Source · Select Committees · Health and Social Care Committee
Recommendation 14
14
Accepted in Part
Paragraph: 83
Lack of systematic assessment for third-party health apps results in quality failures
Conclusion
Digital transformation can offer people more choice and control over their healthcare, and empower them to manage their health, and apps offer an accessible starting point for many. But whether peoples’ experiences with digital healthcare are positive depends in large part on whether they use an appropriate product. The Department and NHS England lack a systematic, consistent way of assessing and demonstrating whether a third-party health app reaches the necessary quality standards, and we heard that a majority of health apps currently available fail on aspects including clinical efficacy, security and cost. This is unacceptable: using an unsuitable health product can affect people’s health, and might make people less likely to opt for digital channels in future.
Government Response Summary
The government closed the previous NHS Apps library as ineffective and established the Digital Technology Assessment Criteria (DTAC) as a national standard for digital health technologies used in the NHS. A directory of DTAC-compliant products is planned for late 2023/24, though it explicitly states this is not an accreditation scheme for all third-party apps.
Paragraph Reference:
83
Government Response
Accepted in Part
HM Government
Accepted in Part
In 2021 NHSX, as part of NHS England closed the NHS Apps library and took a policy decision, in conjunction with the Department of Health and Social Care, that the assessment and accreditation of digital health technologies and health apps should be limited to those being recommended by and used in the NHS. An assessment of the strategy and cost effectiveness of the programme was undertaken and it was determined to be ineffective and poor value for public funds. The closure was based on a number of factors (namely relating to broad selection criteria, leading to an eclectic mix of apps that did not align to national clinical policy or strategy and were not prioritised by clinical unmet need). This approach was agreed with the then CEO of NHSX and Secretary of State for Health and Social Care at the time. It was identified that a baseline criterion was needed to support suppliers and commissioners to align on the baseline requirements for technologies ahead of adoption. The DTAC, Digital Technology Assessment Criteria, was established and sets the national NHS standard that all digital health technologies (not just apps) should meet and the MHRA regulates those which are medical devices. The assessment cost of an app as a result of DTAC is less than 5% of the then Library cost. These standards apply to digital health apps used in the NHS. The NHS should not support, recommend or fund digital health technologies that do not meet these standards. However, this in itself is not an accreditation scheme. A directory of products meeting DTAC standards is planned for late 2023/24. As referenced in the response to recommendation one, NHS England and the Department of Health and Social Care are working towards surfacing a curated selection of digital therapeutics through the NHS App and other national digital channels. When the first therapeutics are available, there will be public-facing messaging to encourage the usage of the technologies via the NHS App.