Digital Health and care

The Suffolk and North East Essex ICS commissioned Healthwatch Suffolk and Healthwatch Essex to complete research with local communities to understand how people have felt about these changes. This report outlines the findings of the research conducted by Healthwatch Suffolk. They devised surveys for the public and healthcare professionals to understand their experiences. This was followed up by conversations with people.

Participants highlighted that digital and remote access had kept health and care services open during the pandemic, in a safe way. Participants also said that digital services could be effective for routine care, follow-up and triage, as well as for administrative functions like booking appointments or accessing health records. Finally, some participants acknowledged the benefits of not having to travel to appointments.

Most health, care and VCSE professionals consider that digital services are effective, although around a third did not agree with this statement. In their qualitative responses, many professionals noted the service benefits of digital care delivery. This included that staff are more productive and that they can treat and support more people. Staff have also commented that digital provision has enabled them to continue to offer safe support in spite of pandemic restrictions and lockdowns.

Alongside the benefits, this research identified many examples where people have been unable to access digital care because they are excluded to some extent. It was common for carers, family members, friends and VCSE professionals to report these experiences on behalf of individuals, however, experiences from people who have little or no digital skills or access, were also captured in both phase one and two of this research. Common reasons for digital exclusion included:

• Not having access to digital technology
• Lacking the necessary skills or confidence to use digital
• Not wanting to use digital technology to access health and care
• Having health or accessibility needs that make digital access difficult or not possible
• Security and trust

Investment in digital inclusion initiatives will help but is unlikely to fully address some of the issues people have described in this research.

Equipment, and access to the right technology, has also been an important consideration for professionals who responded to the phase one survey. Some felt their ability to provide effective care had been limited by the quality and availability of appropriate tools and also inadequate digital infrastructure (e.g. connectivity when working remotely in rural areas). This included systems becoming frozen mid-appointment, down time on servers and connection, and insufficient laptops (with web cam functionality) to meet the demand for video-based services. The current significant variations in systems, websites and approaches are unhelpful to those seeking to learn how to make the most of digital care (this applies to both users of services and those providing care).

Healthwatch Suffolk's 'Guiding Principles'

The detailed findings, coupled with separate co-production online workshops, led to the development of a set of 'Guiding Principles'. They aim to ensure that service providers and commissioners account for the needs of patients and carers when thinking about service design, and digital service design in particular. They are a collection of suggestions from people about the things that must be considered in order to avoid inequality from digital exclusion.

The principles are designed to be incorporated into local NHS and social care plans and strategies, but they also serve as a general reminder about how we must approach service design in the future if we are to ensure that nobody is excluded from care and support. This poster is a quick reference tool that explores the main factors covered by the principles, including:

• Make it a choice
• Keep things accessible
• Signpost for inclusion
• Right tool for the right occasion
• Communicate change
• Simple websites
• Support carers
• Have help on hand
• Security
• Personalise care
• Co-production