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Part of NHS App pilot research findings

What we learned from GP practice staff

Methods and key findings

During the pilot each of the 34 practices was visited by a member of the NHS England ‘Empower the Person’ implementation team to help them prepare. The team provided them with staff and patient promotional materials and additional support as required.

We conducted research through phone calls and visits to the pilot practices. Practice staff were encouraged to discuss their feedback on the NHS App and pilot at team meetings and to submit their feedback using a web form, or via their implementation team contact. A baseline interview was conducted with 16 practices which will be helpful to track changes over time as the NHS App becomes more established.

The main themes from the research were:

  1. During the NHS App pilot there was no noticeable negative impact on the practices involved.
  2. Practice managers felt reception staff didn’t need specific incentives to mention the NHS App to patients; they just needed reminding to develop the routine.
  3. Reception staff were often enthusiastic to promote the NHS App, and felt proud to be the first in the country to offer it.
  4. Some practices needed to learn a new process so they could provide patients with the details they needed to register (if the patient could not, or did not want to use the NHS login registration route in the NHS App).
  5. Practice staff felt more confident to promote the app once they had seen a video of its functionality or had downloaded it and set up an account for their ‘dummy’ or ‘test patient’.

After visits and telephone interviews with practice managers and reception staff we broke down the practices’ journey through the NHS App into 5 stages. Within these stages, we've shared the practice manager's experience in the 'What happened' sections, and a collection of recommendations for our project team under the headings ‘What do practices need?'

A different, more simple, sign-up journey for patients is in place now that the NHS App is available for anyone to download from app stores than was necessary for the pilot. There is also a different support model for practices. This means that some of the following findings will not be experienced during the public rollout.

1. Onboarding: when the practice was briefed about the pilot

What happened?

Practice managers were briefed on the functionality of the app, and the plans for the pilot. They were also given access to an online toolkit to help them prepare their systems and staff, and to promote the app to patients. They were keen to promote it, but running the practice and other priorities meant that in some cases delays occurred with setting a start date.

What do practices need?

They need:

  • knowledge of the support available for staff and patients
  • awareness of the guidance around promoting the NHS App and the key functions
  • guidance on best practice for naming appointments, awareness of how to change appointment names and modify appointment availability within their clinical systems
  • a demonstration of the NHS App
  • guidance on promoting the NHS App and other health apps that are available

New guidance has been issued in the toolkit being provided to GP practices connecting with the NHS App and further best practice will be added in the coming months.

2. Launch: when text messages were sent to all patients

What happened?

GP practices have different contracts or arrangements in place for sending text messages to patients. Nearly all of the practices we selected to take part in the pilot could send text messages to patients. However, the practices were frequently delayed in sending text messages out as they had challenges liaising with third-party providers for their text service, or it was an entirely new process for a staff member.

After sending text messages, a couple of practices received a few patient calls enquiring if the message was genuine.

Some practices quickly put up posters in their waiting rooms and added content to their websites about the NHS App, but many took a few weeks to do this.

What do practices need?

They need:

  • the ability to easily send text messages to large groups of patients
  • awareness of how to send text messages and the length of time it takes to do it
  • clear guidance and templates on how to promote the NHS App on their websites, in the practice and in the community

We have tested different text messages with users to explore how the language we use affects the level of trust and engagement. We have provided guidance and templates to help practices promote the NHS App in the toolkit for practices going live with the NHS App.

3. Initial experience: the first week after initial promotion

What happened?

Practice managers briefed their staff. Most verbally told all receptionists at a meeting and sent them a reminder email with some basic information about the pilot. At some practices that use TPP, staff needed to learn a new process to create a passphrase for a user. This is necessary if a patient wants to register for the NHS App, but cannot or does not want to use the NHS login verification process within the app. Very few practices sent a follow up text or email to their patients.

What do practices need?

They need:

  • clear instructions on how to support patients who want to register for the NHS App but don’t want to use the NHS login verification process, or cannot use it
  • clear communication on the features of the app to address potential confusion in relation to other digital services already available
  • information about how their work promoting the app is leading to sign ups and positive results

We have improved the support materials that practice managers can use to brief staff on the NHS App. Further material will be added to the toolkit in the coming weeks. We're also developing a dashboard that will enable practice managers to see how many of their patients have registered to use the NHS App, use of some of the core functions and more.

4. App live: Practice experience during the pilot

What happened?

Some practices had concerns that sending text messages to large groups of patients would lead to a large number of unnecessary enquiries. However, this did not materialise and the NHS App had no significant negative impact on the practices.

Some practices were frustrated that there was no dedicated support phone line for patients as they expected a service that manages the sign-up for online services should have this. There was a support phone line open throughout the pilot for practice staff, but it only received one phone call.

Practices were mostly unaware of how their appointment names were being displayed to patients in the NHS App and other third party apps and that there was patient confusion.

What do practices need? 

They need:

  • awareness of how their appointment names are being shown, guidance on best practice for appointment naming, and guidance on how to modify them in their clinical systems, as this is not otherwise prioritised
  • promotional materials that explain the benefits of the NHS App to patients that visit the practice
  • flexibility from the Clinical Commissioning Group, the app team and NHS England to promote the NHS App to specific patient groups, and in ways that make sense to their practice population

Between April and July 2019, GP practice staff across England will be invited to attend a series of webinars on the NHS App which will include advice on appointment naming and availability, medical records and safeguarding, and promoting the NHS App. This will form part of a wider engagement campaign we will undertake with practices which will help to ensure they are ready before the NHS App is promoted to patients. Information has also been added to the toolkit for GP practices.

5. Integration and promotion: How the app integrated into routine ways of working and promoting online services

What happened?

Some practices promoted the NHS App by changing their prescription message, by adding paragraphs to appointment reminder letters and emails, and by updating their websites. Many put up posters and gave out appointment cards to patients. No practice during the pilot modified their website fully to add the NHS App as an option for online services or updated their registration forms.

What do practices need?

They need:

  • awareness of significant scheduled changes to the app, such as new features or options for personalisation (for example the ability to nominate a pharmacy)
  • marketing templates for the text for creative promotion methods
  • templates for practices to update their website to showcase NHS App alongside other third party apps
  • confidence and motivation to make more appointments available for online booking

We've included lots of material in the toolkit for GP practices, and will continue to keep information updated. During 2019, case studies will be created to inspire practices to integrate the NHS App into their practices.

Last edited: 20 May 2019 1:11 pm