Evaluating the Uptake of the NHS App in England

Our new study published in the British Journal of General Practice examines uptake of the NHS App in England. The NHS App was launched in January 2019 as a “front door” to digitally enabled health services, allowing patients to access their personal health information online. With the advent of the COVID-19 pandemic, the app saw a significant increase in downloads, especially with the introduction of the COVID Pass feature. However, the uptake of the app has revealed some important trends and inequalities that need to be addressed.

The Study

A comprehensive observational study used monthly NHS App user data at general-practice level in England from January 2019 to May 2021. Different statistical models were applied to assess changes in the level and trend of use of various functionalities of the app, particularly before and after the first COVID-19 lockdown.

Key Findings

Between January 2019 and May 2021, the NHS App was downloaded 8,524,882 times and registered 4,449,869 users. Intriguingly, the app experienced a 4-fold increase in downloads after the introduction of the COVID Pass feature, which allows users to prove their COVID-19 vaccination status. However, the data also revealed disparities in app registration based on sociodemographic factors:

  • There were 25% fewer registrations in the most deprived practices.
  • Largest-sized practices had 44% more registrations.
  • Registration rates were 36% higher in practices with the highest proportion of registered White patients.
  • Practices with a larger proportion of 15–34-year-olds saw 23% more registrations.
  • Surprisingly, practices with the highest proportion of people with long-term care needs saw 2% fewer registrations.

What This Means

The findings indicate that while the NHS App has proven to be an useful tool, especially in the times of the Covid-19 pandemic, its usage is not uniform across various sociodemographic groups. This raises questions about accessibility and the digital divide, which could ultimately impact the quality of patient care and health outcomes.

Further Steps

While the app has clearly benefited a significant number of people, it’s crucial to understand the reasons behind these patterns of inequalities. Further research is essential to delve deeper into these trends and how they may affect the patient experience.

Understanding these dynamics can guide improvements to the app, making it more inclusive and effective for all users. Policymakers, developers, and healthcare providers need to work together to ensure that digital health services like the NHS App are accessible and beneficial to everyone, regardless of their socio-economic status or demographic background.


The NHS App has seen a considerable increase in usage since the onset of the Covid-19 pandemic, highlighting its essential role in modern healthcare. However, the unequal patterns in its uptake call for a focused approach to ensure it serves as an inclusive platform for all. Further research is crucial to uncover the underlying reasons for these disparities and to work towards a more equitable healthcare system.