Digital Health Inequality Pioneers
COVID-19 has led to a more rapid digital transformation of health and care services. The unintended consequence is the widening of the divide between people who are online and those excluded from digital and digitalised services. We have reached a fork in the road, a choice between a tiered or an inclusive digitally transformed health and care service. We choose the latter!
Our exciting new Digital Health Inequality Pioneers project will focus on supporting Integrated Care Systems across the country to take an Inclusive Digital Transformation approach, co-designing services for everyone not just the majority.
We have been commissioned by NHSX and NHS England and Improvement to be part of this project which is one part of a wider 6.5 million pound investment being made to improve access within digital care pathways and virtual treatment, and to improve the processes behind them by way of digital inclusion.
“Digital exclusion is yet another manifestation of the profound inequality which casts its shadow over the UK.”
In this video our senior creative designer Tim Brazier discusses our involvement in the project. To watch with captions, click on the ‘CC’ button.
The ICS Projects
Our team and network of associate experts will be providing support to 10 Integrated Care System (ICS) projects to prepare them for tackling digital health inequalities. The ICSs have presented ideas for how they will make their chosen clinical pathway more accessible to those who are currently excluded; their projects will be one of the stepping stones to an inclusive tomorrow and we’re thrilled to be on that journey with them.
You can click on each heading to find out more about the project.
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Cambridgeshire and Peterborough ICS, in partnership with local maternity and neonatal system digital midwives, plan to identify what the main barriers and blockers are to accessing digital services within the maternity pathway. Results from this will be used to inform suitable localised action required to help improve and address these blockers. The project will also look at how accessing digital services is influenced by deprivation and by patient ethnicity.
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Suffolk and North East Essex ICS, in partnership with Healthwatch Essex and Suffolk, plan to identify the digital needs of patients identified as being suitable for at-home monitoring or other digital care devices. For example the BP at home project where patients wear a monitoring device for a short period of time. Outcomes of the analysis will be used to directly tailor the at-home health care to increase participation in the most deprived communities and mitigate digital exclusion.
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North West London ICS and CCG are undertaking a comprehensive review on patients receiving or needing community or mental health treatment to understand the scale of digital exclusion across North West London. This will involve mapping exercises, literature reviews of existing best practice, focus groups with those who are currently digitally excluded and research exercises to produce a strategy, and action plan to address the gaps, and ensure equitability.
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Central North West London ICS, in partnership with VCSE Mental health alliance, will commission a comprehensive independent review of digital inequalities within their community for patients with severe mental illness. The outcome will be a research report detailing local understanding, a gap analysis and recommendations on how to mitigate digital exclusion. The requirements of that report will be agreed across all partners and will ensure co creation.
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South West London Health and Care Partnership (SWL ICS) has implemented a digital solution for self management within MSK patients in the form of an app. Since release there has been a cohort of MSK patients who have not taken up the use of the app and SWL are undertaking a project to understand the reasons behind this. They want to undertake research to understand the barriers and co-design solutions to help identify and close digital divide gaps. Alongside this SWL will also develop a digital exclusion assessment to use for any new patient facing digital solutions.
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Derby and Derbyshire CCG, in partnership with Florence Nightingale Community Hospital, are implementing a local photography service to support their current Dermatology pathway. Patients who do not have access to digital means to provide initial images or would benefit from a dermatoscope image are able to access this service within a community setting. The pilot may also extend to a mobile service for those who are unable to or find it hard to leave their homes.
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Surrey Heartlands ICS in partnership with Surrey Heartlands CCG, will be commissioning an external contractor to undertake an extensive digital inclusion gap analysis to understand how prospective parents in their most deprived and digitally excluded areas could have better access to services and information. This will include user research primarily aimed at asylum seekers and their families.
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Surrey Heartlands ICS, in partnership with the mental health board, plan to develop and implement a digital inclusion plan for patients who are accessing the Early Intervention in Psychosis (EIIP) service in East Surrey who may be at risk of digital exclusion and not benefitting from digital tools. They will work with a number of stakeholders already working on the inclusion and diversity agenda and will share learnings to support in all projects across the ICS having a digital inclusion plan.
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Bristol, North Somerset, South Gloucestershire (BNSSG) CCG, Healthier Together plans to research, review and address digital inclusion across two of their pathways: cancer and MSK. The MSK pathway already has digital tools embedded and BNSSG wants to understand what the barriers are to those not utilising these tools and create an action plan to address these. The cancer pathway is due to have digital tools embedded and BNSSG wants to look upfront at which cohorts might experience digital exclusion and create an action plan to address this.
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Devon ICS in partnership with Devon CCG plans to undertake user research and a gap analysis to understand the digital barriers faced by patients who live in rural communities. This approach will use virtual consultations and research to understand how patients feel, what support there is and what good looks like to produce a digital exclusion strategy.
“Digital transformation is a core element to enable the NHS to meet the rising demand, costs and expectations it faces. With this shift to more digitally enabled healthcare we must ensure that all service users feel these benefits and are included in these transformations, not excluded.
These 10 ICSs are leading the way to investigate the impact of digital transformations on users and create tangible, shareable actions on how to plan for digital inclusion from the beginning.”
How we’ll support the projects
Thrive by Design will help nurture, test and evolve these ideas and provide tailored coaching to improve the skills of the ICSs on a range of topics, including but not limited to: co-design, data collection & analysis, digital inclusion and strategy.
To kick off the project, we’ve designed a Self Assessment for each ICS to complete as a way of reflecting on their current capacity and capability to deliver inclusive digital transformation. We’ll be using the information and evidence each ICS provide as part of their Self Assessment to design a tailored learning programme that we’ll deliver over the next five months. The learning programme will be a combination of group sessions and individual coaching.
We’ll be working with our wider network of expert associates – the ‘Inclusive Digital Transformation Collective’ to match each ICS with coaches who have the knowledge and skills they need.
Throughout the project we will be posting our shared learnings through blogs and our social media channels, we’ll also share blogs from our commissioners and the ICSs involved for a 360-perspective.
We would appreciate you taking the time to answer one quick question which is “for me, Inclusive Digital Transformation means…” you can submit answers here.
Further resources
Discovering Inclusive Digital Transformation
NHSX Transforming Care Pathways blog.
NHSX Adoption Fund.
FutureNHS Inclusive Digital Transformation Challenge workspace