By Chris Davies, Principal and CEO, The Institute of Clinical Science and Technology
Chronic diseases are common and expensive, they are estimated to kill almost 41 million people a year worldwide, making up seven out of ten deaths globally.
And given that £7 in every £10 of UK health and social expenditure goes toward chronic disease management, it’s time for a shift.
Traditional healthcare delivery needs to transition to a digital-first model that eases the pressure on the healthcare system and future-proofs the NHS.
This approach can enable individuals across large populations to have better agency, better empowerment and more confidence when they navigate their health.
The Institute of Clinical Science and Technology has been supporting this transition for the last decade with the development of digital therapeutics toolkits for major chronic conditions.
They are proven to improve patient wellness, reducie the patient’s need for unscheduled care, move demand from hospital to the community, and reduce levels of NHS expenditure on chronic diseases by optimising resource allocation.
The Respiratory Digital Therapeutics Toolkit was created to support adults living with Asthma and chronic obstructive pulmonary disease (COPD), and parents of children living with Asthma.
Co-produced with policymakers and clinical experts from within stakeholder groups, including NACAP, PCRS, NHS Wales and NHS England, the toolkit provides a personalised, digital care plan and empowers patients to take control of their condition.
The toolkit has reached full adoption across 100 per cent of GP practices and hospitals in NHS Wales, and supports hundreds of thousands of patients living with chronic respiratory conditions such as asthma and COPD.
The success of the toolkit highlights several key areas that deserve attention and can be replicated across England in line with the NHS 10 Year Plan: improvements in patient outcomes, changes in healthcare delivery, behaviour change through integration with care pathways, and the potential for further scaling across other disease areas.
Improving health outcomes at scale
One of the key outcomes of the Respiratory Digital Therapeutics Toolkit is its impact on patient wellness.
Patients using the app, a key element of the toolkit, have seen a 41 per cent improvement in wellness scores after just four months of use.
In addition to improved wellness scores, the toolkit has driven significant reductions in the use of reliever inhalers and the frequency of visits to the GP.
These benefits are particularly pronounced in socioeconomically deprived areas, where chronic disease management often faces heightened barriers due to limited healthcare access and financial constraints.
By reducing disparities in outcomes across different regions and socioeconomic groups, the toolkit initiative serves as a model for equitable healthcare innovation.
Impact on healthcare delivery
The toolkit’s integration into routine care has alleviated pressure on overstretched primary care and emergency services.
Patients have taken greater responsibility for managing their conditions, resulting in a 36 per cent reduction in GP visits and a 19 per cent decrease in A&E admissions.
These reductions represent a shift in the way healthcare is delivered, freeing up critical resources and enabling healthcare providers to focus on more acute cases.
This shift is particularly timely given the growing pressures on healthcare systems across the UK.
Solutions like the Respiratory Digital Therapeutics Toolkit provide a scalable way to meet the rising demand for care without proportionally increasing the burden on healthcare professionals.
By empowering patients, the toolkit not only improves outcomes but also enhances system efficiency.
Driving behaviour change through care pathway integration
The success of the toolkit is rooted in its use of the COM-B (Capability, Opportunity, Motivation-Behaviour) model to drive behaviour change.
It recognises that sustainable improvements in health require more than just information; they need targeted interventions that address the real-world barriers many patients face in managing their conditions.
By incorporating the COM-B model, the toolkit provides tailored support which enhances patients’ capability and motivation to manage their health.
For example, educational modules within the app help patients understand their condition, while reminders and progress tracking reinforce healthy behaviours.
Crucially, 88 per cent of patients accessing the toolkit have been referred by healthcare professionals, highlighting the importance of seamless integration with existing care pathways.
Healthcare professionals play a vital role in promoting digital therapeutics and their trust and endorsement encourage patients to engage with these tools, ensuring that digital health interventions are not seen as standalone solutions but as integral components of comprehensive care.
This collaborative approach has driven high engagement and sustained behaviour change, paving the way for long-term improvements in health outcomes.
A scalable, evidence-based innovation
The evidence-based and co-produced nature of the Respiratory Digital Therapeutics Toolkit has been critical to its success.
Unlike many digital health initiatives that struggle to move beyond pilot phases, this toolkit was designed with scalability in mind from the outset.
It was developed through extensive collaboration between patients, clinicians, and digital health experts, ensuring that it met the needs of all stakeholders.
This approach has not only enabled full adoption across Wales but has also opened the door to expanding the model into other disease areas.
The lessons learned from respiratory care are already informing the development of digital therapeutics for conditions such as diabetes, chronic kidney disease, and cardiac conditions.
By applying the same principles of evidence-based design, patient-centred co-production, and seamless integration with care pathways, the potential for widespread impact is enormous.
Transforming healthcare through digital innovation
The nationwide adoption of the Respiratory Digital Therapeutics Toolkit in Wales represents a turning point for digital health.
It demonstrates that large-scale implementation is achievable when digital tools are designed and deployed in alignment with healthcare system priorities.
Moreover, it highlights the importance of equity in healthcare innovation.
By ensuring that all regions and socioeconomic groups benefit equally, NHS Wales has shown that digital tools can be a force for reducing disparities rather than exacerbating them.
In a world where chronic diseases are on the rise and healthcare resources are increasingly stretched, the success of the Respiratory Digital Therapeutics Toolkit offers a model for the future in line with the NHS 10 Year Plan, placing emphasis on expanding digital innovation, improving patient outcomes, and addressing health inequalities.
It shows that with the right combination of technology, collaboration, and evidence-based practice, we can achieve meaningful improvements in health outcomes at scale, ultimately improving the lives of millions of patients.
The National Delivery Team for Respiratory Care in Wales will be discussing in depth how the results were achieved across Wales during a webinar on 13 March.
Follow this link to register: https://icst.org.uk/events/live-event-national-transformation-of-respiratory-outcomes-through-digital-therapeutics/
