Quiet care at scale: How the NHS App can make remote monitoring work for everyone

 As the NHS accelerates remote care through the NHS App, success will hinge on non-intrusive activity monitoring sensors, simple integrations, and transparent AI, so support works quietly in the background, protects privacy, and reaches people who can’t self‑report. Hannah Groombridge, head of operations at Canary Care, looks at how this might work in practice

The NHS’s ambition to scale remote monitoring and self reporting through the NHS App signals a fundamental shift in how care will be delivered.

Instead of sporadic, in-person check-ins, the UK is moving towards continuous, community-based support, with the focus shifting to new Neighbourhood Health Centres.

Done well, this could transform how we support people living with long-term conditions, reduce avoidable hospital admissions, and relieve pressure on frontline teams.

However, if remote care depends too heavily on patients remembering log-ins, managing multiple devices, or engaging with digital questionnaires, it risks amplifying exclusion, rather than tackling it.

The people most likely to benefit from pro-active, remote support are those often least able to navigate complex digital journeys: vulnerable people living alone, people living with dementia, or people living with learning disabilities, or those who are simply digitally excluded or device-averse.

A model built around smartphones, passwords, and app notifications places the burden of participation on exactly the people who may struggle most.

If the NHS is serious about scaling remote care, it must be designed for those on the margins first, not as an afterthought.

From device management to simple data flows

To achieve this, this means shifting the centre of gravity from device management to simple, reliable data flows.

Instead of expecting patients to juggle wearables and app interfaces, remote monitoring should be anchored in non-intrusive sensors and seamless integrations.

Discreet intelligent activity sensors in key rooms, for instance, can quietly build a picture of daily routines e.g. how often someone is in the kitchen, whether they’re getting up at night more than usual, or if there’s been an unusual period of inactivity.

This information can then flow automatically into the systems that community teams already use, and surface through the NHS App where appropriate, without requiring the person at home to tap, swipe, or charge another device.

People need to know exactly what is being monitored, why, and who will see the data. They need certainty that their information is not being monetised, sold on, or used for purposes beyond their care

Open, interoperable infrastructure is essential so that data can move effortlessly between the NHS App, primary care records, digital social care records, community teams, and home support providers.

When the underlying system works, clinicians and carers see meaningful insights in the tools they already use, rather than logging into yet another dashboard.

And, for patients, remote monitoring becomes something that helps them to live independently, and keeps their loved ones in the loop, not just giving them another task to stay on top of.

Ethical, explainable monitoring beyond ‘red alerts’

As this infrastructure evolves, trust remains non-negotiable.

This public trust hinges on clear consent, clear purpose, and clear boundaries.

People need to know exactly what is being monitored, why, and who will see the data. They need certainty that their information is not being monetised, sold on, or used for purposes beyond their care.

This is particularly essential with the use of AI.

Transparent AI is also critical if activity data is used to generate risk scores or alerts, clinicians must be able to understand and explain how those judgements are made, and patients must be able to challenge or opt out.

Equally important is moving beyond the binary model of remote care built solely around ‘red alerts’.

This system continually flags single abnormalities e.g. one skipped meal or one disturbed night, which risks overwhelming staff, fuelling alert fatigue and eroding confidence.

A small network of unobtrusive sensors can provide reassurance to clinicians, care workers and families, while the person continues their routines uninterrupted

Intelligent activity monitoring should prioritise pattern recognition over one-off events e.g. changes in sleep over days and weeks, gradual reductions in mobility, or shifts in bathroom and kitchen use that signal emerging frailty or infection.

This more-comprehensive picture allows teams to intervene earlier and more accurately, adjusting medications, arranging visits, or involving family before crisis trips into hospitalisation.

Inclusion and the quiet infrastructure of care

Designing products for inclusion means building on what can be referred to as the ‘quiet infrastructure of care’.

Intelligent, discreet activity monitoring can support people who can’t, or won’t, self report, without demanding that they become expert app users.

For someone living with dementia, for example, asking them to fill in a symptom tracker every morning may be unrealistic, and potentially distressing.

A small network of unobtrusive sensors can instead provide reassurance to clinicians, care workers and families, while the person continues their routines uninterrupted.

Done sensitively, this approach also helps to avoid stigma, with technology supporting independence in the background, rather than labelling someone as ‘at risk’ in their own home.

For frontline staff, quiet infrastructure is about removing friction.

Open, adaptable systems mean that community nurses, social workers, and GPs receive timely, contextual information within familiar workflows, not in isolation.

They can focus on the decisions, conversations, and relationships that only humans can provide, rather than on the tech.

Remote monitoring then becomes a force multiplier for professional judgement, not a parallel universe of data that nobody has time to interpret.

The NHS now has a massive opportunity.

Open, adaptable systems mean that community nurses, social workers, and GPs receive timely, contextual information within familiar workflows, not in isolation

By expanding remote monitoring through the NHS App while investing in simple, non-intrusive sensors, open standards, and transparent AI, it can create a model of remote care that is intelligent, integrated, and above all inclusive.

This process will require clear governance, strong partnerships with specialist providers, and relentless focus on ethics and usability.

But the benefits are significant, with the opportunity to provide a health system where support extends into the home quietly and continuously, and where the benefits of digital innovation are felt most by those who have been historically the hardest to reach.