Digital exclusion and access to health services

Healthwatch Lewisham wanted to engage with people who are more likely to be digitally excluded and gain a better understanding of how this might impact their experience with health and care services. They focused on primary care as this is the first point of contact for people accessing services. They partnered with North Lewisham Primary Care Network (NLPCN), who have a shared interest in using patient experience to improve the offer and health of the community they serve. They carried out interviews with 45 residents as part of the project, including older people, people with English as their second language, and people with disabilities.

They found that access to health and social care were mixed. Some people found remote GP consultations to be beneficial and were understanding of the need to shift to these digital care methods whilst the pandemic spread rapidly. Others were unhappy with the quality of care and treatment received using remote consultations and didn’t feel confident with the diagnosis and/or the treatment plan. Both groups advocated for a return to face-to-face appointments

Many participants were disappointed with the level of service received, especially when it came to administration. Numerous participants highlighted the challenges they faced when trying to get through on the telephone. Waiting times for appointments were undesirable with some people not being able to receive appointments for over two weeks, which echoes similar experiences prior to the pandemic.

Some residents experienced multiple barriers when trying to access health care support (affordability, lack of IT skills, and language barriers) which caused high levels of stress and anxiety. Primary Care professionals they engaged with as part of this project discussed the benefits of remote care but also acknowledged that a shift to remote consultations risked excluding a significant proportion of service users from health and social care services.

 As the NHS supports primary care to move towards a digital first approach it is essential that the needs of digitally excluded residents are embedded within delivery plans. There is the danger that the drive for greater digital access leaves behind those who are unable to engage with technology and therefore deepens existing health inequalities.

Most participants would prefer face-to-face appointments as they value them more than the digital approach. Services must ensure that they deliver a hybrid approach of in-person and remote consultations which meets the needs of the local population and which takes account of their access needs.