NHS COVID-19 app prevents 1 million infections and advances mobile medtech

The challenge

The Department of Health and Social Care (DHSC) oversees the UK's National Health Service (NHS), with the aim to help people live more independent, healthier lives for longer.

When the global pandemic hit, however, the DHSC needed to take on a very different role – that of an agile tech startup. That’s because the health department recognised the vital role that data and apps could play in containing the rapid spread of COVID-19. As the world entered lockdown, pressure mounted to accelerate medtech innovation and find a way to reduce the rate of infection and protect lives.

In these challenging conditions, the DHSC and its executive agency, UKHSA (previously PHE), urgently needed to:

• Help contain the spread of the virus, prevent infection, and alleviate pressure on the NHS with a medically approved contact tracing smartphone app.
• Gain the agility to adapt to changing priorities and needs across core workstreams.

The test and trace solution needed to be designed, built, tested, approved, and launched within 12 weeks, and it needed to support six critical features:

• Trace: alert app users when they’ve been near other users who tested positive for coronavirus.
• Alert: enable people to understand the level of risk in their area.
• Check-in: alert people who checked into a particular venue if they may have encountered people who tested positive.
• Symptoms: allow people to check whether they have coronavirus symptoms and whether they need to order a free test.
• Test: enable people to book a test and get their result quickly.
• Isolate: allow people to track their self-isolation countdown and access relevant advice.

What we did

Despite the challenging conditions, we designed, developed, user tested, and launched the beta app in just six weeks – complete with all six mandated features and class 1 ‘medical device’ classification from the Medicines and Healthcare Products Regulatory Agency (MHRA).

Together with the DHSC, we established a multi-disciplinary working group including policy makers, researchers, designers, engineers, plus experts in security, ethics, accessibility and other areas.

This borderless and multidisciplinary approach to innovation – together with our lean delivery approaches and cloud infrastructure – gave the health department the speed and agility to develop and scale the NHS COVID-19 app in just 12 weeks.

Following the national app launch, we designed, developed and deployed new features, such as the ability to search and apply for self-isolation support payments. Each week we continued to launch app updates in line with changing pandemic conditions, policy and guidance.

Key focus areas in our collaboration with DHSC included:

• Scalability: the reliability and scalability of our cloud-based, Amazon-powered infrastructure was essential for supporting the app’s 22+ million users.
   
• Security: we worked closely with the National Centre for Cyber Security (NCSC) who ran surprise scenario tests to ensure the app was secure.
   
• Compliance: we ensure the app passed Government Digital Service(GDS) assessments throughout its product lifecycle and adhered to NHS service standards.
   
• Customer centricity: we iterated designs and conducted ongoing user research and testing to ensure the app catered to a diverse audience. We ensured the app was accessible and compliant with the Web Content Accessibility Guidelines (WCAG).
   
• Data-led decision making: real-time, secure, and anonymised data from the app was used to identify trends and inform and facilitate government policy-making.
   
• Collaborative innovation: together with our innovation partners Google and Apple, we co-innovated ways to improve the accuracy and performance of contact tracing APIs. 
   
• Trust through transparency: we made sure that information about all app updates was publicly available. This helped address privacy concerns – together with the Bluetooth-based Google / Apple Exposure Notification (GAEN) system which protected app users’ personal information.
   
• Stability: our team ensured always-on technical support, and the app never experienced a major incident – despite the huge volume of active users.