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Why is there an 8am rush on the NHS App?
Josh Dresner, User Researcher, has been digging deep into users' experience of the NHS App. He has found some GP practices using the app to transform access to services, while others are still stuck with old habits.
14 October 2019
The NHS App is now live in 95% of GP practices, which means that citizens across most of England can download, register and use all the the features of the NHS App.
In April 2019, I wrote a blog describing the pilot. We were starting to track the experience of app users, and the rollout and onboarding experience for CCGs and GP practices. Since then, we have remained agile and have been improving the app's usability.
Digital transformation isn’t just about changing a few screens, usability testing and tracking usage flows of real users. There is a huge amount of work to find out users’ pains, observing their behaviours and, in some instances, prompting them to act in a different way. This has been true for GP practice staff as much as the thousands of NHS App users around England. Transformation does not happen just because an app is suddenly on an app store.
We’ve seen there is an 8am scramble to book an appointment in the app – an offline behaviour mirrored in a digital environment.
Our team have used analytics to look at the experience intelligently, working to bridge the emotional experience of using a new app with the metrics of usage and usability. We’ve set up heatmaps to see where people tap and scroll. This means that we can see an overall picture of what parts of the page people are interacting with and how far down the content they go.
Heatmap indicating where people tap and scroll on screen
We’ve seen there is an 8am scramble to book an appointment in the app (as well as the rush already experienced by practices directly). So why is there still a rush? It’s because an offline behaviour is mirrored in a digital environment. It isn’t transformation if people are going online at 8am to get an appointment, just like they used to ring the practice at 8am. Over time, more and more practices will see that appointments can be released at different times of day for patients. It should help that the new GP contract says that 25% of appointments must be made available for online booking.
GP practices determine what is made available and when they are released. During our research, I visited one practice in Edmonton, North London, that released some appointments at midnight, and a few others at 8am. The NHS App was being promoted as a way to beat the rush, not digitise an offline habit.
Graph showing surge in appointments at 8am
As a user researcher, I’ve been closer than many in the team to what digital transformation means in the real world of the GP practice and the pharmacy. I’ve been fortunate enough to see reception staff promoting the app enthusiastically to their patients. I’ve heard app users tell me what they love about the app: seeing test results online for the first time and booking an appointment without ringing the practice. We've found that 63% of our app users have never had any health app connected to their GP before, so for many this is a transformation in health and wellbeing management.
Managing expectations of users
We’ve also seen some frustration and disappointment. We categorise and track it all. Alongside analytic data, this feedback all feeds into our prioritisation and re-designs.
The most common disappointment we’ve had has been with the medical records section. NHS App users are expecting to access their entire NHS record, their hospital notes and letters or their test results. In most cases people see their Summary Care Information, which only displays essential records. We are improving the layout on this page, the navigation through this section and the guidance about it. We have changed the section name to GP Medical Record, so user expectations are managed from the start.
This transformation is just beginning. We have developed a detailed toolkit that will help GP practice staff to prepare for and make the most of the NHS App. This includes guidance on preparing staff and systems, promotional resources, and details about upcoming features. Information for patients is also available.
Give the NHS App a try if you haven’t downloaded it yet. More and more practices will be promoting the NHS App over the coming months.
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