This week, Manage my Health went from being me, to a proper team of 3. This has been great, progress feels more tangible and I get stuff out of my head. When new people join the team or we talk about the work, I often mention that I think we as an organisation are over‑indexed on the NHS app. The NHS is a massive (set of) organisation(s) with GP surgeries, hospitals, websites, etc and that focussing heavily on an app feels like a strategy that underutilises the strengths of the NHS. I think these days the desire to make apps, born out of FOMO, has mostly translated into the desire to do AI. I guess apps are moving into the trough of disillusionment phase.

My new job, which I like doing and am excited to see where it goes, is to help bring prevention services to people through the NHS app. So it’s helpful to think about what having an app on your phone could offer users for prevention. There are some things we could offer (assuming we do our job well):

  • easier access to one-off actions – booking a screening, getting a vaccination – without navigating the system
  • relevant services based on the user’s needs – they don’t need to know what exists or what they’re eligible for
  • proactive contact – I’m not sure if this will be possible, but speaking to users when they are in the right frame of mind will be more effective in helping offer support
  • support for behaviour change over longer periods – not a one-off appointment
  • a private interface for sensitive topics – for some, preferable to a conversation

All of this is a big change to how the NHS app works at the moment. Currently the app is good at supporting users to do tasks like order a prescription, check a message, or view a test result.

Adding prevention – especially anything around behaviour change – will make the app into something different. One big theme from the NHS 10‑year plan is that the app will be all the things. There aren’t many ‘all the things’ apps. Different apps for different things tend to be the model. For example, Apple and Google split mail and calendars into separate apps, and as Mike Gallagher points out, not following platform conventions causes friction and erodes trust.

We had our first conversation with the Child Health team this week. They’re the only team in our area organised around a demographic rather than a type of care. The app is designed around managing your own health. But parents managing children’s health have different needs. They want to schedule two children’s appointments together, to see screening results and health visitor notes. Someone with postnatal depression needs support for themselves and their child at the same time. Proxy access, family health, caring for others are different models of care that the current app doesn’t support well.

We’re looking for small opportunities to start with. Places where a cross‑cutting team can support the work that’s already happening. But we’re also trying to think about what the long‑term might be. What should be in the NHS app and if and when the one‑app‑for‑everything approach starts to break – is something we’ll learn as we go. Maybe we’ll find out that smashing everything into the app is a good strategy.