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Original research
Determinants of and barriers to adoption of digital therapeutics for mental health at scale in the NHS
  1. Matt G Williams1,
  2. Richard Stott2,
  3. Nicki Bromwich3,
  4. Susie K Oblak4,
  5. Colin A Espie5,
  6. James B Rose1
  1. 1 Clinical Innovation Adoption, Oxford Academic Health Science Network, Oxford, Oxfordshire, UK
  2. 2 Department of Psychology, Institute of Psychiatry Psychology and Neuroscience, King’s College, London, UK
  3. 3 Strategic and Industry Partnerships, Oxford Academic Health Science Network, Oxford, UK
  4. 4 UK Directorate, Big Health, London, UK
  5. 5 Nuffield Department of Clinical Neurosciences, Sleep and Circadian Neuroscience Institute, University of Oxford, Oxford, Oxfordshire, UK
  1. Correspondence to Matt G Williams, Oxford Academic Health Science Network, Oxford OX4 4GA, UK; Matt.Williams{at}


Objectives Although it is widely acknowledged that digital therapeutics will play a significant role in the future delivery of healthcare, the method by which these innovations may be commissioned by the National Health Service, at scale, remains unclear. This study explores English health commissioners’ experiences of, and attitudes towards, adopting digital healthcare innovations.

Methods 37 commissioners and decision-makers from a range of sectors within the health profession were invited to participate in structured interviews to gather relevant examples of experience and opinions. 14 commissioners participated and the notes from the resulting interviews were interpreted using qualitative content analysis. Controlled interpretation was applied to the categorised responses, paraphrasing and classifying into themes.

Results Common determinants and barriers to adoption of digital mental health expressed during the interview process included commissioners’ lack of familiarity with technology, information governance, digital literacy of users and decision-makers.

Conclusions Recognition of identified barriers may be helpful for innovators when developing engagement and market access strategies and suggest areas for focus and further development within the commissioning process to accommodate digital health solutions.

  • adoption
  • commissioning
  • innovation
  • mental health
  • digital therapeutics
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  • Contributors MGW, NB, SKO and JBR designed the study and prepared the interview questions. MGW, NB and SKO conducted and reported the interviews. MGW, JBR and NB analysed the data and wrote the manuscript with support from RS and CAE.

  • Funding Funding for this work was provided by Innovate UK through the Digital Health Technology Catalyst fund.

  • Competing interests However, at the time of publishing, two authors currently hold positions at Big Health, the developer of the Sleepio product.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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