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In this episode of Up, Up & Away, host Dom Burch is joined by Naomi Watt, from Asthma + Lung UK, for a wide-ranging conversation about behaviour, motivation, and what it really takes to design digital health tools that people actually use.

Naomi reflects on her early career as a respiratory nurse — from reading X-rays on lightboxes to working in A&E, general practice and helplines — and how her passion for learning helped her absorb knowledge almost by osmosis. But she also shares a pivotal realisation: just because she cared deeply about respiratory health didn’t mean everyone else did, or could, in the same way.

That insight became central to her later work. Post-COVID, Asthma + Lung UK recognised that healthcare professionals themselves were a missing link in improving care for people with lung conditions. Clinicians were coming from a huge range of backgrounds — GPs, paramedics, pharmacists, practice nurses — with very different levels of confidence, knowledge and support, often working in isolation within a stretched NHS.

This led Naomi to design the Health Professionals Hub: a dedicated digital portal built not around information overload, but around how people feel when they go looking for help. Drawing on self-determination theory, she explains how autonomy, competence and relatedness underpin engagement — particularly when healthcare professionals are dealing with imposter syndrome or uncertainty.

Naomi introduces the memorable idea of three “knowledge moments” — the “oh no”, “oh” and “ah” moments — and how designing for psychological safety, accessibility and plain English can turn panic into curiosity. She shares practical examples of how small, thoughtful tools can lead to meaningful changes in clinical practice and patient outcomes.

The conversation then widens to young people with long-term conditions, exploring why digital health tools must reflect real life rather than neat clinical silos — and why collaboration matters more than duplication. Naomi makes a powerful case for charities, the NHS and technology partners working together, sharing trusted expertise so it can travel further and reach people in the moments that matter.

This episode is not about an app. It’s about empathy, behaviour, and what it means to design healthcare systems that help people feel capable, connected and supported.

Topics covered

• Naomi’s journey from frontline clinician to system-level designer
• Why healthcare professionals were the “missing link” post-COVID
• Designing for motivation, not just information
• Self-determination theory: autonomy, competence and belonging
• Psychological safety and tackling imposter syndrome
• Why collaboration beats duplication in digital health
• Supporting young people with long-term conditions in the real world

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In this episode of Up, Up and Away, Dom Burch speaks with Bethan Almeida, a senior nurse in Brent Health Matters, about childhood asthma, health inequalities, and what effective, community-led healthcare looks like in practice.

Bethan leads the children’s asthma workstream in one of the UK’s most diverse boroughs, where 149 languages are spoken and many families face barriers around health literacy, income, housing, and access to care. Her role bridges clinical care, public health, and system improvement, with a focus on preventing avoidable asthma harm.

Bethan explains how traditional healthcare pathways often disadvantage families who lack time, money, or confidence to navigate complex systems. Too many children reach specialist care far later than necessary, when much of the harm could have been prevented earlier in the community.

A key insight is that clinicians are not always the most trusted messengers. Families may say everything is fine in appointments, but share the reality with people they already trust — sports coaches, faith leaders, or community organisers. These individuals often have regular contact with families and the time to spot issues early and offer practical support.

Brent’s progress has been enabled by genuine NHS–council collaboration, using existing public health networks rather than building relationships from scratch. This has helped shift care from reactive to proactive — bringing services to families rather than waiting for crises.

One of the most powerful themes is what Bethan calls “compassionate discrimination”. Well-meaning professionals sometimes withhold full advice — for example about reducing dust mites or improving ventilation — because they assume families can’t afford to act on it. While compassionate, this lowers the bar of information and deepens inequality. Bethan argues that everyone deserves the same information, with extra support provided to help those who need it act on that advice.

The team also moved away from standard leaflets after communities said they were inaccessible. Instead, they co-designed simple, visual, multimedia resources that people actually use.

A standout innovation is the Asthma Community Coaches programme — trained local volunteers who support families, challenge myths, make referrals into clinical pathways, and feed real-world insight back into the system. To date, 58 volunteers have completed the programme.

As a result of this work, Brent now has local asthma diagnosis, high-risk clinics, and sustainable pathways that will continue beyond individual staff members.

The episode reinforces a simple but powerful message: people don’t need less information — they need better translation, better support, and genuine partnership.

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In this episode of Up, Up and Away, Dom talks to Matt Bourne, CTO at Tiny Medical Apps, about the company’s remarkable eight-year journey to integrating NHS Login into the Digital Health Passport (DHP) — a major milestone in connecting young people with long-term conditions directly to the NHS.

What sounds like a technical integration is, in reality, the culmination of years of persistence, setbacks, and breakthroughs. Matt shares how TMA began as a small team building multiple patient-facing apps, before realising that regulatory complexity made that model unsustainable — and why creating one trusted, NHS-connected platform became the way forward.

From the early days of hackathons to navigating reorganisations, changing sponsors, and evolving NHS standards, this is a behind-the-scenes look at what it really takes to deliver digital innovation within the health system.

💡 In this episode, Matt shares:

• How Tiny Medical Apps became one of the first SMEs to be offered NHS Login access — and what being an early adopter really meant.
• Why medication adherence became the company’s north star after coroner reports revealed most asthma deaths in young people were preventable.
• How NHS Login transforms the DHP, allowing patients to securely access care plans, reorder medication, and build trusted connections with their GP records.
• What the integration process actually involves — from hazard logs and sandbox testing to balancing safety with accessibility for teenage users.
• How behaviour change theory (COM-B) underpins the app’s design, combining nudges, reminders, and gamified learning to improve long-term health outcomes.
• Why TMA partners with charities like Asthma + Lung UK and Epilepsy charities to deliver clinically accurate content at scale, instead of building it themselves.
• How TikTok and social platforms have helped them reach and engage young people who are often considered “hard to reach” by traditional health services.

🧠 Key Takeaway

🚀 Why This Matters

This episode is a powerful reminder that health innovation takes time, collaboration, and resilience.
TMA’s journey shows how small companies can play a big role in transforming patient care — proving that persistence and open standards can open doors that once felt closed.

For young people managing asthma, epilepsy, sickle cell, or other long-term conditions, NHS Login is more than a sign-in screen. It’s a step toward independence, better medication adherence, and fewer preventable emergencies.