The use of digital channels should be the choice of the individual patient, with those who can’t or don’t wish to use digital tools still able to access services over the telephone or in person. Patients should be able to access advice, support and treatment from primary care using digital and online tools. These tools should be integrated to provide a streamlined experience for patients directing them to appropriate and timely care. In turn, this helps practices to manage demand better, reduce the administrative burden and improve patient and staff experience.
The target is for 75% of the adult population in England to be registered to use the NHS App and NHS website by March 2024. By September 2022, over 30 million citizens had signed up to the NHS App, with almost 450,000 new organ donation decisions made.
In June 2022 alone, the NHS App enabled 1.8 million repeat prescriptions to be ordered, 130,000 GP appointments to be booked and 4.8 million GP records to be viewed, saving vital time for both patients and clinicians.
You can read the latest App related news articles on the website at digital.nhs.uk
Accessing the App
The NHS App was launched in January 2019. It was designed as a standard, branded, trustworthy, online tool for people to use to find health information and access NHS services. It works seamlessly with other services at national and local levels and, where appropriate, is integrated into patient pathways.
The NHS App proved itself a crucial tool in the fight against Covid-19 and changed the way millions of adults in England now access healthcare.
Users will initially need to set up an NHS login, proving who they are, in order to access their NHS account and set up the NHS App. The App is available on iOS and Android operating systems and can use the host device’s secure logon method. The patient’s NHS account then securely connects to information from their registered GP surgery.
Benefit to practices
Practices need to have trust in the digital tools they promote to their patients. The NHS App has been designed, built, tested and clinically reviewed with patient safety at its heart. NHS Digital has produced resources for practices to promote the NHS App to their patients, with posters, leaflets, a waiting room film, guidance for text messages and images for social media and websites.
Supporting patients to use online services like ordering prescriptions, booking appointments, seeking advice or filling in an online consultation, are all ways in which practices can reduce footfall into practice, and reduce the time spent on the telephone, helping to empower patients to take better control of their own health and wellbeing.
There are a number of other apps and online tools available for patients to use but no single one has the full range of services and functionality of the NHS App.
The NHS App can offer the following benefits to practices:
- provides patients with an NHS covid Pass
- offers online consultations through a number of service providers
- includes an NHS App messaging service, which:
- is more secure than other message channels, e.g. SMS (texts)
- can reach the patient regardless of changed phone numbers or different practice registration
- can be longer and richer in content with branding, linked text and interactive elements
- secure messaging enabling patients to send non-urgent enquiries to the practice (EMIS and TPP clinical systems only) who then send replies using the clinical system
- access to patient records allowing patients aged 16 or over to see information contained in their health record, including allergies and adverse reactions, medications including acute medicines, repeat medicines – current, repeat medicines – discontinued, test results (new results will be visible only when filed) historic results (potentially as far back as 2002) consultations (including free text), events and documents
- linked profiles and proxy access, once a GP practice has set up proxy or delegated access, a patient can use the linked profiles feature in the NHS App
- online appointment booking, making directly bookable appointments available for patients to book online will help to reduce staff time spent on the telephone, as well as empowering the patients to manage their own appointments
- patient interaction with referrals, for referrals made through the e-Referral service (e-RS) patients can book, check, change or cancel their appointment, reducing the need for practices to print and post booking instructions. Practice staff will be given the option to send documents electronically if the patient has the service enabled
- prescription ordering, with the option of the patient nominating a pharmacy for dispensing
- updates, guidance on the latest updates and releases.
There is also an ambition to enable patients to request historic coded records access through the NHS App from 2023.
Benefits to patients
Patients can access NHS services through the free NHS App 24 hours a day, 7 days a week. Access is quick and secure and allows patients to book appointments and order repeat prescriptions without the need to be held in a queue by busy practice telephone lines. The App also has access to a number of other services including symptom checkers, NHS 111 and online consultations and is widely described as ‘a digital front door to GP practice services’.
Patients can use the NHS App to:
- get an NHS Covid pass (vaccination status), which may be needed when travelling abroad – the App contains a link to UK foreign travel advice for patients to check up-to-date travel guidance – the pass can be viewed, emailed, downloaded as a PDF or saved to a patient’s Google Pay wallet
- view messages, in a secure inbox, from the NHS App, from their GP practice or other healthcare provider – notifications must be switched on in the App settings to be alerted to incoming messages
- view linked profiles, which enables family members/carers to access health services on behalf of the patient – this has to be enabled by the GP surgery as proxy or delegated access
- securely view the GP patient health record, to see information like allergies, and current and past medicines – patients can also see information like filed test results and the details of consultations
- order repeat prescriptions, from a list of available medicines, and choose the dispensing pharmacy. They can also see the previous order.
- book or cancel appointments at their registered GP surgery and see details of upcoming and past appointments
- view referrals and other healthcare appointments (if the practice has enabled this service)
- Get health advice, for example:
- about Coronavirus
- find trusted NHS information on the NHS website’s Health A-Z pages
- use an active link to NHS 111 for online help and guidance or when to call 111 instead
- answer guided questions online, through a linked online consultation service provider to get a response from the patient’s registered GP practice for themselves or for a child
- view their NHS number, visible on the home page
- view and manage care plans (if the GP practice has enabled this service)
- register for organ donation, and subsequently manage their choices through the link on the App
- choose if confidential data from their health records is shared for research and planning and also change their decision through the App – there is another article in this series on consent to record sharing
- get help with technical issues, with troubleshooting advice and a link to contact the NHS App team
- access a help function, with advice about a range of clinical issues like mental health and urgent medical assistance, as well as help with the App functions, like messaging
Issues and risks
The NHS App needs an internet or data connection to work. It doesn’t store information and cannot be used off-line.
If patients are unable to access their NHS App, they can still access their NHS account through the www.nhs.uk website. The website system uses the patient’s NHS login details as well as two-factor identification for security.
From the end of 2022 practices need to be mindful that patients may be able to see their prospective clinical records, including free text, letters and documents through the NHS App.
In some circumstances this may not be beneficial to the patient. The record may contain information that is particularly confidential and/or sensitive, and which, if viewed by a third party, could become harmful to the patient in some way, e.g. where there is actual or suspected domestic abuse documented and there is a risk of coercion leading to the release of that record. The importance of safeguarding patients from harm is paramount.
It may be appropriate to redact specific information entered into the GP medical record or to limit or prevent the patient (or their proxy) from having access, either temporarily or permanently.
NHS Digital has produced guidance for practices to add an enhanced review code to patient records where there are safeguarding concerns.
As with any technology, there will be rural/geographical areas where patients may be disadvantaged because of network and connection problems. Whilst this is beyond the control of practices, those who operate in these localities need to mindful of the issues and make sure there are sufficient alternative ways for patients to access services.
There is another article in this series on digital inclusion.
Security and data protection
The NHS App has numerous links to other service providers. NHS Digital and a number of data controllers and processors are involved in providing the full service.
There is nothing specific that practices/staff need to do with regards to data security, and the App, other than the annual data security awareness training. You can, however, find out more information on the relevant NHS App data protection and privacy policies at nhs.uk.
Patients also need to be made aware of their responsibility to keep their log-in information and health record information secure. NHS England has produced a booklet for patients called Keeping your online health and social care records safe and secure.
Related GPG content
- Proxy access
- Online appointment booking
- Online repeat prescriptions
- NHS login
- NHS.uk online resource for patients
- Promoting online services
- Video consultation tools – to follow
- Consent to record sharing
- Health equalities and inclusion – to follow
- Subject access requests (SAR)
Other helpful resources
- UK, NHS login
- NHS Digital, Tell your patients about the NHS App
- NHS Digital, NHS App guidance for GP practices
- NHS digital, Clinical safety (to be used to report any clinical incidents that arise from the use of the NHS App)
- NHS Digital, NHS App blogs
- NHS Digital, Learning from early adopter sites
- NHS Digital, National Digital Channels, Platform and Integration Strategy
- UK, Our policies
- NHS England, Guide to offering patients prospective record access