NHS Covid-19 app exceeds 10 million downloads, but has teething troubles

Launched some four months after it was originally promised, the UK’s contact-tracing app is proving hugely popular with the English and Welsh public, even though technical difficulties have emerged, one showing diverging testing acknowledgement capability for users between the two countries.

Following extensive trials and much criticism over a number of mishaps and technical issues, the NHS contact-tracing app for England and Wales was launched on 24 September. Designed to be an important new tool to work alongside the UK’s currently struggling traditional contact-tracing apparatus, it will form a central part of the NHS Test and Trace service in England and the NHS Wales Test, Trace, Protect programme – identifying contacts of people who have tested positive for Covid-19 and helping to prevent further spread of the virus.

The current app is a technological progression of the first version envisaged in April 2020, which was built using a centralised database structure whose limitations were exposed in its first trial in April and May. The product is now based on a decentralised data collection model using Google and Apple application programming interface (API) technology, and is said to have shown in tests – carried out in the London Borough of Newham, on the Isle of Wight and among NHS volunteer responders – that when used alongside traditional contact-tracing methods it is highly effective in contacting people who have tested positive for coronavirus.

Available to those aged 16 and over in multiple languages, the launched app includes proximity tracing using Bluetooth Low Energy, risk alerts based on postcode district, QR check-in at venues, a symptom checker and test booking. The contact-tracing element of the app works by logging the length of time users spend near other app users, and the distance between them, so it can send an alert if someone has been close to a person who later tests positive for Covid-19.

Using QR codes, a “check-in” facility allows customers and visitors to businesses in England and Wales to use the Covid-19 app to check in with their phone instead of filling out a visitor book or tool specific to a business. This will allow NHS Test and Trace to contact customers and provide public health advice should there be a Covid-19 outbreak associated with a venue they have visited. Certain businesses in England are now required by law to display NHS Test and Trace QR codes so customers with the NHS Covid-19 app can use them to check-in.

After an online, TV and newspaper advertising blitz to support the product, data released by the NHS has shown that people in England and Wales have responded overwhelmingly to calls to download the NHS Covid-19 app, with over 10 million people downloading it so far, six million of whom did so on the day it was launched. 

Furthermore, the downloading public has already put the app to use, with more than 1.5 million venue check-ins recorded on Saturday 26 September. More than 460,000 businesses have embraced the app by downloading and printing QR code posters for app users to scan to check-in to premises. This figure was 160,000 just before launch.

UK health and social care secretary Matt Hancock, who has staked a lot of political capital on the app’s success, called the initial enthusiastic response “absolutely fantastic”.

“This is a strong start, but we want even more people and businesses getting behind the app because the more of us who download it the more effective it will be,” he said. “If you haven’t downloaded it yet, I recommend you join the growing numbers who have, to protect yourself and your loved ones.”

Yet despite this optimism, technical hitches have come to light. The intention is that everyone who receives a positive test result can log their result on the app. Those who get a test in an NHS hospital, through a PHE lab – which carry out tests for NHS hospitals – or in a surveillance study, can request a code from NHS Test and Trace to log a positive result.

However, a number of people in England who have had Covid-19 tests in NHS hospitals have not been able to add the result of their test to the app as recommended by the UK government. Interestingly, no such difficulty was reported for those undertaking the same test in Wales. Other users have reported receiving notification to check the app through their smartphone’s alerts but have then found no subsequent warning or notification from the app itself after activating it.

In addition, IT experts have expressed concern about data privacy in terms of future functionality of the app. The Chartered Institute for IT noted that a planned development to the NHS contact-tracing app which will score users’ lifestyles for Covid-19 risk is “alarming” and needs clarity.

“Comments from the [app’s] developers about their plans to provide information to individuals about ‘how risky their life is’ based on Bluetooth contacts are alarming,” said Adam Leon Smith, who chairs the software testing group for BCS, the UK’s professional body for IT.

“These sorts of algorithmic scoring approaches are often inaccurate and can have unintended side effects…Some data is being stored un-encrypted locally,” he said. “This isn’t of great concern as it appears to be just system configuration data, with the sensitive data being stored by Google and Apple. However, as the functionality is expanded to include things like personal risk scores, this needs to be encrypted, and I’m keen to see this isn’t passed to the developer’s servers to establish a centralised tracking system by the backdoor.”