Face to face with digital exclusion

14 September 2021

In a world whose digital dependence has been accelerated still further by COVID, we look at what’s being done to address the needs of those who risk being left on the wrong side of the digital bridge.

Why are we focusing on digital exclusion?

The changes forced by COVID on individuals, communities and health and care services have surfaced the scale and impact of digital exclusion and highlighted the urgency of taking further steps to address it. 

COVID has rapidly increased the number of people online, as well as the range of services which include a digital component within their delivery. It is estimated that, since 2020, 1.5 million more people in the UK have started to use the internet. A quarter of people use it to manage their mental health, and 37% use it to manage their physical health. This compares to 22% who used the internet to manage their physical or mental health only a year previously.

While we may be seeing an increase in internet usage as a result of COVID, this doesn’t mean that the digital divide is reducing. Digital exclusion has been one of the many long-standing inequalities that often go unchallenged by society as a whole – it’s believed that around 19% of the South East’s population do not possess essential digital skills for life and that 11% of people could be classed as digitally disengaged.

It was to help address these skills and engagement gaps that Digital Skills Partnerships (DSPs) were established in 2018. DSPs are funded by the Department for Digital, Culture, Media and Sport (DCMS) and managed by their relevant Local Enterprise Partnership (LEP) or Combined Authority (CA). The South East Digital Skills Partnership (DSP), hosted by the South East LEP, is one of seven such partnerships across England and was launched in 2019.

The South East DSP has identified five digital skills priorities in the region: 

  1. Preventing residents becoming increasingly digitally-excluded
  2. Support to SMEs and charities to help them to improve their digital awareness and capability
  3. Ensuring alignment between the educational offer in the South East and industry need
  4. Support to educators and students to ensure young people leave with the skills they need in increasingly digital careers
  5. The development of a regional Digital Skills Prospectus to enable residents to identify and access learning that’s right for them.

Through the following conversation between George Anibaba, Senior Programme Manager, KSS AHSN and James Harman, Head of Children’s Services, Medway Council, we consider some of the issues and impacts of digital exclusion, and share learning from projects in Kent and Medway.

What does digital inclusion mean to KSS AHSN?

George: As AHSNs, we exist to support the adoption and spread of innovation that works (in English, basically we want to help innovation reach more people who need it faster and more effectively) and we are mindful that what can inadvertently happen (as an unintended consequence) is that you create a divide between the digital haves and the have-nots.

Digital inclusion, in our view and aligned with the NHS Digital definition, has three facets to it: 

  • Skills – being able to use digital devices
  • Access – having accessible services that suit the needs of users and the people that we serve
  • Connectivity – ensuring the right amount of connectivity is available to access essential services in health and social care.

Digital inclusion is about bridging this gap by addressing those three areas.  As an AHSN we’re all about networking, engaging with partners, connecting people who wouldn’t otherwise have connected, who have a mutual interest and mutual goals. One of those connections is with the South East Digital Skills Partnership (SE DSP), which is part of the South East Local Enterprise Partnership (SELEP).

The SE DSP recently launched a working group around preventing digital exclusion. We have partnered with this group and are running a series of events over the next year to gather good practice and insights and inform policy. Forging partnerships with organisations that are trying to tackle the same challenges is crucial to making sure we co-create the right interventions. There’s lots of current and upcoming activity and initiatives on digital inclusion, with some of the key developments in the region coming through the DSPs, who are bringing in organisations and systems like Kent and Medway as well as others that are working in this space.

What is KSS AHSN’s approach to increasing the take up of digital services?

For us, spreading digital innovation includes applying some fundamental principles around delivering meaningful change, which includes utilising quality improvement approaches and tools as well as working with local stakeholders to: 

  1. Better understand their needs at an organisational and wider health and care system level, which includes the populations they serve and making sure that those needs are clearly communicated to digital innovators i.e. industry. We can then help innovators ensure they design or adapt interventions that are effective and work for the needs of individuals and the system(s) in question, and
  2. Signpost our health and care colleagues (to innovations) accordingly
  3. Test innovation in the real world by working both with innovators and health and social care systems that we are testing the solutions in, to make sure they are effective and beneficial
  4. Adopt and spread innovations more widely once they’ve demonstrated outcomes to individuals and wider systems, showing a positive impact. 

We have a number of programmes within our portfolio, including digital ones. The way we support includes the redesign of pathways that feature multiple stakeholder groups, across various health and care settings, where integration across different parts of the system is essential.

We are mindful that some work is prompted by national or regional mandates and we are here to help facilitate any necessary conversations as part of the response to these mandates. We recognised that sometimes there may be genuine barriers to potential adoption and work alongside our partners to understand what they are, where they are in order to properly address them and hopefully have them removed where possible.

We try to help our partners navigate what can be complex systems and help make the journey towards adoption and spread as smooth as possible, ultimately, for meaningful and lasting change to happen and for the right solutions to reach those who need them, at the right time and in the right way. 

What’s the picture in Kent and Medway?

James: In Kent and Medway, COVID has exacerbated this particular issue. In the past, people have managed to find ways around digital exclusion in some way or other. But with people not being able to go out and use public access WiFi, whether it be in libraries, shopping centres or coffee shops, really brought home the fact that people were being excluded early on. 

A lot of people, particularly from socially deprived backgrounds, don’t have WiFi in the home and rely on going out and downloading things they need or making calls. COVID has meant that people are home more and have been running on their mobile phone data, which is often not particularly substantial. 

A lot of the feedback we’ve had from people, particularly families and people that are socially isolated, is it’s running out very, very early in the month. And that’s leaving them very isolated, and not able to connect to some of our health and social care services.

What do you know about your residents’ views on digital services?

We did a big survey across Kent and Medway to understand those three facets of digital exclusion that George referenced. It came out that a lot of people were saying that they didn’t have the skills and the knowledge, a lot said they didn’t have current devices, and then there’s the issue of data limits. The sorts of digital platforms that a lot of our professionals use at the moment can only be used on relatively recent devices, and a lot of people have devices that are a number of years old and just don’t support that kind of software. 

We’re doing further research work because it’s really important to understand the people’s and the residents’ perspective. In the initial survey that we did across Kent and Medway, one of the things that came out clearly was that our BAME communities were reporting a lower level of competence and skills around digital technology. 

We wanted to understand that a little bit more and so we’ve got social research going on at the moment where we’re working with Medway Diversity Forum and Medway Voluntary Action, to get into those communities and understand exactly why that is, and what we can do to support.

What changes are you seeing in your service provision?

Our workforce has upskilled, really, really incredibly over the last 18 months and we should absolutely recognise that. People have really learned a lot and managed to deliver services in a whole host of different ways. A number of our services have mobilised really quickly digitally – our health visiting services for example. 

We’ve put in the tablet loan scheme to support a number of underlying public health programmes. Digital stop smoking services is something that we’ve introduced in the last couple of years, we’ve also been delivering a lot of our support to young mums around parenting, young father parenting programmes, and remote mental health support and training. Now we’re trying to get that balance: we still want to retain some of those excellent things that people have been doing, but we also know that people need some face to face contact as well. 

A lot of our services are coming back to more face to face now across Kent and Medway. We want to put in place strategies across Kent and Medway so that all the work that we’ve spent a lot of time on over the last 18 months becomes sustainable and doesn’t just rely on central funding. We do need to keep that emphasis going and that pace to continue, and the way we can do that is embed it in strategies and corporate priorities.

Get in touch

George Anibaba, Senior Programme Manager, KSS AHSN, and Co-chair, Digital Exclusion Working Group, South East Digital Skills Partnership
George.anibaba@nhs.net

James Harman, Head of Children’s Services Commissioning, Medway Council James.Harman@medway.gov.uk

More from this issue of Innovate

Digital exclusion – a personal perspective

Levelling up health: tackling inequalities across society