NHS, health equity, and digital inclusion

As the NHS launches a new vision for inclusive digital health, Dr Emma Stone, Director of Evidence and Engagement, writes about the importance of health equity and digital inclusion.

If you look on the horizon of our new Digital Nation 2023 – you’ll see an impressive statistic. There are now at least 30 million registered users of the NHS App. That is getting close to half the adult population. Compare that to only 2 million users at the start of 2021.

I’m an NHS App user. I use the internet to look up symptoms; order repeat prescriptions; listen to ‘just one thing’ tips for a healthier life. I’m not alone. In fact, nearly 8 in 10 internet users have used the internet to support their wellbeing in some way (Ofcom 2023).

I believe in health equity and the principle of health being free at the point of access. So it matters that the NHS recognises that not everyone can or wants to access health digitally; that digital approaches need to be designed for inclusion; and we still need to keep some doors and phonelines open. At the same time, I see and feel the pace of NHS digital transformation, and hear stories of frustration and fear. Digital technology can save lives, save money, improve patient outcomes, but only if design, delivery and uptake is inclusive and supported.

A vision for inclusive digital health – where digital and non-digital services are complementary – is set out in a new NHS paper: Inclusive Digital Healthcare: A framework for NHS action on digital inclusion. As members of the VCSE Health and Wellbeing Alliance, we informed the framework and supported engagement, including people who face digital, and wider, barriers to accessing NHS care.

This framework recognises that the NHS – alongside government, businesses, civil society, and other service providers – has a vital role and a share in responsibility for digital inclusion across five action-focused domains:

  • Access to devices and data, so that everyone can access digital healthcare if they choose to and experience the benefits
  • Accessibility and ease of using technology, so that user-centred digital content and products are co-designed and deliver excellent patient outcomes
  • Skills and capability, so that everyone has the skills to use digital approaches and health services respond to the capabilities of all
  • Beliefs and trust, so that people understand and feel confident using digital health approaches
  • Leadership and partnerships, so that digital inclusion efforts are co-ordinated and help to reduce health inequalities.

It also recognises that there already many pioneers in the NHS, acute and primary care who are driving a more inclusive approach – and that there are resources freely available to use such as Learn My Way, the National Databank and National Device Bank.

Tomorrow, Wednesday 11th October, I’ll be speaking at The King’s Fund’s Digital Health and Care Congress 2023. The timing and the panel couldn’t be better, as I’ll be alongside Jason Tutin and Ayisha Hameed from 100% Digital Leeds – a great example of what happens when you blend asset-based community development with cross-sector partnership in a place-based strategy for digital inclusion. They’re also one of the case studies in our new guide, Top tips: Supporting digital inclusion in general practice, and in the NHS framework for action. If you’re going, come and find us on Day 1 at 12.15pm!