Health inequalities and digital exclusion

The Health Foundation’s COVID-19 impact inquiry is essential reading to inform the UK’s recovery and ensure everyone can enjoy good health. In our briefing paper to support the inquiry, ‘Digital exclusion and health inequalities’, we made the case for collaboration, more leadership from Government, and better understanding of how digital technologies shape health access, equity, and outcomes for different groups.

In June, Healthwatch England set out five principles for post-COVID digital healthcare:

• Maintain traditional models of care alongside remote methods and support people to choose the most appropriate appointment type to meet their needs. 
• Invest in support programmes to give as many people as possible the skills to access remote care.
• Clarify patients’ rights regarding remote care, ensuring people with support or access needs are not disadvantaged when accessing care remotely. 
• Enable practices to be proactive about inclusion by recording people’s support needs.
• Commit to digital inclusion by treating the internet as a universal right.

These are excellent principles. I also believe the relationship between digital exclusion and health inequalities goes wider than these. In our ‘lessons learned’ report on digital inclusion in health and care, we said that digital access and skills need to be recognised as wider determinants of health. They are essential for education, employment and social participation as well as for accessing government and health services. 

Through the pandemic, we have seen more use of digital health, like virtual consultations and online patient information. Many of us have benefited from improved control and convenience. However, the pace of change and imperatives of the pandemic have meant many of these changes happened without sufficient patient and public participation, as National Voices highlights. Only an inclusive approach to digital transformation can help achieve better health outcomes for all, and realise the potential for technologies to reduce health inequalities in poorly served communities.

To get there, we must ensure everyone has the digital access, skills and confidence they need (for example, approaches like community digital health hubs). This requires leadership and coordinated action from Government, backed by cross-sector collaboration at all levels – local, regional and national. There are still critical gaps that must be addressed to lessen the impact of digital exclusion on health and wider inequalities. It is still worryingly unclear whose responsibility it is to ensure everyone has the access, skills, and confidence they need to benefit from digital for their health.

At Good Things Foundation, we’ve now got an opportunity to help drive this change in policy and practice – as a new member of the Health and Wellbeing Alliance in England. This Alliance brings together voluntary sector organisations which represent communities experiencing health inequalities to work with the Department of Health and Social Care, Public Health England and NHS England and NHS Improvement. So, watch this space… and meanwhile, take a look at our briefing paper on digital exclusion and health inequalities.

An earlier version of this article was published on 10 August 2021 on Digitalhealth.net.