Jan 2013 NHS Choices awareness and usage tracking survey

1 Customer Insight Public information

April 2013

NHS Choices awareness and usage

tracking

Jan 2013 : Wave 8


Contents

• Introduction

• Research objectives

• Sample and methodology

• Summary

• Internet Usage

• Prevalence & frequency

• Online Health Information & Apps

• Usage and interest in using the internet for health info and communication with NHS/health professionals

• Perceptions of reliability and usefulness of the internet for health info

• Devices used

• Current and future health app behaviour

• Awareness & Usage of NHSC

• Comparisons with other websites, benchmarked against previous years

• Site Users

• Profile of personal and professional users

• Evidence of behaviour change

• Impact on confidence

• Use of site to reduce health risk

• Satisfaction, Future Usage & Advocacy

• Comparisons with previous years and the pop up satisfaction survey

• Appendix


Research Objectives

Benchmark the use of the internet, particularly for health information

Understand frequency of internet usage among the general population

Understand how people currently perceive and use online health information

Track how the pattern of internet usage for health information is changing, including the devices used, and the uptake of health apps

Understand the profile and needs of current users

Understand the profile of site users compared with the general population

Explore how many different people users have looked up health information for on NHS Choices

Understand how the site is meeting the needs of current users and how satisfied they are

Establish attitudinal and behavioural information of users

Track awareness and usage of the NHS Choices website

Track the awareness and usage of NHS Choices compared with previous waves of the survey


Sample and Methodology

Type of survey Omnibus survey conducted by TNS

Methodology CAPI (computer assisted personal interviewing)

Conducted in respondents homes

Fieldwork dates 18th – 22nd January 2013

Sample Total sample n=1709

Results weighted to provide total population figures

Sample structure can be found in the appendix

Sample distribution Nationally representative sample of the general public in England (only adults aged

16+ included in the sample)

Previous research

conducted

Previous waves of the public research omnibus survey have been conducted as

follows:

Wave 1: Sept 2007 (Ipsos MORI survey)

Wave 2: Dec/Jan 2008 (Ipsos MORI survey)

Wave 3: Oct 2009 (TNS survey)

Wave 4: June 2010 (TNS survey)

Wave 5: March 2011 (TNS survey)

Wave 6: Dec 2011 (TNS survey)

Wave 7 : August 2012 (TNS survey)

Sample and Methodology


Internet usage in the past 3 months has increased from 80% in August 2012 to 83%, and 80% of those people use it on a daily basis

60% of the population have looked up health information online

65% of people trust NHS websites

Summary #1

Use of the internet for health information

Awareness and usage of the NHS Choices website

Spontaneous awareness of NHS Choices has decreased from 7% in August 2012 to 5% , but total prompted awareness (name and screenshots shown) has increased by 1% to 28%

Total usage has increased by 2% to 17%

Usage of health apps and future uptake

18% have downloaded a health app – which is almost 7.5 million people!

The most popular are those that help people to lose weight, start an exercise programme or eat more healthily.

When asked what people would like an app for, it was all of the above and also being able to book GP appointments or order repeat prescriptions.

http://www.google.co.uk/url?sa=i&rct=j&q=health+apps&source=images&cd=&cad=rja&docid=goKSkQCgQHhRyM&tbnid=UzjbTlRB9O0p2M:&ved=&url=http%3A%2F%2Fwww.creativemms.com%2Fthe-top-10-health-fitness-iphone-apps-for-summer&ei=n91nUZvgHenL0QX26oGIAQ&bvm=bv.45175338,d.d2k&psig=AFQjCNF3PcpzWBNtxxkXyHs2awv8U6b95g&ust=1365847839775290


32% of NHSC users are professional users (including 18% that also use it for personal reasons), which shows a significant increase of 10% since Aug 2012

The proportion of those using NHSC only for personal reasons has decreased from 75% to 64% since Aug 2012.

However, the proportion of professional users that also use it for personal reasons has increased, therefore the total percentage of personal users is currently 82% (only a 5% decrease since August 2012)

Personal users are more likely to be female, aged 16-44 and C1

9 out of 10 users have used NHSC on behalf of others, with each user looking up information for approx 3 other people in addition to themselves

Satisfaction has increased by 9% since August 2012 to 88%. Advocacy (87%) and likelihood to use again (94%) has increased by 4% and 3% respectively.

In terms of behaviour and attitude change:

There has been a 5% increase since August 2012 in those that say NHSC improves their confidence when seeing a health professional (53%)

Summary #2

The profile and needs of current users


Internet Usage


17% 14%

32% 29%

55%

45%

4% 3%

29% 28%

18%12%

3%3%

4%5%

5%

6%

2% 1%

5% 4%

2%

3%

80% 83%

63% 66%

94% 96%

66% 68%

80%85%

39% 49%

Aug

2012

Jan

2013

Aug

2012

Jan

2013

Aug

2012

Jan

2013

Aug

2012

Jan

2013

Aug

2012

Jan

2013

Aug

2012

Jan

2013

Yes,

within

the last 3

months

Yes, but

longer

than 3

months

ago

Never

used

DE Socio-economic group Total Parents LTC

+3% shift

+10% shift

+2% shift

Carer

+3% shift +5% shift

Q. How recently have you used the internet?

Base all respondents n=1709 un-weighted base, n=40,773 weighted base

• The proportion of DE’s who have accessed the internet in the previous 3 months has increased by 3%

• 10% more people over the age of 65 years are now using the internet.

• Most parents have accessed the internet in the previous 3 months (2% increase from 94% in Aug 2012 to 96% this wave)

• Two thirds (68%) of those with a long term condition have accessed the internet in the past 3 months which is a 2% since

Aug 2012

• 85% of carers have accessed the internet in the past 3 months, which is a 5% rise since Aug 2012

83% have used the internet in the last 3 months

+2% shift

65+ years


Daily

81%

Less often

3%

Once a month

1%

Once a week

4%

Once a fortnight

1%

Every 2 or 3 days

10%

Base all who have used the internet n=1415 un-weighted base, n=35014 weighted base

81% of those who have used the internet do so on a daily basis

Q. How frequently do you use the internet?

• The proportion of the general public who use the internet daily (81%) has increased by 2%, and is the first increase in a

few years.

• Males are significantly more likely to use the internet daily in comparison to females (84% v’s 77%)

• The following groups are significantly more likely to use the internet on a daily basis than the general population:

• Parents (88%)

• 16-44 year olds (89%)

• ABC1’s (85%)

• 89% of those that look up health information online use the internet daily, similar to Dec 2011 (88%)


Online Health Information

& Apps


60% have used the internet to look up health

information

Base all respondents n=1709 un-weighted base, n=40773 weighted base

• This is a 10% increase since Dec 2011 (it is not directly

comparable to Aug 2012 as the question was asked

differently)

• There is only a 3% difference between men (59%) and

women (62%) that have used the internet to look up

health information.

• Interestingly, those with long term conditions are less

likely to use the internet to look up health information

(55%) than those with none (62%)

• Parents are more likely to use the internet to look up

health information (74% v’s 54%)

• When you look at internet users, the percentage

looking up health information online increases to 70%,

which is similar to the recent OFCOM adult media use

and attitudes report, which shows 75% look up health

information online.


61% find online health information useful and the perceived reliability

of NHS info is 17% higher than other health information sites in general

12% 35% 34% 7%12%

Agree Strongly Agree Slightly Neither agree nor disagree Disagree Slightly Disagree Strongly

I trust the reliability

of health

information on an

NHS website

I trust the reliability

of health

information on the

internet in general

Q. How much do you agree or disagree with the following statements about using the internet to look up health information?

I find health

information on the

internet useful

37% 28% 29% 3%3%

25% 35% 28% 5%5%


48%

65%

61%

+2%

+4%

Change since Aug 12

+2%


3%

Variety of devices used to access health information

Q. Which of the following devices have you ever looked up health information on?

Base all who have used the internet to look up health information n=967 un-weighted base, n=24664 weighted base

44% 70%

17%

Other portable device

(e.g. PSP, iTouch) 3%

27%

+7%

-2%

Change since Aug 12

+8%

+6%

+2%


30% have bought or are interested in buying a health app

1%

0%

2%

8%

7%

6%

3%

2%

4%

7%

3%

2%

1%

3%

2%

6%

5%

1%

1%

1%

2%

2%

2%

2%

4%

1%

Eat more healthily

Start an exercise programme

Help you lose weight

Started running

Help during pregnancy

Sleep better

Make booking or ask for repeat

prescription from GP

Improve mental wellbeing\better cope

with stress

Stop smoking

Provide feedback on services

Find local service

Reduce alcohol intake

Something else

Purchased/Downloaded App

Future Interest in App

• 18% have downloaded any health

related app. That is almost 7.5 million

people across England.

• 24% would be interested to download a

health related app in future, which takes

that up to almost 10 million people

Q. Have you ever purchased or downloaded any health related apps to do the following…?

Q. Would you be interested in a health related app to do the following…?

Base all respondents n=1709 un-weighted base, n=40773 weighted base


NHS Choices: Awareness & Usage


• 49% of respondents said they had heard of any NHS website

• There remains some confusion about NHS sites with 11% not sure specifically which NHS/public site they were

aware of - some of these could have been NHS Choices

• NHS Choices awareness is down 2% since Aug 2012, but Google and Boots WebMD have also decreased by the same

amount

5% have heard of NHS Choices although more may have been aware of

it but not known its specific name

33%

3%

2%

4%

3%

3%

2%

35%

16%

10%

6%

4%

4%

5%

5%

3%

3%

38%

17%

9%

9%

7%

7%

6%

6%

5%

3%

39%

15%

11%

9%

5%

6%

7%

7%

3%

2%

6%

NHS Direct

Google

- An NHS/public site

not sure which

Bupa

NHS Choices

Directgov

Wikipedia

BBC Health

Boots WebMD

Netdoctor

March 2011

Dec 2011

Aug 2012

Jan-13

Q. Which health information websites, if any, have you heard of? (spontaneous awareness)


-2%

since Aug 2012


28%

9%

6%

3%

4%

5%

3%

3%

35%

29%

12%

9%

6%

6%

7%

5%

4%

3%

39%

33%

15%

14%

8%

8%

7%

5%

5%

3%

37%

26%

12%

10%

6%

8%

9%

3%

4%

4%

NHS Direct

Google

Wikipedia

Directgov

Bupa

NHS Choices

BBC Health

Netdoctor

Boots WebMD

NHS/public site - not sure which

March 2011

Dec 2011

Aug-12

Jan-13

There is no change in usage of the site since June 2010

43% (-5%)

31% (-9%)

14% (-5%)

11% (-6%)

7% (-3%)

10% (=%)

10% (+1)

4% (-2%)

5% (-1%)

5% (+1)

Internet users (+/-/= change since Aug 2012)

No change

since Aug 2012

General Public

Q. Which of these health information websites have you used in the last 12 months?

Base all respondents n=1709 un-weighted base, n=40,773 weighted base;

internet users n=1415 un-weighted base, n=35014 weighted base

No increase in site usage between Aug 2012 and Jan 2013

• BBC Health is the only site to show a reported increase in usage, and NHS Choices remains unchanged, whilst the rest have

decreased.

• 50% of respondents said they had used any NHS website (a 2% decrease since the last wave)

• Three quarters (76%) of internet users who are aware of NHSC, have used the site, which is a 4% increase since Aug 2012

• As per the last wave, usage of NHSC is slightly higher (8%) than its spontaneous awareness (5%), which could be because of the

NHS brand or because the name invokes a greater level of awareness


Decrease in spontaneous awareness but prompted awareness and

usage has increased

5%

28%

17%

60%

0%

10%

20%

30%

40%

50%

60%

70%

May-

10

Jul-

10

Sep-

10

Nov-

10

Jan-

11

Mar-

11

May-

11

Jul-

11

Sep-

11

Nov-

11

Jan-

12

Mar-

12

May-

12

Jul-

12

Sep-

12

Nov-

12

Jan-

13

Spontaneousawareness

Promptedawareness(Hompage &site pagesshown)

Total usage(spontaneous +prompted)

Use the internetto look uphealth info

* Dip caused by question change *

Base all respondents n=1709 un-weighted base, n=40,773 weighted base; internet users n=1415 un-weighted base, n=35,014 weighted base

GENERAL PUBLIC (depicted in the graph):

• Total awareness among all adults (spontaneous and prompted) 28%

• Total usage among all adults (spontaneous and prompted) 17%

INTERNET USERS (for comparison to graph):

• Reported usage amongst internet users (seeing a list) remains at 10% since Aug 12. Usage amongst internet users (shown screenshots) is

20%, a 4% increase since Aug 12

• Awareness of NHSC amongst internet users (who see the screenshots) is 34%, which is a 5% increase since Aug 12

• 70% of internet users look up health information online.


NHS Choices 10% 19.52%

% difference

NHS Direct 43% 1.10%

+18.42%

difference

-33%

difference

Reported Usage

(Omnibus survey Dec 2011) Market share Aug 2012 (Hitwise data)

NHS Choices has the highest market share

• Although only 10% of the general public claim to have used the site, NHS Choices actually had the highest market

share (in the Health and Medical Information category) at 19.52% in Jan 2013 compared with other health information

websites

• This has increased by 2.6% since Aug 2012 and ranks at #1 in this category compared to NHS Direct at #15.

Ranking chart from Hitwise – Health information

websites


NHS Choices: Site users


Who is using NHS Choices?

• There has been an 11% decrease in the number of personal site users since Aug 2012, however, when adding in the

professionals who also use the site for personal reasons, the overall personal users is 82% (which is only a 5% overall

decrease since Aug 12).

• There is 10% overall increase amongst professional users, and the total number of health professionals using NHS

Choices is now 20% (a 7% rise since Aug 2012)

For personal use only (64%)

Total personal use including

professionals (82%)

For professional use (32%)

For myself, a member of my

family or for a friend (64%)

For personal and professional

reasons (18%) • Health professional (11%)

• Non-health professional (7%)

For only professional reasons (14%) • Health professional (9%)

• Other professional looking for someone

else as part of my job(3%)

• Other professional (2%)

Positive or negative change in the proportion of people using the site since Aug 2012

Q. Which one of the following best describes the reason why you generally visit NHS Choices?

+4%

Base all NHSC users n=282 un-weighted base, n=6982 weighted base

-11%

+6%

+10%

Please note the professionals are based on small

baseline of people when looking at the actual figures

(i.e. the un-weighted figure is approx 89 people)

-5%


Typical NHS Choices users

Gender • Female - 60%

• Male - 40%

• The gender spilt shown here is more accurate than that of the satisfaction

survey which is more biased towards females due to the self selected

methodology

Age • <24 - 23% (2% more than same study in Aug 2012)

• 25-44 - 52% (3% more than same study in Aug 2012)

• 45-64 – 19% (6% less than same study in Aug 2012)

• >65 -5% (no change since the same study in Aug 2012)

Socio-economic

group

Significant change in use amongst all but the C1 demographic group:

• AB – 16% (13% less than same study in Aug 2012)

• C1 – 39% (1% more than same study in Aug 2012)

• C2 - 23% (5% more than same study in Aug 2012)

• DE - 22% (7% more than same study in Aug 2012)

Long term

conditions

• Have long a LTC / disability 22% (3% more than same study in Aug 2012)

Carer • Carers 22% (1% less than same study in Aug 2012)

• Just under a quarter of our personal site users are carers

Children in family • 48% of personal users have children (5% higher than same study in Aug

2012)

• 69% of those with children use NHSC for personal reasons. In comparison,

60% of those without children use choices for personal reasons.

Use the site for

personal use:

For myself,

member of my

family or friends

Base all respondents who use

the site for themselves, friends

or family n=4468 weighted base

Profile of the typical NHS Choices user (personal use)


90% of site users have used the site to look up info for others

One

Person

43%

None

7%

2-5

people

39%

6-10

people

4%

11-25

people

1%

Q. How many different people have you looked up health information for on the NHS Choices website?

Base all who have used the NHS Choices website n=282 un-weighted base, n=6982 weighted base

• On average, an NHSC site user looks up information for 3 people

• Compared to Aug 2012, 5% more people look up information for one person, 12% fewer people look up health information

for 2-5 people, and 5% more answered for no other people.

• In total, approx 6.3 million users use the site for others

Don’t

know

3%

25+

people

3%


Evidence of behaviour change


19% 34% 30% 11% 7%

Strongly agree Slightly agree Neither agree nor disagree

Slightly disagree Strongly disagree

Q. In the last 12 months, using the NHS Choices website has helped me be more confident when seeing a

doctor or other health professional

Base all who have used the NHS Choices website for personal use n=233 un-weighted base, n=5727 weighted base

Confidence when dealing with health professionals

• 53% of NHS Choices users say that using the website has helped them be more confident when seeing a doctor or other

health professional. This is a 5% increase since Aug 2012.

53%


57% have used info from NHSC to make a health related choice

43%

57%

Yes

No

6%

2%

3%

20%

8%

2%

3%

5%

7%

7%

7%

7%

8%

Eat more healthily

Help you lose weight

Help during pregnancy

Sleep better


Improve mental wellbeing\better cope with stress

Research\information (on health\illnesses\symptoms)

Stop smoking

Decide to get child vaccinated

Decide to go for a health screening

Started running

Reduce your alcohol intake

Something else

• 42% of personal site users have used the site to make a positive health behavioural change such as eating more healthily,

taking up exercise, losing weight, stopping smoking etc.

Q. In the last 12 months, have you ever used the

information from NHS Choices to make a health related behavioural choice (from a specified list)?



7%

7%

7%

6%

5%

3%

2%

2%

3%

42%

9%

15%

3%

1%

3%

1%

4%

34%

8%

20%

3%

4%

6%

15%Eat more healthily

Help you to lose weight

Research/information on health/illnesses or

symptoms


Improve your mental wellbeing/better cope with

stress

Stop smoking

Decide to get child vaccinated

Decide to go for a health screening

Started running (or learn how to run)

Reduce your alcohol intake

Other (please specify)

Any health risk information

Jan-13 Aug-12

Lots of evidence of the site being used to improve health

Q. In the last 12 months have you ever used information from NHS Choices to do any of the following?



Satisfaction, Future Usage & Advocacy


Not sure, 6%

Probably not,

1%

Probably, 48%

Definitely, 46%

83% are satisfied; 87% will use NHS Choices again and 76% would

recommend it

Neither ,

11%

Dissatisfied,

1%

Satisfied,

64%

Very

satisfied,

24%

Base all who have used the NHS Choices website n=282 un-weighted base, n=6982 weighted base

Definitely, 43%

Probably, 43%

Not sure, 10%

Probably not,

3%

0.3%

dissatisfaction -

1.7% since

March 2011

3% Unlikely

to

recommend

(-5% since

Dec 2011)

9% increase in satisfaction (88%), 94% are likely to use NHSC again

and 87% would recommend it

Q. Overall, how satisfied were you with the NHS

Choices website?

Q. How likely would you be

to recommend the NHS

Choices website?

Q. How likely would you be to use the NHS Choices

website again?

• All the differences (both positive and negative) seen since August 2012 are significant differences

• Across all these questions, it is good to see nobody selecting the extreme negative end of the scale with very dissatisfied or

definitely not, and even the negative response we do receive is by a very small proportion, which indicates the site is meeting

the needs of all users.

0.3%

dissatisfaction -

1.7% since

March 2011

94% Likely

future

usage

(+3% since

Aug 2012)

88%

Satisfactio

n (+9%

since Aug

2012)

1%

dissatisfaction

(-1% since

Aug 2012)

1% Unlikely

future usage

(-1% since

Aug 2012)

87% Likely

to

recommen

d (+4%

since Aug

2012)


Appendix


69%

31%

35%

65%

45%

55%

Child/children No children

22%

34%

20%

24%24%

36%

40%

20%20%

20%21%

19%

AB C1 C2 DE

51%49%

57%

43%

38%

Working Not working

51%

49%50%50%

57%

43%

Male Female

15%16%

18%

12% 12%

10%

18%19%

20%

18%

24%23%

24%

16%

8%

3%

1%

16%

12%

10%

4%

16-24 25-34 35-44 45-54 55-64 65-74 75+

Working status

Sample Structure (weighted)

Base all respondents Jan 2013 n=1709 un-weighted base, n=40,773 weighted base; all who have used the internet n=1415 un-weighted base,

n=35014 weighted base; used NHSC site n=282 un-weighted base, n=6982 weighted base

Gender Age

Socio-economic group Children

57%


Sample structure 2/2

9%

11%

15%

17%

9%

13%

9%8%

11% 11%

18%

9%

6%

12%11% 11%

17%

14%

7%

11%10%

14%

6%

15%

6%

11%10%

North

East

North

West

Yorkshire

& The

Humber

East

Midlands

West

Midlands

East of

England

London South

East

South

West

80%

19%

75%

25% 20%

81%

LTC Non-LTC

81%

19% 19%

81%

21%

79%

Carer Non-carer

Sample Structure (weighted)

Government regions

Long term condition (LTC) Carer

Base all respondents Jan 2013 n=1709 un-weighted base, n=40,773 weighted base; all who have used the internet n=1415 un-weighted base,

n=35014 weighted base; used NHSC site n=282 un-weighted base, n=6982 weighted base


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Health & Medicine

Jan 2013 NHS Choices awareness and usage tracking survey