NHS Humber and North Yorkshire Integrated Care Board looks after the NHS spending and performance across a region home to 1.7million people.

One of the biggest challenges facing the Humber and North Yorkshire Health and Care Partnership is managing the growing lists of patients waiting for access to treatment and care. So as part of its Recovery in Primary Care Plan, it has been working to improve the outcomes and experience for patients with planned appointments or interventions, focusing on prevention and management of long-term conditions.

The team identified that health apps can offer convenient and effective ways for people to improve their health whilst waiting for surgery, in preparation days before surgery, then to speed recovery and improve condition management after discharge.

To uphold consistent clinical standards, the team wanted a specific set of apps for each target area. They wanted to know that ach app meets clinical, data and security standards, and decided that less complicated, low risk apps would achieve a higher recommendation rate from clinicians and adoption rate by patients.

Solution

The Board already had a working Health App Library provided by the Organisation for the Review of Care and Health Apps (ORCHA), giving its public a source of safe health apps across a wide variety of health conditions. So, it asked the team at ORCHA how this platform could be utilized to actively put the right apps in the hands of the right people at the right time. To target those waiting for surgery or for those wanting to manage and maintain their long-term health and well-being needs.

As part of its big update at the start of 2023, knowing a Health App Library needs to be as relevant to an audience as possible, ORCHA enabled the Library to be highly configurable. One such feature is its ability to easily add a dedicated campaign landing page to the Library that drives targeted health app adoption. Designed to a health provider’s specific needs, the page feature images, copy, video and specific apps to address the needs of a specific patient cohort.

Working closely with Humber and North Yorkshire Board, ORCHA created a Waiting Well and Beyond campaign. This included:

• Reviewing the most common health conditions, and with a clinical team mapping the most effective apps to each area, based on reviewing data from the hundreds of health app assessments conducted by ORCHA in each field.
• A campaign landing page featuring 10 apps that support the most common health needs faced by those on the elective care waiting list. These include pain management, sleep, general health and fitness, drinking, smoking and mental health and wellbeing.
• Targeted communications to reach those waiting, to drive them to the landing page. This included social media posts, GP practice text messaging, mentions in outpatient letters, and QR code sheets for practitioners.
• Training to a range of clinicians to enable them to feel comfortable recommending apps from the campaign and also to understand how the ORCHA platform can support more widely with their patients.

Results

During August and September, the programme saw 7,648 people visit the page, and approximately 27% of these people download a health app as a result (1,021 on page downloads and an equal number of off-site downloads).

Based on NICE evidence, each download helps save the NHS £93 in costs. And so over eight weeks, this campaign not only helped provide support to people when they needed it, improving their health, but also saved the NHS £189,906. If this continues over one year, the saving could be over one million pounds (£1,006,706).

Commenting on the campaign, Carrie Cranston, Strategic Digital Programme Support Manager, Humber and North Yorkshire Health and Care Partnership said: “Our ICB were looking at how we could maximise our elective care recovery programme, to reduce the capacity in demand for local services across Humber and North Yorkshire.

“ORCHA have supported us in promoting the use of self-care apps within our local population and this campaign has allowed us to begin the wholesale adoption of digital health within our local communities.”

Following the inquiry into digital transformation in the NHS, the cross-party Health and Social Care Committee has now published its recommendations, which is forward-thinking.

We are pleased to see that the report emphasises the need for a core infrastructure that can effectively deliver safe health apps to the public across the NHS and Social Care. At ORCHA, we have already taken steps in this direction by providing Health App Libraries and Digital Health Formularies to NHS and Social Care organizations, which align with the report’s ambitions.

While progress has been made in some regions of the UK, it is important to acknowledge that universal implementation is still lacking, resulting in inefficiencies and creating disparities between areas. However, we believe that by addressing these challenges, we can overcome the current postcode lottery scenario.

The committee report rightly points out that there is a lack of a systematic and consistent approach to assessing and demonstrating the quality standards of third-party health apps against the Digital Technology Assessment Criteria (DTAC) by the Department and NHS England. We fully agree that needs improving, as using an unsuitable health product can have a negative impact on people’s well-being and deter them from embracing digital channels in the future.

In line with the report’s recommendations, we have conducted over 24,000 assessments of health apps, and DTAC assessments since its introduction in 2021, enabling us to identify excellent apps that can genuinely enhance an individual’s health and well-being. However, this process has also highlighted that a staggering 80% of health apps on the market do not meet the necessary quality standards.

To address this issue, the committee suggests that the Department and NHS England collaborate to establish a comprehensive accreditation scheme for third-party healthcare apps, alongside the current practice of recommending specific apps on some nhs.uk webpages. Moreover, the scheme should be easily accessible for individuals, enabling them to verify whether a healthcare app they are using or considering is recommended by the NHS.

We have witnessed the positive impact that a health app library, complemented by a well-executed communications campaign, can have. For example:

• CW+, the official charity of Chelsea and Westminster Hospital NHS Foundation Trust, and a coalition of NHS organisations including Central North West London NHS Foundation Trust, West London NHS Trust and Imperial College, created a Health App Library designed to support children and young people struggling with their mental health, and their families and carers, to access safe, accredited health apps to support them. More information can be found here: https://orchahealth.com/first-dedicated-app-library-for-children-and-young-people-mental-health-support/
• Ingeus, the company which delivers the National Diabetes Prevention Programme on behalf of the NHS, use the Lancashire and South Cumbria Health and Care Partnership Health App Library. By building the recommendation of health apps into their care pathway, they have been able to augment the support they give to patients. More information can be found here: https://orchahealth.com/nhs-diabetes-prevention-case-study/

Therefore, we hope that this report will inspire more organizations to recognize the benefits of implementing a safe health app library, which continuously assesses and ensures the security of health apps for patients.

Ideally, as recommended in the report, NHS England should establish centralised systems to manage this infrastructure, promoting greater efficiency and providing universal access to all patients. If such a framework were put in place, we would be delighted to contribute to the development of a comprehensive solution.

For further discussions on establishing the core infrastructure for safe digital health, we invite you to contact us.

You can read the full report at the following link: https://committees.parliament.uk/committee/81/health-and-social-care-committee/news/196058/government-must-address-past-mistakes-to-deliver-digital-transformation-in-the-nhs/

Faced with mounting pressures, the NHS and Social Services are increasingly turning to digital technologies to relieve pressure on services and build a more sustainable system. But despite encouraging programs of work, a parliamentary expert panel has found that overall progress towards improving the digital capabilities within the NHS is too slow.

So, what is stopping wholesale adoption of digital health in health and care services? Where are the barriers? And where are the opportunities? 

To better understand the nation’s true opinions, ORCHA has, for the third year, commissioned independent research to ask 2,000 UK residents what they think.

Download our report to discover:

• What are patient attitudes towards digital health in the UK today?
• How is digital health usage changing?
• Are people finding digital health helpful?
• Which regions are most activated in terms of digital health?
• How does the NHS influence the public’s digital health choices?

Click here to fill out the form and get your copy.

Decisions taken now by the NHS will impact our whole nation

We are encouraged that the Government has announced it will invest £310 million over the next five years in digital health technologies to improve the health of the 2.3 million people unable to work due to long-term sickness(1). 

This is a significant move towards a digitally integrated healthcare service. To realise the full potential of this opportunity, the whole NHS needs to look at how to accelerate the digitisation of mental health services plus other areas such as the NHS Health Check.  

This may be a ringfenced investment targeted at just one population cohort, but the implications are much bigger. The safety, data privacy and health outcomes of the entire nation will depend on what the NHS does next. 

Public expenditure will be impacted too. The right choices in digital health will ensure significant returns on investment, reducing costs and demand in both NHS and social services. 

Essential steps for the NHS to consider 

The NHS needs to consider how it can rapidly establish the core infrastructure for digital health that has long in place for medicine. The three most pivotal elements are:  

1. Choice of digital health technologies – There are more than 325,000 digital health technologies designed to support people. They are not all designed equally, the clinical safety, data security, and usability vary significantly. NHS teams need to ensure the very best-in-class products are commissioned.  As both the market and products themselves are dynamic, there should be a continuous process to assess current digital health technologies and reassess those that meet defined standards and regulations, such as those outlined in the NHS Digital Technology Assessment Criteria (DTAC).  
2. Putting the patient at the heart of the decision – There is no single mental, musculoskeletal (MSK) or cardiovascular health app that will work for everyone. A national digital health formulary, echoing the British National Formulary (BNF) for medicines, is required to ensure the right product is selected for each person, at the right time in their care pathway, to achieve the best possible outcome for them.  
3. Safe delivery and governance – Safety is paramount at every step of the process. From educating the staff who will be selecting a digital health product, such as an app, to electronic delivery of the recommendation, and tracking for product recall or providing supplementary information on its use.   

£310 million sounds like a big sum, but without these core elements, the impact digital health delivers will not be realised.  

With them, the health outcomes and savings seen will ensure the programme of work not only continues but lays the foundation for other services to follow.  

ORCHA continues to support the digital transformation of the NHS 

But this isn’t virgin territory. ORCHA has already worked with Occupational Health, Musculoskeletal  and Mental Health teams from across the NHS and seen real results. These practical everyday examples highlight this: 

“Our elderly patients find it hard to come in for regular appointments here. So, if we can use apps on their tablets to assist in their progression, in addition to their therapy and not as a replacement for it, they don’t need to come in so often and it will help them progress.” Hannah Silcock, occupational therapist at Bolton NHS Foundation Trust.

“As a practice nurse we see a lot of patients with chronic conditions. We only see them once or twice a year to review. To be able to give them something to help them manage their conditions on a daily basis is really beneficial, for example to help those with diabetes manage their blood glucose levels.” Jane Patrickson, Bradford practice nursing team.

“Digital health is becoming part of the armoury of tools that our clinicians have…Service users and clinicians are tapping into this. Ultimately, if we get this right, this is about keeping people as people and stopping them from becoming patients in the first place.”  Chris Chaney, CEO of CW+, the charity of the Chelsea and Westminster Hospital Foundation Trust.

At this time when the NHS is faced with unprecedented pressure, we welcome this funding from the Spring Budget, but urge caution around the next steps.  

ORCHA has created the country’s first Digital Health Formulary, to help healthcare professionals prescribe safe digital health products and health apps to patients. Learn more about how ORCHA supports health and care organisations to deliver digital healthy safely. 

About ORCHA

ORCHA provides everything a health system needs from assessing digital health technologies and providing the safe deployment, workforce development and prescription infrastructure to achieve this, which complements other system initiatives. Our cloud-based system has been designed to easily integrate with existing NHS infrastructure, including the NHS App and Electronic Patient Records (EPRs). It also places very minimal demands on existing stretched NHS IT and digital transformation resources whilst ensuring a fully governed, safe process for the deployment and activation of these tools.   

(1) Source: Office for National Statistics (INAC01 SA: Economic inactivity by reason (seasonally adjusted) – Office for National Statistics (ons.gov.uk))