How we helped the NHS Couch to 5K app reach more people across the UK

Over the last 10 years, NHS Couch to 5K has become one of the UK’s most widely used public health apps - supporting more than eight million downloads and over one billion minutes of movement.

What’s just as important as that scale is how the service has evolved. DHSC has continued to invest in making NHS Couch to 5K more inclusive and usable - thinking carefully about how the experience can work for more people.

That includes people who experience the app in different ways depending on their needs - including disabled users, people with hearing loss, and those who rely on assistive technologies or alternative ways of interacting with the app.

Our work has been part of that ongoing evolution, supporting DHSC over a number of years as the app has continuously improved, helping them understand how updates perform in practice and what that means for the people using it day to day. 

A service that keeps evolving

Rather than a one-off piece of work, this has been a steady process of supporting change as it happens - reflecting how accessibility work becomes part of ongoing product delivery over time.

Each update to the app brings new considerations, and our focus has been on helping surface how those changes behave in practice - particularly from an accessibility perspective.

A big part of this has been regular WCAG audits and accessibility testing. Each time new features are introduced, we look at how the experience performs for people using assistive technologies or different ways of interacting with their device. This runs alongside development, so accessibility is part of the conversation as the product evolves, not something reviewed afterwards.

We’ve also supported other types of testing across the app - including functional testing, user acceptance testing (UAT), and penetration testing - but accessibility has remained the consistent thread throughout.

Bringing in real user perspectives

Working with DHSC and specialist partners, including RNID and Purple Goat, we’ve also brought in lived experience.

These sessions - including people with hearing loss and wheelchair users - help ground decisions in real use and highlight how accessibility changes depending on how people experience digital services. They also show where the app works well, but also where small barriers can appear that aren’t always visible through testing alone.

It helps shift the focus from assumptions about accessibility to how people experience the service in their day-to-day lives.

When accessibility shows up at features

As the service has evolved, new features have been introduced to improve the experience for more users.

One example is haptic feedback.

Developed by DHSC as part of wider accessibility improvements, it adds vibration cues alongside audio and visual guidance, so people have another way to follow their sessions.

Our role was to test how this worked across different devices and situations, making sure behaviour was consistent before release. For some users, it simply makes the experience easier to follow in real-world conditions where audio alone isn’t enough - a small change that improves how the app can be used in practice.

Working on something that builds over time

NHS Couch to 5K is a good example of what steady, long-term accessibility work looks like in practice.

Over time, the combination of WCAG audits, testing and user research has helped shape a service that works better for more people. Not through one big change, but through many small improvements that build on each other as the app evolves.

What’s stayed consistent is the intent: making sure changes are informed by real use, so the experience improves in ways that genuinely matter to the people using it.

And that’s really the thread through all of this. Accessibility isn’t something you finish - it’s something that sits alongside change, shaped by real use and real feedback, and reflected in how services evolve over time.

About Zoonou

Zoonou is a UK-based digital QA and accessibility company. Our Accessibility Team work closely with clients to make accessibility part of everyday delivery - supporting teams to create inclusive digital experiences that work for real users.