Local Healthwatch NHS App and Independent Feedback Report

This report presents the views and experiences of 1,709 people across 19 Local Healthwatch areas regarding the NHS App and attitudes toward providing feedback about NHS services. 

The findings illustrate both the opportunities and risks associated with the NHS’s rapid shift toward digital‑first models, especially alongside proposals to transition independent feedback functions into NHS structures. This report provides a timely snapshot into whether people are ready for an increased reliance on digital channels and what may be lost if an independent voice for health is taken away.

Findings

Our findings show that the awareness and use of the NHS App varies widely across ages and communities, with older people and marginalised groups most likely to be digitally excluded. Confidence in getting help digitally sharply declines with age, and many people prefer human contact and independent routes. 

The app is mainly used for passive and viewing activities rather than people actively managing their care, and only around half of respondents would use it to give feedback on a health service. Strong preferences for in‑person and non‑digital options highlight the need to maintain and promote accessible routes whilst digital channels are improved.

Why Independence Matters

In July 2025, Dr Penny Dash's review of patient safety across the health and care landscape in England was published. The 10 Year-Health Plan (July 2025) agreed to carry out all of the recommendations made in the review including to bring together the work of local Healthwatch into Integrated Care Boards and Local Authorities. These plans will get rid of a 52-year precedent of incorporating an independent public voice in relation to people’s health and care services.

Local Healthwatch’s statutory independence allows it to act without fear or favour, challenge poor practice and expose system failings without being constrained by internal priorities. Moving this role in‑house not only places the organisation receiving feedback in charge of interpreting and acting on it, but also removes people’s choice to anonymously share feedback with an independent organisation. This risks undermining public confidence and the safety people feel when speaking up in the first place.

Independence protects honest and early warnings for issues both across the system and for individuals, and whilst digital channels can add convenience, independent channels add confidence. 

Policy Guardrails for Patient Voice and Digital Transformation

To ensure that a digital expansion does not compromise independence and equity, the following principles must underpin national and local policy and its implementation.

1. Independence – Independent and anonymous feedback must be preserved alongside NHS-led mechanisms, to ensure that people can speak openly without fear or favour.
2. Choice – Non-digital pathways (telephone, letters, in-person) must remain permanently available, fairly promoted, and be treated as equal in status and quality to digital alternatives.
3. Impartiality – Feedback interpretation should not be controlled by the service provider delivering the care. Separation is vital to protect accountability and ensure fair treatment.
4. Transparency – Patients must understand how their feedback is collected, analysed, acted upon, and how any data is stored or shared.
5. Integration – Digital tools must enhance, not replace, independent voice, community advocacy, or patient experience channels.