Extending Digital Self-Management into the Community

A reflection on how digital health, self-management technology can support clinical assessment days, and reach further into the community

Clinical Assessment Days (CADs) have become a well-established way for MSK physiotherapy providers to support large numbers of patients closer to home, in a more informal setting, while helping to reduce waiting lists. Their success lies in giving large numbers of patients timely access to physiotherapy assessment and treatment in community settings, but as healthcare continues to evolve, there is an opportunity to extend the impact of CADs even further by embedding digital self-management support into the patient journey.

At getUBetter, we regularly provide a digital layer to CAD days by integrating digital self-management support directly into the CAD pathway. This enables the locally agreed digital self-management tool to be introduced to patients face-to-face, supporting onboarding at the point of contact.

To date, we’ve supported more than 40 CAD days across a range of NHS services and regions in England. Through this work, we’ve gained valuable insight into the factors that influence the success of a CAD day, both physically and digitally.

What we’ve learned from supporting CAD days

Our experience has shown that communication, staff understanding, training, pathway design, unconscious bias and leadership all play a significant role in determining outcomes.

1. Staff Training Matters

Training staff to understand and value digital support alongside routine NHS care is essential.

When clinicians and support teams understand how digital self-management complements existing services, they are more likely to introduce it confidently and encourage patient adoption. Their confidence directly influences patient confidence.

2. Clinicians Need Hands-On Understanding, Not Assumptions

For digital health tools to be successfully integrated into care, clinicians need practical experience of the technology and a clear understanding of how and when it should be used. There are still unsubstantiated assumptions about who can and cannot benefit from digital tools. Age, ethnicity and deprivation are often perceived as barriers.

However, experience consistently challenges these beliefs:

• People aged 50 to 90 use technology extensively.
• getUBetter can read content aloud in 20 languages.
• Patients from ethnic minority backgrounds often use the platform more and report higher levels of satisfaction.

Where patients need support getting started, CAD days create a valuable opportunity for digital technology providers to help with onboarding and build confidence from the outset.

3. Patient Flow Makes a Real Difference

How digital support is positioned within the patient journey matters.

When support tools such as getUBetter are placed in a separate room at the end of the pathway, they are often perceived as optional rather than as part of routine care. This typically results in significantly lower uptake.

By contrast, when digital self-management support is presented alongside physiotherapy services as a standard part of care, engagement is considerably higher.

4. Communication Must Work Both Ways

Clear communication is essential throughout the CAD process. Patients need to understand the role of everyone involved in delivering support, not just the physiotherapy service. Equally, physiotherapists and other staff need clarity about the purpose and value of the digital support being offered.

Alignment across all stakeholders helps create a more consistent patient experience and ultimately drives better outcomes.

What Success Looks Like in Practice

The impact of these principles can be significant. Within a single day, we’ve seen 200 patients from an MSK physiotherapy service sign up to digital support, as well as 80 people physically helped to start using getUBetter alongside their MSK physiotherapy care. This level of engagement was achieved through three simple factors:

• Positioning getUBetter alongside the physiotherapy service rather than separately.
• Ensuring staff were well trained and confident in the digital offer.
• Maintaining strong communication between the MSK team and patients.

The result was a seamless blend of face-to-face care and digital self-management support.

Can the digital front door move further into the community?

While CAD days remain an efficient and effective way to improve access to care and reduce waiting lists, many Integrated Care Systems (ICSs) and MSK providers are now exploring how the digital front door can be extended much further into the community. The aim is to provide convenient access to health and work support wherever people need it, creating a population-wide approach to prevention, self-management and access to care.

This universal model enables people to access trusted, safe self-management support 24 hours a day, seven days a week, while also facilitating navigation and self-referral into physiotherapy services when appropriate.

Four ways to extend access beyond the CAD day

1. Create Community-Wide Visibility

Providing access to digital support in everyday community settings helps raise awareness and encourage early action.

Examples include:

• Advertising on buses and at bus stops.
• Promotion through local radio.
• Signposting in community venues

This approach provides around-the-clock support at home, encourages earlier intervention and prevention, and gives citizens permission and confidence to self-manage alongside routine care.

2. Embed Support Across the Whole Care Pathway

Digital self-management tools are most effective when they are available consistently across healthcare touchpoints. Examples include integration with:

• AI-enabled NHS 111 services.
• Community pharmacies.
• Minor injury units.

This creates a more connected and consistent patient experience.

3. Integrate at a National Level

National integration can help people find support earlier and more easily. For example, the cMSK referral pathway via the NHS website and NHS App can direct people seeking MSK support straight to their local getUBetter login page, reducing friction and improving access.

4. Use Targeted Outreach to Reach Priority Groups

Population health approaches can help identify cohorts of patients who may benefit most from digital self-management support. Using GP records, providers can target support in line with local strategies and neighbourhood priorities, including:

• Women’s health initiatives.
• Heart health programmes.
• MSK prevention and self-management pathways.

This enables support to reach people proactively rather than waiting until they present to services.

Looking Ahead

Clinical Assessment Days have demonstrated the value of bringing care closer to communities while helping services manage demand and reduce waiting times. However, their greatest potential may lie in what happens beyond the day itself. By embedding digital self-management support into CAD pathways and extending access across communities, healthcare systems have an opportunity to move from reactive treatment towards earlier intervention, prevention and continuous support.

The lessons learned from more than 40 CAD days suggest that success depends not just on the technology itself, but on how it is introduced. Staff training, pathway design, communication and leadership all play critical roles in ensuring digital support becomes a routine and trusted part of care.

As Integrated Care Systems continue to develop population health approaches, the opportunity is clear: move the digital front door beyond healthcare settings and into everyday life, making trusted support available whenever and wherever people need it.