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How to avoid the digital exclusion of patients

Pritesh Mistry digital exclusion
By Pritesh Mistry Digital Technology Fellow at The King's Fund
3 April 2023

Digital technology has an important role to play in a modern healthcare system. Patients and the public agree with this – but they also expect choice and services that are designed to meet their needs. However, The King’s Fund research shows these expectations are rarely met. 

We found that members of the public feel they are offered only digital routes to health care. Moreover, digital services are often designed with a ‘one size fits all’ mentality, and there is inconsistency from provider to provider.

The result is that patients feel excluded and frustrated. Sometimes, it leads to people avoiding healthcare services altogether until their situation becomes too severe for this to be an option. 

Why digital exclusion happens

People can be digitally excluded for a number of reasons. These include a lack of access to devices, insufficient internet data and low digital skills and confidence. Another obstacle could be poorly designed technology and services.  In addition, there may be no privacy at home, making it harder for patients to engage with services.

It is also important to remember that digital exclusion is not static. Individuals can become digitally excluded as their health and personal circumstances change. 

Integrated Care Systems’ (ICS) role in facilitating and supporting collaborative working means they should develop ways for staff and senior leaders to work locally with communities and organisations to improve digital inclusion. There are three areas to prioritise and act upon. 

Firstly, ensuring people have devices, internet data and support in developing skills to be online confidently. Building partnerships with local tech suppliers and charities is an excellent way to source devices and data for excluded people. For example, collaborating with voluntary and community organisations helps to identify digitally excluded people and provide them with devices and data.

Collaboration to address digital exclusion

Voluntary organisations are also well placed to support digitally excluded people to develop the skills and confidence to be online. Devices, data and skills must go together – if any of these elements are missing, the device is just an expensive paperweight.

The second priority area is working with communities to co-develop services and technologies. Patients expect to have a choice in how they access services. So, digital-only services should be complemented with traditional no-tech and low-tech options that use public digital access points in libraries, GP practices and pharmacists.

One size does not fit all, and offering patients a choice of digital services and tools can improve digital inclusion. NHS and social care organisations working alongside local authorities, charities and voluntary organisations can co-develop services and digital tools with communities to ensure they are inclusive. 

National support needed

The third priority is building upon the partnerships across NHS, social care, local authorities and voluntary organisations to form hubs to share and apply best practice. These collaboration hubs can capture what’s working, providing insights into the needs of different communities. Forming collaboration hubs helps share good practice and use the expertise to continue improving the quality of services and consistency across providers.

National changes must support partnerships and local working as they undertake these three improvements. For example, ICSs require resources and support to build the capability, capacity and partnerships to create hubs of collaboration to improve digital inclusion. In addition, national bodies should encourage physical and low-tech alternatives to complement digital-first or digital-only services.

The combination of national changes with ICSs’ work to build and grow partnerships can significantly improve the digital inclusivity of healthcare services. This is essential to create a more inclusive modern NHS and social care.

Pritesh Mistry is Fellow (Digital Technology) at The King’s Fund.

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