliamentary Group on Personalised Medicine: “We need to strain every sinew to bring the public with us. It needs to not sound like a science experiment, it needs to sound like something that is going to save my mum, my child, and provide reassurance about the kind of information that the state will hold about people and more importantly the purpose to which it will be put, which is about saving and extending lives” . Successful delivery and uptake of the NHS App could help provide this reassurance.

As the government and NHS strive to deliver on the person-centred healthcare agenda, apps such as this could encourage patients to gather more information about their lifestyle, health and behaviours. Information is power and, thus empowered, it is hoped patients will be able to participate more fully in clinical decision making to agree interventions that best suit their personal needs and goals. The ultimate goal being to promote behaviours that will keep the patient healthier longer, encourage compliance with treatment regimens that are more compatible with individual lifestyles and keep them out of hospital.

The long-term goal is admirable. However, the obvious concomitant to enabling access is that more people will indeed access health services, driving up demand on already stretched primary care services.

Looking into the future, increasing use of the NHS App and related apps could pave the way for using citizen generated data (CGD) in clinical decision making. Integration with other apps and wearables that measure variables such as activity levels, sleep, or environment could enable clinicians to build a more complete picture of the patient rather than one drawn solely from limited clinical interactions, something the PHG Foundation is exploring in our Citizen Generated Data project.

 

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