Digital front door technologies to gather service user information for NHS Talking Therapies for anxiety and depression assessments: early value assessment

Health technology evaluation
Reference number: HTE30
Published: 24 July 2025

1 Recommendations

1.1

Two digital front door technologies can be used in the NHS during the evidence generation period as options to gather service user information for NHS Talking Therapies for anxiety and depression assessments in people 16 years and over. The technologies are:

Limbic Access
Wysa Digital Referral Assistant.

These technologies can only be used:
if the evidence outlined in the evidence generation plan for Limbic Access and Wysa Digital Referral Assistant is being generated
once they have appropriate regulatory approval including NHS England's Digital Technology Assessment Criteria (DTAC) approval.

1.2

The companies must confirm that agreements are in place to generate the evidence. They should contact NICE annually to confirm that evidence is being generated and analysed as planned. NICE may revise or withdraw the guidance if these conditions are not met.

1.3

At the end of the evidence generation period (3 years), the companies should submit the evidence to NICE in a format that can be used for decision making. NICE will review the evidence and assess if the technologies can be routinely adopted in the NHS.

What evidence generation is needed

More evidence needs to be generated on digital front door technologies, including:

the quality of the information collected
their impact on clinical decision making in clinical assessments for NHS Talking Therapies for anxiety and depression
their impact on administrative burden
time saved on collecting routine information
feedback from people using the service
costs including for training, promotion and digital safety assurance.

The evidence generation plan gives further information on the prioritised evidence gaps and outcomes, ongoing studies and potential real-world data sources. It includes how the evidence gaps could be resolved through real-world evidence studies.

What this means in practice

Limbic Access and Wysa Digital Referral Assistant can be used as an option in the NHS during the evidence generation period (3 years) and paid for using core NHS funding. During this time, more evidence will be collected to address any uncertainties. Companies are responsible for organising funding for evidence generation activities.

After this, NICE will review this guidance and the recommendations may change. Take this into account when negotiating the length of contracts and licence costs.

Potential benefits of use in the NHS with evidence generation

Access: Using digital front door technologies may improve the quality of clinical assessments for NHS Talking Therapies services. Healthcare professionals could use the time to have better quality face-to-face clinical assessments with service users about their presenting problems.
System benefit: These technologies could potentially reduce administrative burden by removing the need to manually copy and paste referral information to populate fields. Also, they could potentially reduce the time spent collecting routine information during clinical assessments.
Clinical benefit: Clinical evidence suggests that digital front door technologies may save time on collecting routine information. The evidence on clinical impact with these technologies is limited. But it suggests that they may improve outcomes and workflow. This, in turn, may result in a higher quality clinical assessment, leading to identifying the correct treatment pathway more accurately.
Resources: Any time saved would not be used to reduce face-to-face time spent with the person having the assessment. So, it would not result in more assessment appointments per healthcare professional. But it could increase the quality of assessments, with subsequent benefits.
Equality: Digital front door technologies may help reduce access barriers for some historically harder-to-reach populations.

Managing the risk of use in the NHS with evidence generation

Costs: The available data about any subsequent benefits is too uncertain to be able to quantify and offset them against the additional costs of the technologies themselves.
Information governance: Potential risks include confidentiality breaches or issues accessing or retrieving data. So, all service providers should ensure they have appropriate IT infrastructure and information governance protocols in place.
Service user outcomes: Digital front door technologies are not expected to directly affect service user outcomes. But they could potentially improve the quality of information collected and enhance the quality of face-to-fact clinical assessments in NHS Talking Therapies services. This could lead to better and more accurate treatment decisions and more effective care pathways. More feedback from people using digital front door technologies is needed on ease of access, usability, information clarity and relevance, comfort and privacy.
Equality: If NHS Talking Therapies services continue to provide multiple referral methods to access them, people attempting to access them are unlikely to be disadvantaged if digital front door technologies are introduced.

Why the committee made these recommendations

The evidence for Limbic Access and Wysa Digital Referral Assistant supports their use in gathering service user information for NHS Talking Therapies for anxiety and depression assessments while further evidence is generated.

The clinical evidence on time saved on collecting routine information and clinical impact with these technologies is limited, but suggests that they may improve outcomes and workflow. For example, any time saved on collecting routine information could reduce administrative burden. Also, it may be used to discuss presenting problems and objectives in more detail with the healthcare professional during the assessment. This may result in a higher-quality clinical assessment, leading to identifying the correct treatment pathway more accurately. These technologies may also improve access to NHS Talking Therapies for anxiety and depression. This is because some people may prefer to use digital technology to access care rather than traditional routes. The risk associated with using these technologies is low. But more evidence is needed on their clinical effectiveness.

Early results from the economic evidence suggest that the technologies could be cost effective, even if only a few minutes are saved on collecting routine information for each assessment. More evidence is needed on the cost implications of using these technologies.