The Healthy London Partnership’s children and young people’s programme was set up in 2015 in order to ensure that the population of London’s children and young people were given the best start in life. A quarter of the population are under 18, 40% of 15 year olds drink alcohol once a week and 20% of 13 year olds drink alcohol once a week. The aim of our programme is to reduce these figures and ensure that children and young people had an equal place at the table to other services in the NHS. NHSGo was launched in July 2016 following a long period of consultation and co-design with hundreds of young people (see co-production section).
Highly Commended in Digital Innovation in Health category #MHAwards18
Please briefly describe your project, group, team or service, outlining what you do and why it makes a difference
The Healthy London Partnership’s children and young people’s programme was set up in 2015 in order to ensure that the population of London’s children and young people were given the best start in life. A quarter of the population are under 18, 40% of 15 year olds drink alcohol once a week and 20% of 13 year olds drink alcohol once a week.The aim of our programme is to reduce these figures and ensure that children and young people had an equal place at the table to other services in the NHS. NHSGo was launched in July 2016 following a long period of consultation and co-design with hundreds of young people (see co-production section).The most used sections concern sleep, alcohol and substance misuse, depression and anxiety, and sexual health.It is free to download, and use of the app is confidential and discreet; the pages that users view are not tracked on their viewing history.The app was designed in order to help young people to know how to access health services, where and when to get health advice, where their local health services are, and what their health rights are when accessing services; all issues that they told us concern them.
Currently, the app has achieved 72,769 downloads, which have been driven by a combination of social media marketing (mainly Facebook and YouTube), and speaking to young people and youth organisations and health professionals about it.
What makes your service stand out from others? Please provide an example of this.
From our evaluation, download statistics and heartfelt reviews on Apple Store, we can see that our app is not only functioning as a useful, informative platform for young people, but also is making a real difference for some of our users. On the Apple App Store, it has an average rating of 5 stars which we are very proud of.On the Google Play Store, it has an average rating of 4.0, and whilst the number of reviews is fairly low (150 to date), it is indicative of a positive impact on users.Some of the positive comments include:
Cam Shadow – Lovely – So so so amazing, I wish there was an app like this when I came out as trans, I trusted my doctors to refer me to the right place but was faced with such a lack of knowledge, was told completely the wrong information time and time again and even after having to do all my own research without any help, I was denied loads of services and had to fight my corner so much to have access to what I needed. This app is so wonderful. Makes me so happy to see resources like this for people with all types of experiences. (Apple)
Meg9249 – Really Useful – Really useful for finding out information about a new diagnosis or something you’re worried about. Also has a feature to find services near you which is great, and has pages on LGBT issues, cyber bullying, mental health etc. Really handy 🙂 (Apple)
Paula Navarro – Great app, i love the division of sections such as mental health, LGBT or sex and relationships. Whilst the interface needs development its a really easy way to check medical terms and see what clinics are around. (Google)
Robbie Barclay – Already on the course and its helped sorting out a 2 year mental illness in less than 2 weeks, safe to say these new NHS apps are a must download!! ( Google
How do you ensure an effective, safe, compassionate and sustainable workforce?
We highly appreciate the hard work and commitment from the staff at NHSGo, and understand the correlation to supporting their wellbeing whilst providing plenty of opportunities. This is why we encourage all staff to attendtraining sessions, facilitate team building away days, provide opportunities for promotions, offer flexible working and much more to provide a supportive work environment.
Working for children and young people, we saw an opportunity and a duty to support young people through providing both placements, and work experience to help further their education. Specifically, we employed and mentored a student to work on multiple aspects of NHSGo the past year which has not only helped them to gain experience, but benefitted us through their insights into what young people want and need.
We also perform annual Performance Development Reviews (PDRs) as a chance to reflect on our skills, receive feedback and voice any concernsthat staff may have. This provides an invaluable platform not only for reflection, but also a chance for individual forward thinking to ensure our team feel that they are progressing at the right pace.
The app is available to download anywhere in the world. We previously opened the market internationally to support international students who may be moving to the UK. This app can be promoted anywhere in the UK. Instead of all 32 CCGs in London developing their own app, we developed one which works everywhere and put together a strong marketing campaign to support it. Organisations that are interested in the app can download the promotional materials on www.nhsgo.uk and promote it in their local area. They can also use any one of our several promotional YouTube videos, such as this to learn about particular health issues:
https://www.youtube.com/watch?v=mMBVW2lKtj0. We share the app through many avenues, such as paid advertising on social media, presenting at conferences publishing our work on sharing resources such as the Academy of Fab Stuff. We always welcome any feedback and we are happy to help with any queries.
When promoting the app, we go out to youth organisations and engage with the leaders and young people and children at them.Examples include the National Citizen Service, where we engaged with hundreds of teenagers, Islington Boxing club, Young Minds, Great Ormond Street Youth Forum, as well as London Youth.
We also have taken every opportunity through our wider work to speak to clinicians and health and care professionals about the app.Part of this is to promote the app, but it is also to hear about the things that people want from the app.Fortunately, we are able to reassure them about their concerns, and use their feedback towards improving the app.For example, those worried about the confidentiality of the app need not be.We are able to reassure them that the pages they access are not recorded or tracked.In particular, from speaking to younger people in organisations we engage with, we know that we would like to include video and pictorial content for those who find reading more difficult, or for whom English is not their first language.
Recently, clinicians have offered to start promoting the app in their clinics, and we have spoken in schools, at local PSHE network meetings and to youth voluntary sector organisations about prompting the app to support young people.
Do you use co-production approaches?
We wanted young people from London to be at the heart of the Healthy London Partnership Children and Young People’s Programme and held an engagement event for young people back in November 2015 asking young people about what they thought of the NHS and health service and what they thought could be improved. Around 100 young people attended the event. They came out with five key messages: – They didn’t know how to access health services
– They didn’t know where to get health advice
– They didn’t know when to get health advice
– They didn’t know where their local health services were
– They didn’t know what their health rights were when accessing services Our aim was to find a way that young people could find out all these things in an easy and accessible format. The young people suggested that an app would be the best way to do this. Over the next few months we worked with a focus group of young people to plan and deliver the app that they wanted.
After the initial engagement event with young people we ran a series of workshops with young people to design the contents, feel, image and usability of the app. The young people were involved in every decision. We held focus groups with young people in Croydon and with the sexual health organisation Brook. From these sessions the app was developed. They determined: -The name of the app
– The recognition that this was an NHS product
– The colour scheme
– The layout of the app
– The way the content was presented
– The confidentiality of the app We also completed a survey where 500 young people responded to what information should be included in the app. This included the topics: sleep, LGBT, family health, long terms conditions, anxiety and depression, young people’s health, puberty and growing up, allergies, colds, flu and pains, smoking, drugs and alcohol and eating healthily and exercise.
Young people were also involved in the tender process to select a company to develop the app and the marketing app. They were crucial and present at every key decision making point and as a result created an app which worked for them. Since the creation of the app, we have also commissioned ‘YouTubers’ to promote the app through their social media platforms and a YouTube video which they have shared.
Also, 150 young people were consulted as part of the original evaluation of our app. Since, we have seen engaged with a variety of groups including scouts, hospital youth forums and more where we heard similar messages to previous engagement events. This feedback helped build a picture of what young people were look for from the app, in turn shaping its development.
Do you share your work with others?
Yes, we love sharing our work on NHSGo.We are passionate about making sure that as many people as possible download this free and confidential to use resource.You could say that sharing it is our raison d’être.We always have a pile of NHS Business Cards with us, and are always happy to post more posters, speak to people over the phone, twitter, Facebook or Instagram about it, attend meetings and conferences, and share it as widely as possible.As it is free, anybody who has a smart-phone can access it, so it’s incredibly easy to share.
We also commissioned popular ‘YouTubers’ and their platforms to promote and share our app, whilst co-creating a YouTube video acting as an advert for NHSGo. This has then been shared on both NHSGo’s and the individual YouTubers platforms allowing us to reach a large target audience. The NHS Go videos have been viewed over 1,400,000 times in total, sharing learning about important health topics such as sleep and mental health with young people from fellow young ‘influencers’. We are also able to reach a large audience through paid-for advertising on Instagram and Facebook.
What outcome measures are collected, how do you use them and how do they demonstrate improvement?
As confidentiality is the key concern for children and young people, we do not collect any personal data on our users. We can however see through download figures doubling within 1 year from 35,000+ to 70,000+, alongside our increasing interest from multiple parties, our app is successful and is satisfying our audience in accordance with their requests.
Although we do not collect personal data, we receive monthly updates from our app developers on overall app use statistics. We have the ability to see which pages are most popular as a whole, receive feedback from voluntary quizzes, and discovered that people spend longer on NHSGo, compared to equivalent apps. Not only does justify the work we have put in, it also allows us to focus content through our push notifications and rolling banners based on the feedback we receive. This helps us when deciding what materials to share on our social media platforms as we can see which content is most popular at that time.
We also look at the time that young people spend on the app, and find that compared to other health information apps, NHS Go users spend considerably longer on it than other users do on other health apps. This demonstrates that users value the information and layout of the app.
Has your service been evaluated (by peer or academic review)?
In 2017, we commissioned a London-based university to evaluate the app. The results of this evaluation are available on Healthy London Partnership’s Resources page.
The evaluation focused on 3 factors:
1. How are young people engaging with the NHSGo app?
2. Does the NHSGo app enable young people to access high quality health information? 3. Does the NHSGo app have a positive impact on young people’s health behaviour (e.g. improving access to health services and intentions to engage in health improving actions)?
Within this research programme, we found that:
Research Question 1: CYPs see the perceived usefulness of NHSGo, and feel empowered to independently access health information (often on sensitive topics).
Research Question 2: Access to health information amongst our samples was generally good. Users report that NHSGo is inclusive, topical and easy to use. However, e-Health literacy (particularly for disadvantaged groups or those with lower reading ages) may be impaired by current technical, design and content issues that could be fixed with relative ease.
Research Question 3: Users do not obviously see the need to make changes as a result of using NHSGo, and will need more engaging, interactive, varied and relevant content – that can be customised to them – for this to be fully optimised. Those who feel informed by NHSGo, and who trust it, are more like to act on the advice given.
This research programme combined four studies, using user feedback and expert reviews. The full programme of research was designed and interpreted according to evidence-based frameworks and models taken from academic fields. As a result of this comprehensive research programme, the WWK team conclude that:
NHSGo is an innovative, timely and welcome contemporary tool for addressing the health needs of children and young people in London. By now attending to key technical, design and content recommendations outlined in this report, NHSGo can fully realise its potential for improving CYP’s e-Health literacy and health-related behaviour.
From the beginning of June 2018, the app has achieved • 72,769 downloads,
• 753,623 screen-views in app.
• 92,415 views of the website. This shows the app has nearly doubled both download and screen views between its second and third year.
We know that the pages on Depression and Anxiety are the third most referred to topic in the app (behind finding GP Practices, and Sex and Relationships.)As well as the positive and growing numbers of downloads, we also feel that its re-development will be a success.By listening by young people, we have created an app that reflects what they feel they need, and we will be continuing to do that.
How will you ensure that your service continues to deliver good mental health care?
As this app was created for young people, feedback from our audience will always be the driving force for the development of NHSGo. We will continue to engage with young people through our focus groups, digital ambassador programme and social media, listening to changing needs and concerns of young people, and the way in which they prefer dealing with these concerns.
A benefit of engaging with such a wide audience is that we are constantly receiving feedback and incorporating it into our development. For example, we received feedback that a number of our Android users were experiencing some technical glitches whilst using the app, so we fed this to our tech team, and have invested heavily in creating a new digital platform that will run IOS and Android from that same server enhancing our Android’s user’s experience.
Whilst we are currently redeveloping to make the app more visually appealing and interactive, increasing user experience, we are also looking into the ability for CCG’s to add locally relevant content which will enhance the service for the user. This has the benefit of providing on-going funding from the CCG’s through a yearly subscription fee. This will be cheaper than providing individual services for the CCG’s whilst also developing the system further, and ensuring the maintenance of NHSGo through management changes. Having already mentioned the online reviews and scores, we also have been able to respond to more constructive feedback that we have received.For example, diversifying the mental health content, in response to in-app feedback a comment received online that we received:
Adam Blackwell: “It’s good and provides you with necessary information but I do feel that when it talks about mental health, it only talk about depression and body image or abuse etc. What about other mental health difficulties like OCD or schizophrenia etc.” (Google)
Lastly, we are currently in the process of assembling a digital ambassador’s team made up of a variety of young people, to help promote NHSGo and act as a central feedback point to Healthy London’s Children and Young Peoples team. This will assist our continuous redevelopment as a response to feedback, ensuring a more efficient, more engaging, user friendly service, as well as enhancing our responsiveness and social media engagement.
Having already mentioned the online reviews and scores, we also have been able to respond to more constructive feedback that we have received.For example, diversifying the mental health content, in response to in-app feedback a comment received online that we received:
Adam Blackwell: “It’s good and provides you with necessary information but I do feel that when it talks about mental health, it only talk about depression and body image or abuse etc. What about other mental health difficulties like OCD or schizophrenia etc.” (Google)
What aspects of your service would you share with people who want to learn from you?
Due to the extent of or engagement activities, we have an abundance of rich feedback from young people on a variety of topics ranging from anxiety’s associated to GP visits, to technical app user interface. This information would be very useful to a range of interested parties We would be happy to share challenges encountered and solutions when creating a confidential app, useful for young people more engaged in technology than seen before. Creating and running an app can be very labour intensive and we would want to support other organisations which is why we are looking to add CCGs locally relevant content.
How many people do you see?
NHSGo has received 72,769 downloads since the end of 2015 on IOS and Android as well as 753,623 screen-views in app
How do people access the service?
We mainly use social media marketing to promote self-referral, as this can reach a large number of our audience. This can then be shared face to face through friendship groups etc. NHSGo is available to download on both IOS and Android through Google Play and the App store.
Sharing articles will be an element of our re-development, which will in turn drive organic growth through users sharing it with their peers.
A large section of our app is our services section, that can direct users to all available services near their post code, through an interactive map.
Here is our social media platforms and our YouTube video:
Our developers are constantly checking for app glitches, and have created a central management system that flags glitches to the team. We are able to respond quickly because of this. Our Digital ambassadors will also be listening for problems through their engagement with our users.
What inequalities have you identified regarding access to, and receipt and experience of, mental health care?
In our evaluation some users identified that they found it difficult to access health information due to issues with their family or culture. NHSGo provided the confidential service they needed and opened up health topics that previously may have been considered taboo.
What is your service doing to address and advance equality?
Reviews we received in our evaluation demonstrate how NHS Go provides people with information that they may have found it difficult to access previously, often due to their family environment:
“I’m Asian and Muslim… and it’s really kind of awkward if you’re a young woman especially if you are a young unmarried woman … it’s like, whoa what are you up to?… So you want to have that information freely accessible in a private way.”
(Sasha, female 22)
“I think one of the things that is good is people who might find it difficult to talk about things… [NHSGo] allows you to answer your questions more discreetly sort of thing. Come to think about it there are certain things I’d like to look at on the app and I would look because I’d feel more comfortable”
(Bob, male 20)
How do you meet the needs of people using the service and how could you improve on this?
As we are able to see which pages are viewed the most, we are able to direct our social media content and in app banners to the most pressing issues.
What support do you offer families and carers?
Although our app is aimed for young individuals, we do provide a family health section that covers a range of family health issues. This was a want identified by our users in our engagement.
Population details
Brief description of population (e.g. urban, age, socioeconomic status):
Aimed at Children and Young People, aged 16 – 24
Size of population and localities covered:
72,769 downloads.
Commissioner and providers
Commissioned by (e.g. name of local authority, CCG, NHS England):
