This morning, the NHS Health Apps Library – a “pilot programme” that has been endorsing hundreds of apps to patients since 2013 – was finally shut down. It is replaced by a set of pages on the NHS Choices website which promote a total of seven “online mental health services”. [1]

Serious concerns have been raised over the past year by researchers at Imperial College London and Ecole Polytechnique CNRS, France [2] and by medConfidential [3] with regard to the security, safety and suitability of dozens of apps which were endorsed in the Apps Library.

A handful of apps – including Kvetch, Doctoralia and My Sex Doctor [4] – were silently withdrawn following complaints, but it is unclear how NHS England intends to notify patients left hanging now that “innovative” apps it has been promoting for up to two years have had their approval pulled.

The closure of the Apps Library coincides with the Second Reading of the Access to Medical Treatments (Innovation) Bill – a Private Members’ Bill by Chris Heaton-Harris MP, a version of which was introduced previously in the Lords by advertising magnate Lord Saatchi.

Apps fall within the Bill’s definition of “innovative treatments”, opening far wider questions as to the use of the database [5] that would be created under Section 2 of the Bill. Minister for Life Sciences, George Freeman MP, tweeted during the debate [6] that he did not intend for the database to be used for marketing to patients, but the Bill itself and existing legislation [7] provide no legal bar.

All of which further calls into question the stated ambition of Secretary of State for Health, Jeremy Hunt, “to get a quarter of smartphone users – 15% of all NHS patients – routinely accessing NHS advice, services and medical records through apps by the end of the next financial year.” [8]

Phil Booth, coordinator of medConfidential said:

“While we welcome the closure of this sprawling, unaccredited mess of apps and internet quackery, NHS England must now demonstrate how radically it has changed its approach to innovation if it wants to avoid destroying patient trust.

“Promoting predatory ‘bait and switch’ apps targeting teenagers, like My Sex Doctor, was certainly an “innovation” for the NHS. Real doctors would have laughed the charlatans out of the surgery and got back to helping patients, but it seems Tim Kelsey’s team welcomed them with open arms.

“Jeremy Hunt and George Freeman may not intend for any of this to be used for marketing to patients, but there’s no legal bar. And as NHS England’s abortive attempt with apps has shown, not thinking this through properly puts patients at risk.”

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Notes for editors:

1. Just three of these “services” are available as apps: http://www.nhs.uk/conditions/online-mental-health-services/Pages/introduction.aspx
2. http://www.theguardian.com/society/2015/sep/25/nhs-accredited-health-apps-putting-users-privacy-at-risk-study-finds which led to the removal of My Sex Doctor and other apps. Full study published here: http://www.biomedcentral.com/1741-7015/13/214
3. http://www.computing.co.uk/ctg/news/2415698/caredata-nhs-choices-and-now-apps-could-it-be-three-failures-in-a-row-for-tim-kelsey
   
4. Kvetch app was a self-described “experiment” that proposed to “make sickness social”, with a communally-visible “alcoholism” group it encouraged individuals to “check your friends in for a laugh”. Barcelona-based Doctoralia (still available in UK apps stores) failed to correctly list GPs working in UK practices, listing at least one GP who had died tragically, and had complex DPA issues that failed to meet the Apps Library’s own criteria for inclusion. My Sex Doctor (also still available in commercial apps stores, and still claiming NHS endorsement) targets teenagers with sex advice, with a stated business model: “Once gained their trust we can leverage it for commercial purposes” – see slide 11, http://www.slideshare.net/FabrizioDolfi/my-sexdoctor-pitch-deck-43296908
5. Which Chair of the Health Select Committee, Dr Sarah Wollaston MP, described as “a vast sprawling database of anecdotal treatment for male pattern baldness”. Debate transcript: http://www.parliament.uk/business/publications/hansard/commons/todays-commons-debates/read/unknown/12/
6. https://twitter.com/Freeman_George/status/654976202810269696
7. See medConfidential’s briefing, following a meeting with Chris Heaton-Harris on 30 Sept: https://medconfidential.org/wp-content/uploads/2015/10/medconfidential-1-Marketingtopatients.pdf
8. Official report of Jeremy Hunt’s speech, 2 September 2015: https://www.gov.uk/government/news/health-secretary-outlines-vision-for-use-of-technology-across-nhs – updated on 18 September following the announcement of the consultation on the role and remit of the statutory National Data Guardian, who will produce “clear guidelines for the protection of personal data against which every NHS and care organisation will be held to account.”

medConfidential campaigns for confidentiality and consent in health and social care, seeking to ensure that every flow of data into, across and out of the NHS and care system is consensual, safe and transparent. Founded in January 2013, medConfidential is an independent, non-partisan organisation working with patients and medics, service users and care professionals.

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