CRediT contribution statement
Felix Greaves (https://orcid.org/0000-0001-9393-3122): Conceptualisation (equal), Funding acquisition (equal), Methodology (equal), Supervision (lead), Writing – original draft (lead), Writing – editing and reviewing (equal).
Chrysanthi Papoutsi (https://orcid.org/0000-0003-1189-7100): Conceptualisation (supporting), Funding acquisition (supporting), Methodology (equal), Supervision (supporting), Writing – original draft (supporting), Writing – editing and reviewing (supporting).
Sukriti Kc (https://orcid.org/0000-0003-3525-3908): Data curation (equal), Formal analysis (equal), Investigation (equal), Writing – original draft (supporting), Writing – editing and reviewing (supporting).
Salina Tewolde (https://orcid.org/0009-0005-1512-6903): Data curation (supporting), Formal analysis (supporting), Investigation (supporting), Writing – original draft (supporting), Writing – editing and reviewing (supporting).
Claire Reidy (https://orcid.org/0000-0002-0013-6843): Data curation (equal), Formal analysis (equal), Investigation (equal), Writing – original draft (supporting), Writing – editing and reviewing (supporting).
Bernard Gudgin (https://orcid.org/0000-0001-9606-5121): Conceptualisation (supporting), Funding acquisition (supporting), Methodology (supporting), Writing – original draft (supporting), Writing – editing and reviewing (supporting).
Anthony A Laverty (https://orcid.org/0000-0003-1318-8439): Methodology (equal), Supervision (supporting), Formal analysis (equal), Investigation (equal), Writing – original draft (supporting), Writing – editing and reviewing (supporting).
Azeem Majeed (https://orcid.org/0000-0002-2357-9858): Investigation (supporting), Writing – original draft (supporting), Writing – editing and reviewing (supporting).
Ceire Costelloe (https://orcid.org/0000-0002-3475-7525): Methodology (equal), Supervision (supporting), Writing – original draft (supporting), Writing – editing and reviewing (supporting).
John Powell (https://orcid.org/0000-0002-1456-4857): Conceptualisation (equal), Funding acquisition (equal), Methodology (equal), Supervision (supporting), Writing – original draft (supporting), Writing – editing and reviewing (equal).
Acknowledgements
We are grateful to the teams at NHSX, NHS Digital and NHS England who worked with us to support this work. This includes Ian Phoenix, Sam Shah and Tara Donnelly who provided support and advice in the development of the project. We are also grateful to Emily Beech, Kristen Allen, Felix Mukoro and Emma Bradley, among others, who worked with us as the delivery team to discuss and help interpret our findings. We are grateful for the support of the NIHR Applied Research Collaborations in North West London and Thames Valley, whose digital health themes collaborated to support this study, including case study sight identification and recruitment of PPIE members. We are grateful to the NIHR Clinical Research Networks, who supported the recruitment of practice case studies. We would like to thank all of the PPIE members who contributed to several workshops, discussion and document reviews across the project.
Study advisory group
We would like to thank the following Study Advisory Group members for their invaluable advice and contribution to the project: Claudia Pagliari (chair, Edinburgh University), Gordon Moultry (patient and public involvement representative), Ronen Rosenblum (Harvard University) and Helen Atherton (Warwick).
Patient data statement
This work uses data provided by patients and collected by the NHS as part of their care and support. Using patient data is vital to improve health and care for everyone. There is huge potential to make better use of information from people’s patient records, to understand more about disease, develop new treatments, monitor safety, and plan NHS services. Patient data should be kept safe and secure, to protect everyone’s privacy, and it is important that there are safeguards to make sure that they are stored and used responsibly. Everyone should be able to find out about how patient data are used. #datasaveslives You can find out more about the background to this citation here: https://understandingpatientdata.org.uk/data-citation
Data-sharing statement
All data requests should be submitted to the corresponding author for consideration. Access to anonymised data may be granted following review. Any queries should be addressed to the corresponding author.
Ethics statement
Ethical approval for the qualitative study was granted by the National Research Ethics Service and Health Research Authority, Reference 21/WS/0031 (approved by the West of Scotland Research Ethics Service on 2 March 2021). Ethical approval for the quantitative studies was provided by Imperial College London Research Ethics Committee (ICREC), Reference 21IC7292 (approved on 11 November 2021). The qualitative study was registered with the ISRCTN registry – ISRCTN72729780.
Information governance statement
Imperial College London and the University of Oxford are committed to handling all personal information in line with the UK Data Protection Act (2018) and the General Data Protection Regulation (EU GDPR) 2016/679. Under the Data Protection legislation, Imperial College London and the University of Oxford are the Data Controllers, and you can find out more about how we handle personal data, including how to exercise your individual rights and the contact details for our Data Protection Officers here: www.imperial.ac.uk/research-and-innovation/research-office/research-governance-and-integrity/what-is-research-governance/data-protection---information-for-participants/ and www.ox.ac.uk/privacy-policy
Disclosure of interests
Full disclosure of interests: Completed ICMJE forms for all authors, including all related interests, are available in the toolkit on the NIHR Journals Library report publication page at https://doi.org/10.3310/XYRV6485
Primary conflicts of interest: Felix Greaves: PHR – Research Funding Board 16 February 2016–13 May 2020. PHR Prioritisation Group 19 February 2016–13 May 2020. PHR Programme Advisory Board 13 January 2015–13 May 2020. Felix Greaves was employed by the National Institute for Health and Care Excellence (NICE) to 2023. Felix Greaves is employed by the Department of Health and Social Care (from August 2023), in addition to his role at Imperial. Bernard Gudgin: HTA EESC Panel 1 January 2016–31 May 2018. HS&DR Funding Committee Members 19. September 2018–30 September 2020. Anthony A Laverty: PHR Funding Committee – 13 June 2017–29 February 2028. PHR Prioritisation Committee – 15 February 2021–29 February 2024. Programme Oversight Committee – 14 February 2017–30 June 2027. John Powell was employed by the National Institute for Health and Care Excellence (NICE) to 2023. John Powell receives funding from the National Institute for Health and Care Research (NIHR) Applied Research Collaboration Oxford and Thames Valley at Oxford Health NHS Foundation Trust. NIHR HTA and EME Editorial Board 2005–22. COVID-19 Reviewing 1 June 2020–30 September 2020. ESP – Evidence Synthesis Programme Grants Committee 2021–2. ESP – NIHR Incentive Awards Committee 2021. ESP – Evidence Synthesis Programme Advisory Group 2020–2. TARs Contract Retender 2020 Committee, 2020.
Copyright and credit statement
Every effort has been made to obtain the necessary permissions for reproduction, to credit original sources appropriately and to respect copyright requirements. However, despite our diligence, we acknowledge the possibility of unintentional omissions or errors and we welcome notifications of any concerns regarding copyright or permissions.
Publications
Kc S, Tewolde S, Laverty AA, Costelloe C, Papoutsi C, Reidy C, et al. Uptake and adoption of the NHS App in England: an observational study. Br J Gen Pract 2023;73:e932–40. https://doi.org/10.3399/BJGP.2022.0150
Kc S, Papoutsi C, Reidy C, Gudgin B, Powell J, Majeed A, et al. Differences in use of a patient portal across sociodemographic groups: observational study of the NHS App in England. J Med Internet Res 2024;26:e56320.
Reidy C, Papoutsi C, Kc S, Gudgin B, Laverty AA, Greaves F, Powell J. Qualitative evaluation of the implementation and national roll-out of the NHS App in England. BMC Med 2025;23:20. https://doi.org/10.1186/s12916-024-03842-w
Conference presentations
Papoutsi C, Reidy C, Powell J, Greaves F, Gudgin B. The ‘Unrealistic Simplicity’ of the NHS App as ‘Front Door’ to the NHS in England: Qualitative Study. BSA Medical Sociology Conference 2022, Lancaster, UK, September 2022.
Reidy C, Powell J, Greaves F, Gudgin B, Costelloe C, Tewolde S, Papoutsi C. Patient, Staff and Stakeholder Experiences with the National NHS App in General Practice: Qualitative Evaluation. European Health Psychology Society (EHPS) Annual Conference 2022, Bratislava, Slovakia, August 2022.
Reidy C, Papoutsi C, Greaves F, Gudgin B, Costelloe C, Tewolde S, PowelI J. Patient, Staff and Stakeholder Experiences with the NHS App in General Practice: National Evaluation Using Qualitative Methods. Health Services Research UK (HSRUK) 2022, Sheffield, UK, July 2022.
Reidy C, Papoutsi C, PowelI J, Gudgin B, Costelloe C, Tewolde S, Greaves F. Patient, Staff and Stakeholder Experiences with the NHS App in General Practice: National Evaluation Using Qualitative Methods. Royal College of General Practitioners (RCGP) Annual Conference, and The World Organization of Family Doctors (WONCA) 2022, London, UK, June 2022.
Kc S, Tewolde S, Laverty AA, Costelloe C, PowelI J, Papoutsi C, et al. Evaluation of the Adoption and Use of the NHS App in England Using a Mixed-Methods Approach. HSR UK Conference, Birmingham, 4–6 July 2023.
Kc S, Tewolde S, Laverty AA, Costelloe C, PowelI J, Papoutsi C, Reidy C, Gudgin B, Shenton C, Greaves F. Adoption and Use of the NHS App in England: A Mixed-Methods Evaluation. BJGP Conference, London, 31 March 2023.
Public/community engagement
Reidy C, Papoutsi C, Greaves F, Gudgin B, Laverty A, Kc S, PowelI J. Patient and NHS staff perspectives of digital inequalities in the national rollout of the NHS App in general practice. NIHR Applied Research Collaboration (ARC) for Oxford and the Thames Valley Showcase Event, November 2022.
Reidy C, Papoutsi C, Greaves F, Gudgin B, Laverty A, Kc S, PowelI J. The NHS App and Digital Exclusion. Reading Voluntary Action Voluntary and Community Sector Forum, Reading, UK, March 2023.
NHS App evaluation project website: www.arc-oxtv.nihr.ac.uk/research/national-rollout-NHS-app-evaluation
Policy presentations
Monthly presentations and discussion of emerging results with the NHS England and NHS Digital NHS App delivery team January 2022 to July 2023
Our results were shared – by the NHS England team – with the NHS Inequalities board in April 2023.
Invited evidence submission to the health and social care committee of the houses of parliament – see Appendix 5.
Disclaimers
This article presents independent research funded by the National Institute for Health and Care Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, the HSDR programme or the Department of Health and Social Care. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, the HSDR programme or the Department of Health and Social Care.