Title: Evaluating the national rollout of the NHS App in England
Funder: Department of Health and Social Care

Abstract: The National Health Service (NHS) in England is introducing a new smartphone app for patients: the NHS App. This will be available to everyone in England from July 2019. People will be able to use the App to see their medical records, book appointments, order repeat prescriptions and add their name to the organ donation register, and do other tasks related to their health and care._x000D_ _x000D_ This research will look at what people think about the NHS App, how it is adopted and whether people use it to do the things it was designed for._x000D_ _x000D_ The research will have two parts. In the first part we will use interviews and discussions with people who use the App, and with doctors and other staff who work in the NHS, to understand what these people think about the App, how they use it, and what impact it has on their lives and their work. We will also sit with people and watch how they use the App in real life._x000D_ _x000D_ In the second part, we will use information from people’s NHS health records to measure how people have used the App. We will see how often people who use the App use it to look at their medical record, book appointments and get repeat prescriptions._x000D_ _x000D_ We will work closely with the NHS England and the team who developed the App so that we can learn from their experience, and we can feedback our findings to help them improve the App. In both parts of the study, we will look at how different types of people use the App, including people of different ages, different parts of the country and from different backgrounds._x000D_ _x000D_ Patients and the public have been very involved in the development of the App. We will continue to work closely with both groups to help design and do our study by creating a new group of members of the public to help us do this. For example, we have asked members of the public what questions to ask, and how to ask them when we talk to patients and NHS Staff. We will also ask them about our work looking at patient data, including what we should look for and how we should tell patients about what we are doing with their data. We will also ask our public members to help with understanding what we have found out, and writing our academic papers._x000D_ _x000D_ We will also work with our public group to help communicate our findings to NHS staff, patients, policymakers and the public. We will do this by going to events where we can talk about the work, preparing presentations for people to use to explain our work in their own practices, and also by writing about it on the NHS App’s web pages.

Lay abstract: Aims and Objectives: _x000D_ This project aims to identify and understand the use and acceptability of the NHS App, measure the extent to which it improves patient experience and influences health service access, and understand patterns of early take-up and participation._x000D_ _x000D_ Background: _x000D_ The National Health Service (NHS) in England is introducing a new smartphone app for patients: the NHS App. This will be available to everyone in England from July 2019. Initial functions include online GP appointment booking, access to medical records and ordering repeat prescriptions._x000D_ _x000D_ Methods: _x000D_ The study will have two workstreams. A qualitative element will use comparative case studies in 5 general practices to explore experiences and views on the acceptability of the App through interviews and focus groups with patients, GPs, practice staff, commissioners and policymakers. Iterative thematic analysis will allow us to develop a theory of change for the NHS App. Our theoretical approach will be based on the Non-Adoption, Abandonment, Scale-up, Sustainability and Spread (NASSS) framework._x000D_ _x000D_ A quantitative element will look at patterns of uptake and adoption of the app, and its various functions. This will involve analysis of NHS App usage, together with bespoke practice level data linkage with the Patient Online Management Information (POMI) and Clinical Practice Research Datalink (CPRD) data. Primary outcomes will be use of online appointment booking, access to medical records online and online repeat prescriptions, comparing changes before and after the introduction of the NHS App._x000D_ Patient participation will be done through a specific PPI group for this project, who will be engaged in the design, delivery and interpretation of the research, including as co-researchers in the analyses._x000D_ _x000D_ Timelines for delivery: _x000D_ This work will be done in a 24 month period starting in January 2020._x000D_ _x000D_ Anticipated impact and dissemination: _x000D_ The study is being done in collaboration with the team at NHSX delivering the App. The research will feedback early findings to the delivery team and policymakers to inform their work through regular structured meetings between the research and delivery teams. NHSX have identified that our overall findings will inform future decisions about the continued development and funding of the App – a strategic project for the future digital transformation of the NHS. The study also presents methodological novelty in data linkage for digital interventions, generalizable learning on the adoption of technology and has widespread implications for primary care practice. Dissemination will include conventional academic approaches, but also conferences and online material specifically targeted at patients, GPs, and practice managers.

Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE