Case study
Review of healthcare apps for NHS England
The NHS app, launched in 2019, is designed as a trustworthy online tool for people to access NHS services and find health information.
Uptake of the NHS App increased dramatically during the pandemic and, according to the NHS, “has changed the way millions of adults in England now access healthcare”. In 2023, NHS England engaged Opencast to review the user experience and functionality of the NHS app – with the ultimate objective of driving innovation and wider adoption of the channel.
Challenge
Explore how people use healthcare apps
The NHS England app was designed to work seamlessly with national and local services – and, where appropriate, integrate into NHS patient pathways. The app also offers a messaging service for health and care providers, giving users more choice in how they interact with NHS professionals.
Anyone aged 13 or over and registered with a GP in England can access the app – and by the start of 2023 the app had over 30 million sign-ups. Patients had ordered more than 22 million repeat prescriptions in the previous year alone and booked 1.7 million GP appointments via the app in the same period, saving valuable time for both patients and clinicians.
In late 2023 NHS England asked Opencast to assess the app to understand how people used the NHS and comparator apps, what worked well and what NHS England could learn from apps offered by nine other healthcare organisations. In particular, they wanted to explore:
How the core user experience differs between different healthcare apps
What, if any, native features are used to improve the user experience in comparator apps
What the most important journeys are across the apps
If other apps innovate faster and understand if they are better equipped to solve issues
The project focused on the performance and design of the NHS app and its proposed design changes, which were due to launch in late 2023 in the first major update to the app since its introduction.
The client was seeking:
Evidence to help provide direction and support decision making
Findings to initiate further changes in the app
Wider understanding of the availability of services within the app
NHS England also wanted a final research document to be available to key opinion leaders and policymakers including government ministers.
Response
Find out how easy apps are for people to use
Our eight-week user-centred design (UCD) project focused on addressing the challenge with a comprehensive response. Opencast created several different work streams, drawing in multi-disciplinary expertise from across the business to add richness to the research and data.
We brought together expertise in user research, interaction, service and content design alongside product, delivery, and technical expertise. An agile approach promoted iterations and tight feedback loops to enable quick decisions and remain focused on outcomes.
Taking a user-centred approach, the team’s overall work focused on:
Core experience (sentiment analysis, heuristics review and user research)
Use of native features (feature analysis)
Journey deep dive (mapping user flows/journeys)
Incident management (app release schedule analysis)
The team conducted an in-depth research study into the usability of the NHS app. The work involved:
A review of the existing NHS app user interface against Nielsen Norman’s 10 heuristic principles to identify opportunities to enhance it
Heuristic review of the updated NHS app design, (due for release at the end of 2023), to identify opportunities for future development, alongside a similar review of nine selected comparator health apps, to identify innovations and alternative approaches to design for healthcare
A comprehensive, in-depth review of all the key features of the NHS app and the nine other healthcare apps for comparison
A user research study, managed by Opencast, looking at the key journeys in the NHS app and users’ experience of engaging with its different services
A review of the release schedules and data for the NHS app and nine comparators
A sentiment analysis of the NHS app
Research conclusions
Sustainability considerations were another element of the app review. The NHS app has already had a positive impact on the environment and has been helping NHS England reduce its carbon footprint. Over 200,000 online consultations through the NHS app by 2021 meant that fewer visits by car or taxi were being made to GP practices. Responding to the NHS’s stringent environmental policies, reforms and targets, the Opencast team considered sustainability factors using DEFRA’s 10 planet-centric design principles and suggested recommendations for further optimisation.
A final report from Opencast on its app review included the findings of the research, highlighting key challenges and user pain points with the NHS app, as well as those of the nine others. It set out detailed recommendations for improvements that could be introduced in the next release of the NHS app.
Work on the project was completed in December 2023, and the Opencast team presented the findings of its report, and the lessons learned, to NHS England decision makers in January 2024.
The research concluded that, overall, the NHS app is well-designed and highly accessible. In comparison with the nine comparator apps, the NHS app follows rigorous design patterns that have been well researched with users. While comparator apps employ some best practices, none of the nine measured up to the same high standards set by the NHS app.
On innovation and enhancement, the research found comparator apps did innovate in small areas – and a thorough analysis identified several features that could be included in future versions of the NHS app.
Other app features included prescription ordering and medication reminders and the research found there was flexibility in other apps around messaging and appointment booking (including options for video calls). The heuristic review found several opportunities to improve the experience for users.
The app review found that, despite an overall very positive picture, there was room for the NHS app to improve its consistency in user experience and take a more patient-centric view in the way the information is laid out in the app (which currently reflects the NHS structure).
Tools used during the work included: MonkeyLearn, AppFollow and Brand24, BrowserStack, Jira, MS Teams, SharePoint and PowerPoint.
Impact
Clearer insights for increasing reach of NHS app
Evidence to help provide direction and support decision making
The report has offered the NHSE app team impartial expert advice and insights that can be used to support other streams/programmes of work. This could leverage faster innovations and developments in the design team going forward.
Findings to initiate further changes in the app
The findings are likely to be shared more widely to underpin discussions about the future development of the app, including an exploration into how to integrate native features into the NHS app. The research has left the NHS app team in a good position to secure support from senior stakeholders for not just the further development of the app, but also evidence to support other programmes of work more widely across the NHS.
Wider understanding of the availability of services within the app.
Our research found that the NHS app works well when users have access to all the services it offers. The biggest challenge for the future success of the app will be in giving all users equal access to these services, regardless of their choice of GP.
The project and final report will help NHS England to develop its insights to help increase reach for the NHS app. Implementation of our recommendations will also help enhance the user experience of the NHS app and its functionalities.
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