Apps

Apps

Mobile device and computer apps are software applications, usually designed to run on smartphones and tablet devices e.g. iPads.

Some patient apps will have made available NHS Patient Facing Services (PFS also known as ‘GP online services’) features, read about these and apps within PSNC’s Update about PFS & app offerings.

In the future the recommendation to a patient to use a high quality app may be as common an occurrence in pharmacies as provision of verbal advice on lifestyle or a patient’s medicines.

COVID-19 update: See ‘NHS COVID-19 app‘ section below.

Types of apps

Common types of health apps include:

  1. Medical apps, which involve a medical purpose, such as diagnosis or treatment decisions (e.g. a dosage calculator app that recommends a medicine dose based on a patient’s details). Medical apps are medical devices and therefore should be CE marked if sold or distributed within the UK. The MHRA has published app guidance and a flow chart that provides further information on apps and how to determine whether an app involves a medical purpose;
  2. Medical device accessory apps are apps which work in association with a CE marked medical device, and so do not need their own CE mark, e.g. an app which connects to a blood pressure monitor; and
  3. Health apps which are not classified as medical devices which might, for example, help to support a discussion with a clinician, but would not determine the treatment decision, e.g. an app that recorded or accessed data without complex calculations (e.g. an electronic health record or a simple step-monitoring app).

In the future the recommendation to a patient to use a high quality app may be as common an occurrence in pharmacies as provision of verbal advice on lifestyle or a patient’s medicines.

Patient app lists

NHS Apps Library

The NHS Apps Library includes a selection of tools that have met some NHS-set standards (see the ‘Apps standards’ section). Many of these apps have also made use of NHS Patient Facing Services (also known as ‘GP online services’) features.

Apps with pharmacy-related functionality

These include but are not limited to:

App/website name Order repeat medicines from GP Access health information Book GP &/or pharmacy appointments Notifications about prescriptions being dispensed / ready for collection Reminders to take medicines Notes / functionality
Co-Op Health (previously ‘Dimec’ acquired by Co-Op pharmacy)* Patients can use the app to order NHS repeat prescriptions with smart devices. They can sync medicines history with their GP record, order NHS repeat prescriptions, and receive notifications on the status of requests. Medicines can be arranged to be ready for collection from the pharmacy of their choice.
Engage Consult* (GP) Engage Consult allows patients and carers to connect with their GP practice and access services online from a PC, tablet or smartphone. It can be used to order repeat prescriptions, book appointments, and have an online consultation.
Evergreen Life* (GP) Evergreen Life is a personal health record app that stores patients’ health information in one place. Patients can also create an account on the Evergreen Life website. It enables patients to actively manage their health, fitness and wellbeing. For example, they can order repeat medication, track their lifestyle goals, book GP appointments, and view and download their medical record using either the app or the website.
Healthera* (GP) The Healthera app aims to help patients use their local pharmacy services. They can use it to manage their repeat prescriptions and medication, book appointments and contact their pharmacist for clinical advice.
NHS App (GP) Scheduled for release in December 2018 after some piloting is completed. The NHS App will enable: accessing NHS 111 Online and the NHS website symptom checker; booking GP practice appointments and receiving reminders; ordering their repeat prescriptions; viewing GP medical record; ability to register as an organ donor; and setting national data sharing preferences. Further features will be added over time.
NHS COVID-19 app The NHS COVID-19 app launched during September 2020. It is being promoted to members of the public, as the Government sees this as a vital part of the NHS Test and Trace service in England. See the section on this webpage below about ‘NHS COVID-19 app‘.
Now Patient and Now GP apps These apps are associated with the Now Healthcare Group and the Now distance selling pharmacy. Now GP offers GP consultations.
Patient Access (GP/pharmacy) An app related to the EMIS GP clinical system. It supports ordering of repeat medicines, viewing of health record information and booking of GP or pharmacy appointments.
Patient Services (GP) A website related to the Vision (INPS) GP clinical system. It supports ordering of repeat medicines, viewing of health record information and booking of GP appointment prescribing system.
 SystmOnline 

(GP)

An app related to the SystmOne (TPP) GP clinical system. It may support ordering of repeat medicines, viewing of health record information and booking of GP appointments.

*Listed within NHS Apps Library

See also: NHS website list of online service providers.

NHS Apps Library

See the ‘NHS Apps Library’ within the ‘Patient apps lists’ section of this webpage.

NHS App

Read more at: NHS App.

Read about NHS COVID-19 app within the relevant section below.

NHS COVID-19 app

The NHS COVID-19 app launched during September 2020. It is being promoted to members of the public, as the Government sees this as a vital part of the NHS Test and Trace service in England.

The Government is encouraging businesses and organisations, such as hospitality services, to display official NHS QR code posters at their venue entrances to help support contact tracing.

NHS COVID-19 app users will then be able to scan (check-in) as they enter a venue. This means that if people visit the venue and later test positive for coronavirus, other app users who were there at the same time may be sent an alert, if local public health teams think this is necessary.

Community pharmacies are not required to display NHS QR code posters but may do so, according to Government advice.

Government advice on which venues should display the official QR poster states that for community pharmacy:

‘Customers generally move around the space rather than congregate, and are expected, by law, to wear face coverings. QR codes are therefore not required but can be used if a community pharmacy wishes to offer this option.’

If community pharmacies provide flu vaccinations at other premises, for example, a community centre, an NHS QR code poster may need to be displayed and a log of those attending may need to be kept.

QR code posters at their venue entrances to help support contact tracing.

Advice for pharmacy staff to pause the app whilst working if they use the app: NHS England and NHS Improvement (NHSE&I) advises healthcare workers to pause the app while working in a healthcare building, such as a hospital or GP surgery. This includes an NHS community pharmacy. The app should also be paused if working behind a fixed Perspex (or equivalent) screen, which is big enough to provide adequate protection.

Read up-to-date information:

Recommending apps

If recommending apps to patients, you should consider:

  • Read our briefing Features of higher quality health apps, and how to give app feedback. This provides pharmacy contractors and pharmacy teams with information about health apps which may be used by patients or health and care workers. It explores the features of higher quality apps and more;
  • Consent and patient considerations: Informed consent from the patient is required for their use of an app. You must never sign the app terms and conditions on patients’ behalf to avoid liability issues. Patients should be aware that some terms and conditions state the data they input into the app could be seen by others. You could give advice about higher quality features to help them to make informed choices, considering the potential benefits as well as the risks;
  • The importance of human touch alongside the digital interactions which apps can offer – clinicians and support networks can have a powerful impact on wellness. Some apps could underestimate the importance of patient/clinician relationships and more generally the patient’s wider human relationships; and
  • Maintaining your awareness of current lists of apps: Ensure that you are aware of the commonly used app stores lists (see patient apps lists section of this webpage).

Patient apps features (pharmacy)

Patients may increasingly opt to seek out and use the internet or apps to support their health and their interactions with health and care staff even beyond those PFS.

Examples of types of pharmacy apps features:

Category of app/online feature Example features which patients are using or requesting
To be reminded • E.g. Reminders to take medicines for patients, or patient reminders to collect medicines from the pharmacy. Reminders could be sent by SMS  text message, emails or app notification.
To learn healthcare information (general or personalised) • E.g. Patient access to their own electronic health records.
To express choices about care

• E.g. Selection of EPS nomination choice of pharmacy: The NHS App is piloting this feature to be made available within NHS App.

• E.g. Organ donation preferences can be set using the NHS App.

To express choices about their health and care data • E.g. Patient data opt-out system: NHS Digital’s national data opt-out system offers patients the opportunity to make an informed choice about whether they wish for their personal identifiable information to be used where only research / planning as the reason. Patient can express their wish via the NHS App, the NHS website or the NHS Digital telephone contact centre.
To confirm their identity (Authentication) • E.g. NHS login: Patients feedback to NHS Digital suggested that there had been frustration with separately authenticating their identity each time they began to use a different NHS-related app (e.g. with a new registration process to gather many new login details). The purpose of authentication systems is to protect user data. The NHS App is already integrated with the NHS login authentication system. This NHS login system enables the patients go through a robust authentication system which more than one app developer can align with. App developers that fulfil criteria may integrate with NHS login to provide patients with a smoother experience for patients that use multi apps that enable ‘log-in with your NHS login’.
To book pharmacy appointments • E.g. Pharmacy appointment booking: Some pharmacy contractors may enable patients to use an app or website to book a pharmacy appointment with the pharmacy.

 

Order repeat medicines (apps)

A NHS PFS capability.

 

EPS nomination change (apps)

An NHS App capability.

 

Notifications about prescriptions being dispensed / ready for collection (apps)

A capability within some pharmacy apps.

 

Reminders to take medicines (apps)

A capability within some pharmacy apps.

 

Pharmacy appointments (in apps)

Some pharmacy contractors may choose to enable relevant patients to book a pharmacy appointment with the pharmacy, using a patient app. See above within the ‘Patient app lists‘ and the column relating to ‘Book GP or pharmacy appointments‘.

App developers that report such functionality currently include:

  • Patient Access (an app related to the EMIS GP clinical system)

Community Pharmacy IT Group received feedback from some pharmacy contractors that it would be helpful if NHS App could enable such a feature. PSNC and CP ITG are supportive of NHS pharmacy appointment standards and systems integrating with those standards. If you would like to share views with PSNC about this, or report other apps which start to provide this functionality please contact PSNC’s IT team. Digital appointment systems can also assist pharmacies with scheduling video consultations services.

See also patient apps lists

Patient choice

Patient apps, EPS nomination, and choice

EPS nomination must allow patient choice of pharmacy/dispenser and pharmacy/dispenser setting of nominations must only be undertaken where there is informed consent from the patient.

A poster which sets out the right for patients to make their own choice has been produced and pharmacies are asked to display this prominently and as close as practicable to the location where patients receive prescriptions. Distance selling pharmacies and apps which allow nomination-setting should display this information prominently on their websites/apps and take reasonable steps to bring this notice to the attention of all patients, for example by including a copy of this notice with dispensed medicines that are delivered to patients.

Patient app developers can also add functionality to enable patients to be able to change their EPS nomination. This may be directly within the app or it may be through an indirect process in which the patient expresses a wish to change nomination using the app, and the relevant EPS user acts on this and uses their system to make the change. EPS users should make changes to nomination settings in accordance with the expected nomination core principles.

GP practice apps and nomination guidance: The nomination core principles apply for all EPS users. GP practice staff supporting use of GP practice apps which enable or promote nomination change, should also ensure these apps do not inadvertantly contravene nomination guidance. British Medical Association (BMA) and PSNC agreed guidelines to ensure proper prescription practices are followed.

App developers and patient choice

App developers which enable patients to use digital tools to help a patient select their choice of pharmacy should ensure that patients are exposed to balanced information in order to continue to make fair choices. Patients must continue to be empowered to make a fair choice about whether to use an app and their choice of pharmacy.

Some points are set out below which relate to patient choice:

  • Patients have the right to choose any pharmacy to provide services for them.
  • The NHS Constitution set out that patients must receive fair choice.
  • PSNC’s briefing about apps has previously explained that:
    • “A poster [pdf] which sets out the right for patients to make their own choice has been produced and pharmacies are asked to display this prominently and as close as practicable to the location where patients receive prescriptions [or make nomination choices].
    • Distance selling, internet pharmacies and apps which allow nomination-setting should display this information prominently on their websites/apps and take reasonable steps to bring this notice to the attention of all patients, for example by including a copy of this notice [or information] with dispensed medicines that are delivered to patients.
    • NHSE&I previously asked that this information was made visible within pharmacies and it can also be made available within websites /apps.
    • Patient choice of pharmacy should not be unduly influenced whether via an app or website or other technology. Patients which believe their choice has been restricted may follow the process set-out on NHS England’s Poster/guidance on freedom of choice including patient process for complaints (pdf).
  • Apps within the NHS Apps Library must continue to meet appropriate NHS standards (see the ‘Apps standards’ section of this webpage). There are questions within this assessment which relate to fair patient choice.

Further info

See also: Reporting IT and Patient Facing Services (PFS, NHS) (‘Patient choice’ section).

App standards

Apps standards include those which enable apps to be included within NHS Apps Library and others kinds of standards.

NHS Apps Library standards

Apps developers must work through NHS Digital’s digital assessment questions (DAQ) in order to be included within the NHS Apps Library.

The questions in the assessment cover:

PSNC provided some input into the development of these questions to help ensure there were some questions included to protect fair choice of pharmacy and cross referencing the NHS EPS nomination guidance. NHS Digital manage the questions. The full list of questions and more information about the assessment questions is found at the NHS Digital website. The DAQs are reviewed and updated further to help make sure that products within the NHS Apps Library ought to meet appropriate standards.

See also: Update about app standards and list of pharmacy DAQ questions.

IM1 and PFS online services standards

See: Interface mechanism (IM1) NHS standards. which may enable apps to interoperate with NHS Patient Facing Services (PFS, online services).

GP Connect standards

See: GP Connect.

Other standards

App developers must also continue to meet relevant other standards.

There are processes for feeding back about apps (see the section below).

Feeding back about apps

Feedback

Give positive and negative feedback to app developers to help them improve their apps. Contact them using either their link at their app store listing, or using contact information from the developer’s website.

Review

Reviews can be left at the app store listing or elsewhere online. If reviewing apps then consider whether the app demonstrates the features of higher quality apps described earlier.

Report

If you have concerns about a health app, you can report it to:

  • Information Commissioners Office (ICO)  – those UK apps which might be misusing data.
  • National Reporting and Learning Service (NRLS) – those apps which may be contributing to the occurrence of patient safety incidents.
  • NHS England Identity team – those app developers which may be contravening NHS identity/logo guidance e.g. use of the NHS logo to suggest that the app developer or their product is allowing a free and fair choice of pharmacy. If the choice is limited then this should be clear to all patients.
  • The app developer – you may email the app developer to ask your question, if their contact details are included on their website.
  • NHS Digital – those apps listed in the NHS Apps Library. NHS Digital request that if you would like to report an issue with any individual library-listed app, please contact the app provider directly but also email NHS Digital. See the ‘App standards’ section of this webpage to learn more about the standards expected for those apps listed within the NHS Apps Library.
  • The app store company – those apps which might be failing to meet expected standards e.g. Apple App store or Google Play.
  • If you have concerns about a health app (or indeed another technology) used by a healthcare provider in relation to its impact on full patient choice, then further information is set out about how you or patients can make a complaint at: psnc.org.uk/reportIT.

Pharmacy staff apps

Office software

See: Office software.

COVID-19 support update: Free access to wellbeing apps

NHS England and NHS Improvement (NHSE&I) have issued information on the first in a series of psychological support for all NHS staff, including those working in primary care, during the COVID-19 outbreak. NHSE&I note the importance of healthcare workers looking after their own health and wellbeing, whilst supporting patients and their family.

The initial offer involves free access to a number of wellbeing apps (Unmind, Headspace, Sleepio and Daylight) from now until the end of December 2020 to support healthcare workers’ mental health and wellbeing. Information on how to access this support is available on the NHS Employers website; an NHSmail email account may be required to access some of the apps.

CPPE

The Centre for Pharmacy Postgraduate Education (CPPE) maintains a list of apps that may be useful for pharmacy staff. Some of the listed apps are sources of information, some can be used during consultations with patients and some are for signposting to support healthy lifestyles and self-care. The sixth edition of the list was updated in December 2016.

Reference apps

Healthcare professionals are increasingly turning to apps such as: drug reference guides, medical calculators, clinical guidelines and other decision support aids, textbooks and literature search portals.

Studies

Patient journeys with apps (NHS Digital study)

NHS Digital, as part of a “Patient Enablement” project within the “Digital Medicines” domain of work, investigated ways of improving the repeat prescription process for patients. Through user research they were able to look at the issues patients could face with the current repeat prescription process and consider solutions to those issues. NHS Digital have published: Patient facing applications and prescribed medications – Outputs from discovery work to help those working within the healthcare space.

App data into records

In some cases, appropriate data sharing agreements might allow patients to choose to have data from their app or wearable integrated with their health records which can be shared with healthcare professionals such as community pharmacists.

App developer info

NHS Developers Network health apps hub provides further information about developing useful health apps for patients and pharmacies. The assessment framework is also explained there.

Guidance about emails: If pharmacy app developers, or others acting on their behalf, send out electronic marketing e-mails to individuals, it should be recorded how and when consent was obtained where consent was captured. As part of the NHS Apps library assessment questionnaire app developers are asked to confirm that they “can evidence that the individual gave their valid consent to the processing [of data] i.e. how and when consent was obtained and the information provided to the individual (data subject) at the time“.  The Information Commissioner’s Office (ICO) also provide guidance about appropriate use of email which pharmacy app developers can review to understand their obligations in relation to electronic marketing e-mails to individuals.

Guidance about patient choice: See the ‘Patient Choice’ section.

 

Further info

PSNC briefings:

Also see:

If you have queries on this webpage or you require more information please contact it@psnc.org.uk. To share and hear views about digital developments with like-minded pharmacy team members, join the CP Digital email group today.

 

 

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