The must-read stories and debate in health policy and leadership.

The NHS’ digital front door

The NHS App will, the long-term plan tells us, become the digital front door for patients.

In the future, the patchy coverage of hundreds of patient health apps used in the NHS will be channelled through the NHS App, tidied into a clean blue and white NHS design. This will simplify the landscape for patients, who will know that, for most of their digital interactions with the NHS, they can start with this one app.

But the NHS App is a long way from being in a position to manage this and grappling with well-rehearsed difficulties of making different IT systems communicate with one another (interoperability).

HSJ reported on Wednesday that NHS Digital has not been, as of yet, able to integrate the NHS App with any of the current providers of the 32 online and video GP consultations.

This is hopefully a technical hurdle to be overcome. But, if the NHS App can’t plug into apps already widely used in the NHS, then it risks becoming just another novel app among many, rather than the NHS’ digital front door.

After a pilot late last year, the NHS App went live in December, but patients whose GP practice has not plugged into the app (ie: most of them) can only use it to check their symptoms (through NHS 111 Online powered by NHS Digital’s pathways software).

Full access to the app would allow patients to book appointments, order repeat prescriptions, access their health records and update their data sharing preferences. Every GP practice in the country is expected to connect to it by July.

However, the functions above are mostly centrally provided by NHS Digital already, making them easier to integrate into the NHS App. A far bigger challenge will be linking into many apps already being used at a local level (or where this is not possible, displacing them).

Suppliers in the market are nervous and uncertain about the impact of the NHS App and whether it will replace or disrupt the digital patient services they are already providing locally to the NHS.

Several have expressed frustration about getting a clear steer from NHS Digital on how to connect to new central services such as the NHS App and NHS Log-in, the new national digital patient ID service.

Such complaints are no surprise, as suppliers jockey for advantage as they feel the market – in this instance digital patient services to the NHS – shifting beneath their feet.

Bringing together these disparate and sometimes competing apps under a single NHS App umbrella will be a huge technical and organisational challenge for the NHS. If it even half succeeds, it will be a significant achievement.

The wait

North central London is struggling to meet the 62-day target for cancer patients. Its latest papers reveal the aggregate proportion of patients entering treatment inside two months is at 77 per cent, below the 85 per cent target.

The aggregate performance across the area last got over the threshold in December 2017 – the first time it hit the mark in three years.

The sustainability and transformation partnership said there are issues with treatment pathways within trusts, where capacity issues cause delays, and delays accrue when patients are transferred from one trust to another for treatment.

It has written to University College London Hospital Foundation Trust to make sure the FT is on top of problems with its prostate pathway. And STP paperwork published in January said there is an “investigation into the rising waiting list backlog at Royal Free London [FT]”.

This is part of the STP’s latest attempt to get its providers back on target for cancer waiting times. Its committee papers over the past year show it has had to push back the date by which it hoped to recover the 62-day target several times.

It refreshed its recovery plan in November and is paying particular attention to prostate and bowel pathways. The perennial grapple with cancer waiting times is set to continue.