Health professionals can consider digital and mobile interventions as a supplement to regular services to support behaviour change in people at risk of developing chronic conditions.
A draft guideline from the National Institute for Health and Care Excellence (NICE) says that digital interventions such as apps, wearable devices and online programmes and websites may help people achieve health goals.
This includes helping people to be more physically active and manage their weight.
The recommendations are in line with the NHS Long Term Plan, though NICE says the digital tools should be offered in addition to existing health and care services, not as a replacement.
'Faces of the NHS app'
The NHS has revealed the first nine frontline NHS staff members who have been selected to become the ‘faces’ of a campaign to promote the NHS app to patients.
Nearly 700 NHS staff from across England applied to be a part of the initiative when it was announced in September 2019.
From those applications, an initial nine NHS staff have been selected by a panel of senior clinical leaders.
They will feature in posters, leaflets, videos, social media posts, and other content that is being created to help promote the NHS app, which already has more than 230,000 users.
Physio face
The ‘faces’ include physiotherapist Harriet Brown who leads the community rehabilitation team at Hockley Health in Solihull, part of Solihull Community Services, University Hospitals Birmingham NHS Trust.
She specialises in elderly care rehabilitation, falls prevention and is very keen on health promotion and encouraging her patients to remain active.
‘The NHS app has the potential to bridge generations because of its simplicity and convenience. If my grandma can use it then anyone can - and it means she can do it whilst in the comfort of her own home rather than stood outside the GP practice or pharmacy.
Empowering patients
‘People's lives are so busy and digital tools like the NHS app makes it much easier for people to manage their own healthcare, as well as giving them more opportunity to be actively involved in it and navigating round the different systems which the NHS app brings together.
‘It really is key to empowering our patients and the public to self-management.’
CSP health informatics lead Euan McComiskie said that some physiotherapy services in the UK have been exploring the use of digital tools to supplement existing provision for a number of years.
Power of digital
‘This recognition of the power of digital by NICE should be seen as an encouragement for these services to continue their innovation and for other services to explore the potential of digital tools.
‘If delivered correctly there is an opportunity to improve patient outcomes and experience, and to improve service efficiency and staff wellbeing,’ he said.
People
‘As ever, the focus of any digital intervention should be on the people involved (patient and clinician) and not simply about the technology.
‘Physiotherapy remains a profession that deals directly with patients and physiotherapy staff will not be replaced by robots,’ Mr McComiskie said.
‘However, those physiotherapists empowered by technology will absolutely replace those who are not.’
Behaviour change
Paul Chrisp, director of NICE’s centre for guidelines, said: ‘Digital interventions for behaviour change could help people make important improvements to their lifestyle, which may reduce their risk of developing serious chronic conditions such as diabetes and cardiovascular disease.
‘Clinicians may choose to consider these interventions as an option to work alongside traditional health care services towards a change in behaviour.’
The draft guidance recommends using resources from expert sources when possible, such as Public Health England and the NHS apps library, to ensure the content has been assessed for safety, effectiveness and data security.
Possible complications
While highlighting the potential benefit of digital interventions, the NICE recommendations acknowledge possible complications with their use and urge clinicians to take care that patients do not rely on the apps as a way of avoiding seeing a professional.
The guideline also points to the uncertainty of their effectiveness when used alone and recommends them only as supportive tools in addition to regular services.
It is therefore recommended that healthcare professionals advise patients on digital interventions as appropriate, on a case by case basis.
Examples of apps provided by Public Health England
• Couch to 5K: an easy to follow programme that helps people gradually increase their activity until they can run five kilometres
• Change4Life Food Scanner: a scanner that allows you to see review the health rating of your groceries so you can make more informed choices
• Easy Meals: offers healthy recipes for meal inspiration
• Smoke Free: a four-week programme that provides practical support, encouragement and tailored advice to help you quit smoking
• Drink Free Days: an easy to use app that helps you track your drinking habits and set goals
Examples of apps that have been assessed by the NHS
• iPrescribe Exercise (free): creates a 12-week exercise plan based on health information set by the user
• Sugarmedown (subscription fee): allows you to monitor how much added sugar you eat and offers a 12-week programme of food plans and workouts
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