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Digital exclusion – bridging the gap

Savannah Fishel

Ahead of the digital exclusion day of our conference (Tues 16 Mar), National Voices Policy and Engagement Officer Savannah Fishel says the issue of digital exclusion goes far beyond trying to maintain contact with patients during the height of a pandemic, and cuts to the core of deepening health inequality More information, and how to register for our conference

  • How Can We Dismantle Health Inequity Together?
  • Digital health and care
  • Health inequalities
  • COVID-19

COVID-19 necessitated a seismic shift towards remote healthcare, leaving behind people who lack the confidence, skill-set or resources to enter the ‘digital front door’ of the NHS’.

But the issue of digital exclusion goes far beyond trying to maintain contact with patients during the height of a pandemic, and cuts to the core of deepening health inequality. On day three of National Voices’ Conference, ‘How Can We Dismantle Health Inequity Together?’ we will focus on digital exclusion. Expert by experience Hameed Khan will be joined by Emma Stone and James Watson-O’Neill, CEOs of The Good Things Foundation and SignHealth respectively.

The ‘digital divide’ is no clear-cut partition between those who are and are not computer literate. It is better understood as the long chain of factors required for digital engagement, such as resources, connection, motivation, confidence and skills. Any weak link risks breaking the chain and inhibiting access altogether.

Perhaps a person lacks the resources to purchase a device or a broadband plan; or has a smartphone, but struggles to use it due a visual impairment; or is deterred by stories of scams and data-mining on the news, having lived their entire life without internet. True digital inclusion means tackling each of these barriers and more. It requires understanding individuals and communities, considering the complex web of social and environmental factors that work together to determine whether people can access virtual care, such as poverty, safety concerns or disability.

Simply being told that you should be online is not a motivator. As the health and care sector, we must facilitate positive conversations about digital opportunities and build trusted relationships, supporting both staff and patients throughout transitions. We must remain vigilant if new services or ‘solutions’ fail to meet accessibility requirements, they risk exacerbating inequity. We must involve diverse patient voices at every design stage and consistently chase and implement feedback, understanding that the codesign process is non-linear.

On day three of our conference (March 16th) we’ll hear from James Watson-O’Neill (session one, 9.30am), who created the 24/7 interpreter service BSL Health Access in the first wave of the pandemic, and from the Patient Information Forum (13.00) on their work with Connected Nottinghamshire to make the NHS App more user-friendly.

Over the past year, local and national charities have innovated in ingenious ways, forced to move predominantly online with little warning. As part of our NHS-funded project on digital exclusion, we are developing principles for inclusion, we have been interviewing voluntary sector organisations to spotlight inclusive innovations, and we will be co-producing solutions, so do email me to get involved.

At 14.15 on March 16th, three of National Voices’ members will consider The Human Within The Digital, discussing the use of digital tools to increase patient engagement and harness the power of ethical and non-extractive storytelling in policy influencing. Compassion in Dying, Macmillan and Future Care Capital will share various experiences of using digital tools, such as recording end-of-life plans, authentic storytelling to engage policymakers, facilitating peer partnerships to build trust within communities, and using fictitious narratives to spark thinking about near-future issues in health and care. We will discuss advantages, as well as challenges of digital engagement, and potential solutions.

Clearly, digitisation presents the healthcare sector with a world of opportunities, but these transitions are engulfed in risk. As we evolve digitally as a sector and as a nation, communication, co-design and building trusted relationships within communities remains pivotal, because only through genuine inclusion can we tackle health inequity.

More information, and how to register for our conference.


Savannah Fishel is Policy and Engagement Officer at National Voices.