The outfit where the NHS England Digital boss is headed? Turns out their code is 'not technically suitable' for the £6.4m NHS App

Integration don't LIVI here any more

Updated A Discovery Report from NHS Digital has given video GP provider LIVI a kick in the integrations.

The report*, seen by The Register, paints a picture that will not be to the liking of outgoing NHS England executive, Juliet Bauer, who confirmed she would be leaving the UK's health service for the app-happy outfit earlier this year.

The former NHS England digital exec attracted ire earlier this week after writing what observers described as a "puff piece" extolling the virtues of her new employer without, er, mentioning that she'd have that employer's name on her business cards in a matter of months.


In her piece, which is still lurking behind The Times' paywall (much to the annoyance of her former employer), Bauer stated that she was "proud of her part in encouraging the integration of digital into our NHS".

It's an unfortunate turn of phrase since, according to the Discovery Report, integration (and integration with the wares of Bauer's new employer) is something that isn't going well within the bowels of NHS Digital.

NHS Digital and NHS England have been piloting their own app, which is a joint project, since September 2018 and persuaded 3,000 patients over 34 GP surgeries to use the thing. To put that in context, as of 2017 there were 7,361 GP practices. For the lucky participants, the app allows users to perform activities such as booking appointments.

For the rest of us, it's a glorified symptom checker upon which the NHS spanked an impressive £6,358,773, according to a Freedom of Information request filed after developer Kainos trumpeted its involvement in the project.

The app can be downloaded now, and NHS Digital plans to roll out more features over the coming year, integrating with the four IT systems used by GPs – EMIS, TPP, Vision and Microtest.

Nice app, but what about the online consultation?

However, NHS Digital has bigger plans, which is where the wheels are threatening to fall off.

The next step is to bring online consultations into the app, and for this a number of third party suppliers were studied, including Babylon’s GP At Hand (in whose PR puff the UK Health Secretary, Matt Hancock, infamously appeared) and Juliet Bauer's new bosses, LIVI.

According to our source, LIVI was the frontrunner out of the seven that actually engaged one-to-one and NHS Digital spent three months working out how it could integrate the company's wares (as well as those of its competitors) into its digital platform.

Sadly for Bauer, the answer is "not very well" because LIVI, according to the NHS report, has "no external APIs available, so app-to-app integration is the only technically feasible pattern".

So, while LIVI's app does permit a video consultation with a GP, the only way to get there from the NHS App is to lurch into it via deferred deep links. The report also noted that there was no login integration.

NHS Digital is obviously not keen at all on this: it highlighted concerns that the user might get confused and also not re-engage with the NHS App. It also worries that things are a bit fragile and could easily break should LIVI change its application.

Finally, it noted that getting anything working with the desktop version of the NHS App would be a complete no-no – LIVI lacks any sort of patient-facing desktop product for video consultations, according to the report.

Integration 'not satisfactory from a technical point of view'

Based on its findings, the report recommends that NHS Digital steers clear of LIVI's take on integration because it is "not satisfactory from a technical point-of-view" unless research deems that users won't be unduly alarmed by being flung from app to app.

To be fair to LIVI, while it requires an archaic app-to-app method of integration at present, NHS Digital itself has yet to implement an API of its own for Triage or Consultation. The report recommends that this would be a good idea. Without it, the current crop of GP-friendly apps have little access to NHS patient records.

A source told us that right now, manual transcription is the one true way.

In the meantime, the "discovery" process rumbles on with other providers such as eConsult still hoping to land snout-first into the NHS trough win the potentially lucrative triage and consulting work.

A spokesperson from NHS England told The Register:

The NHS App team at NHS England and NHS Digital are working with 32 companies to investigate the potential of online consultations in the NHS App. This work showed that Livi's product was not technically suitable.

LIVI has yet to respond to our request for comment. ®

* Thanks to the NHS Open Sorcerer for the tip


LIVI has made contact to say:

"We’re pleased to be involved in the ongoing consultation process with the developers of the new NHS app alongside a number of other digital healthcare providers. We will continue to support this important NHS work."

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