Healthcare apps: it's good to chat

19 March 2021

Caroline Palmer on how text messaging healthcare app ChatHealth has come into its own, and how community practitioners can embrace digital too.  

Young people, children and families are living through unprecedented times. Throughout the ongoing Covid-19 pandemic they are facing school closures, social isolation, financial difficulties, bereavement, worries about elderly and vulnerable relatives, strained family relationships and limited access to all their usual support networks. This is significantly impacting emotional health and wellbeing needs: half of 16- to 25-year-olds say their mental health has worsened since the start of the pandemic (Prince’s Trust, 2021).

Access to NHS service provisions has changed in response to the pandemic, often switching to remote care where possible. However, it has never been more important that people know how and where to seek help from healthcare professionals when needed. To this end, many community healthcare teams across the UK have been supported by Leicestershire Partnership NHS Trust (LPT) to facilitate easier access to confidential help and advice via the safe and secure messaging platform, ChatHealth.

Where ChatHealth began

In 2012, face-to-face care was the default service model. But young people in Leicestershire had told school nurses they wanted a discreet and anonymous way to get advice about a range of health issues, particularly for sensitive topics such as mental health. Messaging was one of the most popular ways for people to digitally communicate with family and friends (Ofcom, 2012). As a result, LPT went ahead with the development of ChatHealth, a secure, web-based tool for nurses to receive and respond to text messages sent from service users’ mobile phones.

The decision was taken to create a bespoke healthcare messaging tool after considering several off-the-shelf products that did not fulfil safety and security requirements for healthcare messaging. Ongoing consultation and guidance from nurses, police, safeguarding teams, information and clinical governance teams, the NSPCC and the Royal College of Nursing, as well as engaging with service users themselves, has shaped the development and standard operating procedures for ChatHealth.

New parents ask about a range of concerns, including breastfeeding, general health, constipation, sleep and feeding

Initially, some nurses feel uncomfortable communicating with service users via messaging, particularly with anonymous contacts. However, through their training and everyday use, they come to embrace ChatHealth, recognising the benefits and seeing the positive impacts and outcomes it can have.

The ambition of the NHS Long-term plan (NHS England, 2019) is that ‘digitally enabled care will go mainstream across the NHS’ with a priority to drive NHS digital transformation and ‘create straightforward digital access to NHS services, and help patients and their carers manage their health’. The school nursing team at LPT were ahead of their time in pioneering the technology to reach young people in this way and have paved the way for many others to follow.

Spreading secure messaging

Following ChatHealth’s initial pilot in Leicestershire, several other healthcare teams all proved keen to replicate the same model to connect with service users.

Now, in 2021, ChatHealth has been adopted by over half of school nursing teams across the UK to reach young people (ChatHealth, 2021), with many setting up additional messaging helplines for the parents and carers of school-age children. A quarter of all health visiting teams in England (ChatHealth, 2020) now use ChatHealth to provide convenient access for new parents of 0 to 5-year-olds about a range of concerns, including breastfeeding, general health, constipation, immunisations, sleep and feeding (Palmer, 2019).

A growing area of interest for ChatHealth – following another ‘first of its kind’ launch in Leicester – is the implementation of perinatal mental health messaging helplines for new and expectant mothers.

ChatHealth’s expansion into more services is putting a greater number of different service user groups in touch with healthcare professionals. This is fulfilling its purpose of supporting greater efficiencies by enabling individual nurses to provide services to many more people. ChatHealth has now been implemented into more than 55 NHS trusts and healthcare organisations, making access possible for around four million people.

Response to COVID-19 and beyond

As the pandemic began to affect our world, healthcare services already offering a blended approach to care delivery were in a good position to quickly respond to changing demands and needs. While restricting face-to-face contacts, they could focus on offering remote models of care to stay connected with service users. A healthcare professional from an NHS trust using ChatHealth said: ‘Resources like ChatHealth are vital for helping to support our young people during this time.’

During the first peak of the pandemic, messages to ChatHealth increased nationally by 50%. When looking into the reasons why people were seeking support, emotional health was top of the list. Service users, unsure where to turn for help, appreciated the ease and convenience of getting confidential advice via ChatHealth. Feedback was positive, with one ChatHealth user saying: ‘Great service, fast response, and it’s really reassuring to know this number can be used for any concerns, especially in these unusual times.’

Throughout the pandemic, we have seen a greater appetite from healthcare teams to adopt new ways of working and move towards digital transformation. Between April 2020 and July 2020, our ChatHealth support team supported as many implementations to go live as we did in the whole previous year. Adjustments to our implementation processes, enabling project catch-up calls, training and engagement sessions to take place online allowed ChatHealth projects to progress at a faster pace while still maintaining clinical safety and security. This meant new user organisations could quickly start offering their ChatHealth messaging service to reach increasingly vulnerable young people and families.

Be part of it

ChatHealth is an innovation that has been developed by the NHS for the NHS. It’s our aim to provide seamless, widespread access to ChatHealth for all young people and families across the UK to enable confidential, easy access to healthcare services in their communities.

We are seeking community practitioners interested in making potential service transformation across a variety of healthcare settings, including young people’s mental health, adult mental health, perinatal mental health, school nursing, health visiting, sexual health, drugs and alcohol and weight management, to name but a few. The ChatHealth support team provides a quick route for you to set up a safe messaging service, so you can stay focused on providing high quality care.

You can also help by promoting ChatHealth messaging services that are available to young people and parents and carers in your local area. Many healthcare teams have stocks of posters and business cards and regularly post about ChatHealth on their social media channels. Service users can visit chathealth.nhs.uk to find local ChatHealth services and start a chat with healthcare teams.

Digital methods of care, such as ChatHealth, are not intended to replace face-to-face care, but provide the tools for healthcare professionals to offer greater choice in how service users can seek health and wellbeing support. With ongoing NHS pressures and social restrictions due to the current pandemic, ChatHealth has been an invaluable service for many, benefiting both service users and healthcare professionals to remotely engage in a timely and convenient manner. Prior to the pandemic and in current times, we have found that service users will use a messaging service to seek advice if they are given a choice. Likewise, healthcare professionals are keen and willing to participate in digital improvements to service.

Caroline Palmer is the digital development clinical lead for ChatHealth. She qualified as a children’s nurse in 2007 and has worked in acute care and in community services working across both school nursing and children’s community nursing.


Has the Covid-19 pandemic prompted your healthcare service to embrace digital technology to connect with service users in your community? How might your clients benefit from ChatHealth? Join the conversation on Twitter @CommPrac with hashtag #ChatHealthNHS


ChatHealth. (2021) Personal communication

ChatHealth. (2020) ChatHealth Impact Report 2019/2020. See: chathealth.nhs.uk/wp-content/uploads/2020/09/ChatHealth-Digital-Impact-Report-2019-2020.pdf (accessed 3 February 2021).

NHS England. (2019) NHS Long Term Plan. See: longtermplan.nhs.uk/online-version/chapter-5-digitally-enabled-care-will-go-mainstream-across-the-nhs/ (accessed 3 February 2021).

Ofcom. (2012) Communications Market Report 2012. See ofcom.org.uk/__data/assets/pdf_file/0013/20218/cmr_uk_2012.pdf (accessed 3 February 2021).

Palmer C. (2019) Use of a text messaging service for communication with parents and carers. See: https://journals.rcni.com/primary-health-care/evidence-and-practice/use-of-a-text-messaging-service-for-communication-with-parents-and-carers-phc.2019.e1472/full (accessed 3 February 2021).

Prince’s Trust. (2021) The Prince’s Trust Tesco Youth Index 2021. See: princes-trust.org.uk/Document_Tesco-Youth-Index-2021.pdf (accessed 3 February 2021).

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