Inclusive Digital Transformation: what you need to know
Knowledge into Action Briefing
“Inclusive digital transformation is very complex and the success of it is often based on nuances within how questions are asked and how that is communicated to patients and staff. There is no one size fits all approach with this work and something that will be ever continuing and evolving and underpinning both digital and non digital implementations”
Integrated Care System respondent to Thrive by Design Survey 2021
About this briefing
Inclusive digital transformation is in the early developmental stages in most parts of the NHS. Language, policy and practice is still emergent. There is growing interest and approaches are being tested and developed by pioneers.
This briefing is to share Thrive by Design’s thought leadership on inclusive digital transformation and learning on ‘what good looks like’ for practice and policy.
The insights will support people at national, system and local level to embed inclusive digital transformation into ‘how we do things’ around here.
Work by Thrive by Design which underpins this briefing:
Supporting NHS Trusts and Integrated Care Systems e.g. mapping needs work with Connected Nottingham and Cheshire and Merseyside ICS and inclusive digital transformation approach for Norfolk and Waveney ICS and Leeds and York Partnership NHS Foundation Trust.
Mapping work on digital inclusion for NHSX.
Facilitating the ‘Digital Health Inequality Pioneers’ programme for NHS England and Improvement to support ICSs to advance leading work.
Co-designing a digital skills guide for the NHS Confederation Mental Health Network.
Co-design work for Professor Trish Greenhalgh and team on what inclusive remote video consultation looks like.
Exploring ways in which to enable a more Inclusive Digital Transformation approach to mental health services at a local, regional and national level for NHS England and Improvement.
The issue
Inclusive digital transformation is an approach developed by Thrive by Design in recognition that digital exclusion is a complex system issue not an individual problem and that to tackle it health and care systems need to go beyond digital inclusion interventions.
Definitions
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Broadly defined, digital exclusion is where a section of the population have continuing unequal access and capacity to use Information and Communications Technologies (ICT) that are essential to fully participate in society. It is the result of an inequitable society and is a complex, dynamic and multi-layered system issue. Factors and barriers include life context, e.g. income, age, health conditions, and precarious life circumstances, digital access, skills, confidence and motivation, trust and concerns related to security and privacy and system side issues such as staff access, skills, confidence and motivation and poor infrastructure.
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Digital inclusion is the interventions designed to support people who are not able to use digitally-enabled services and tools. The Government Digital Service defined digital inclusion as making sure that people have the capability to use the internet to do things that benefit them day to day. The NHS Digital ‘Digital Inclusion Guide’ states that digital inclusion includes; digital skills, connectivity and accessibility.
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Inclusive digital transformation is a flexible and customisable approach developed by Thrive by Design following a co-design discovery process with many different partners across the English health and care system. It recognises that digital exclusion is a complex system issue and aims to build greater digital equity into the system in a way that is meaningful to the local context.
This means focusing on co-designing inclusion into digital transformation as far upstream as possible with people at risk of digital exclusion and other stakeholders.
It involves cross-sector and collaborative leadership developing a shared strategy based on an understanding of local needs and assets.
It recognises the importance of person-centred wraparound support and access to accessible technology and the internet, both for people who use and deliver services.
This approach recognises poverty is often a primary root issue and advocates a systemic approach to tackling digital and data poverty.
Improving practice and policy
To help improve practice, based on two years of research and practical co-design activities, Thrive by Design has produced a canvas which describes the factors which need to be in place to achieve good inclusive digital transformation.
This can be used as a mechanism through which ICSs and others can self assess, track and review progress towards inclusive digital transformation in a way that is flexible and meaningful to the local context.
Inclusive Digital Transformation Canvas - for things to consider around putting each of these factors into practice read the full briefing.
To encourage and support progress, Thrive by Design recommends national policy makers and organisations:
Provide clear policy direction and guidance, including strengthening inclusive digital transformation within the health inequalities agenda
Improve long term revenue funding models
Build local leadership understanding and buy-in
Strengthen initiatives on developing a digitally ready workforce
Improve public awareness, trust and understanding in digital approaches
Support better evaluation methods
Address deficits in access to local and national data on those digitally excluded.
Examples of good practice
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Get Nottinghamshire Connected is a digital and social inclusion project working across Nottingham and Nottinghamshire to support the most excluded people across the city and county gain the essential skills and confidence they need to start using technology, and get connected.
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Norfolk and Waveney Health and Care Partnership have developed a cross sector partnership approach which has mapped needs and assets, carried out user research, tested and evaluated a pilot device lending programmes and are running learning and co-design programmes as the foundation for an inclusive digital transformation strategic approach.
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Devon ICS is focused on increasing confidence, knowledge, support and skills with rural communities to help tackle digital and health inequalities. It has a cross sector partnership approach to undertaking 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.
Conclusion
Digital exclusion is a complex system issue and bringing about positive change might seem daunting. Therefore, start from where you are and start small. Whilst it is vital to take the time to understand the context and needs, it is also important to value existing strengths and assets and go where the energy is, set shared goals and take iterative steps in the right direction.
The golden thread is to put the voices of people for whom change matters most at the heart of the approach.
Join nearly 300 people from a diverse range of backgrounds and places on our Inclusive Digital Transformation Challenge community on FutureNHS.
To find out more about our work email us on info@thrivebydesign.org and follow us on Twitter @TweetsByThrive.