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Community digital inclusion and access to services

An evaluation of a city-wide, voluntary sector-led digital inclusion programme examining impacts on digital health service use.

Key messages

  • a city-wide digital inclusion programme delivered through voluntary and community sector organisations improved use of digital health services
  • partnership working with local voluntary organisations was central to engagement
  • place-based delivery helped reach residents facing digital exclusion
  • digital inclusion support extended beyond skills to include confidence and trust
  • findings suggest that local context shapes the effectiveness of digital interventions.

Policy implications

  • digital inclusion strategies should be delivered through trusted community organisations
  • place-based approaches may be more effective than generic national programmes
  • integration between health services and voluntary sector partners can support equitable digital access
  • future programmes should build evaluation into design from the outset.

Gaps

  • lack of controlled study design limits causal inference
  • limited analysis by age, ethnicity or deprivation
  • uncertainty about which population groups benefit most
  • need for longer-term follow-up on health outcomes.

Commentary
This study provides evidence that community-led digital inclusion initiatives can improve engagement with digital health services. By working through voluntary and community sector organisations, the programme was able to reach residents who might otherwise remain excluded from digital care.

Considering care equity, the findings reinforce the importance of place-based delivery. Digital exclusion is shaped by local factors, including trust, social networks and access to support, which community organisations are often well placed to address.

The emphasis on partnership working highlights that digital inclusion is not solely a technical challenge. Social relationships and local infrastructure play a key role in enabling people to engage with digital health services.

However, the study also highlights evidence gaps. Without controlled designs and analysis, it remains unclear which groups benefit most and whether digital inclusion reduces or widens inequalities. Strengthening evaluation methods will be important to guide future use of technology in care.

Digital poverty in the UK

A national assessment examining the scale, drivers and impacts of digital poverty in the UK, with implications for health and social care access.

Key statistics

  • an estimated 13-19 million people aged 16 and over in the UK experience digital poverty
  • digital poverty is driven by income constraints, infrastructure gaps and limited digital skills
  • significant regional variation exists in levels of digital poverty
  • modelling suggests substantial social and economic benefits from reducing digital poverty.

Key messages

  • digital poverty affects a large proportion of the UK population
  • lack of access to devices, connectivity and skills is unevenly distributed
  • digital access is closely linked to income, geography and education
  • reducing digital poverty delivers wider social and economic benefits
  • digital access functions as a determinant of health and social care inequality.

Policy implications

  • funding for devices and connectivity is needed at population scale
  • digital skills support should be embedded within public services
  • national and local strategies must address infrastructure and affordability
  • tackling digital poverty is integral to reducing inequalities in health and social care.

Gaps

  • need for more granular data on impacts for specific population groups
  • challenges in evaluating long-term effects of large-scale digital inclusion programmes.

Commentary
This report positions digital access as a foundational condition for participation in modern health and social care systems. By quantifying the scale of digital poverty and its underlying drivers, it shows that exclusion from digital services is not marginal but widespread.

The findings highlight how digital poverty maps onto existing patterns of disadvantage. People with lower incomes, weaker infrastructure and fewer digital skills are more likely to face barriers to online health information, digital appointments and technology-enabled care. As digital routes become increasingly embedded in service delivery, these gaps translate directly into unequal access.

Rather than framing digital exclusion as an individual deficit, the report emphasises its structural nature. Access to devices, affordable connectivity and skills support emerges as a prerequisite for fair access to care, not an optional add-on.

Overall, the analysis supports that efforts to expand digital health and care must be accompanied by large-scale investment in inclusion. Without addressing digital poverty directly, the use of technology in care risks reinforcing existing social and care inequalities rather than helping to reduce them.

The economic impact of digital inclusion in the UK

Economic analysis examining the costs and benefits of improving digital skills and reducing digital exclusion in the UK, including implications for public services such as health and care.

Key statistics

  • around 11.5 million people in the UK lacked basic digital skills in 2021, falling from 12.4 million in 2019
  • without intervention, 5.8 million people may remain digitally excluded by 2032
  • around 508,000 people per year would require digital skills training to achieve full inclusion by 2032
  • every £1 invested in digital skills training is estimated to generate £9.48 in economic benefits
  • digital inclusion could generate around £899 million in NHS savings between 2023 and 2032

Key messages

  • digital skills are increasingly essential for participation in everyday life, employment and access to services
  • large numbers of people remain digitally excluded, particularly older adults and those with lower skills levels
  • improving digital inclusion can generate economic and public service benefits
  • digital skills support programmes are required to reach people who are not yet online
  • digital inclusion requires coordinated investment in skills, devices and connectivity

Policy implications

  • sustained national investment in digital skills training is needed
  • programmes should target groups most likely to remain excluded, including older adults
  • digital inclusion strategies may reduce pressure on public services
  • digital skills should be treated as core infrastructure supporting access to services

Gaps

  • the report focuses mainly on economic modelling rather than direct health or social care outcomes
  • there is limited analysis of how digital inclusion programmes affect different groups
  • behavioural impacts on service use are assumed rather than directly measured
  • more research is needed on links between digital inclusion and care access

Commentary
This report provides an economic assessment of digital inclusion in the UK, focusing on the potential benefits of improving digital skills across the population. The analysis frames digital inclusion as a key component of economic participation, with implications for productivity, employment and the use of public services.

The findings suggest that improving digital skills could also generate savings for the NHS, partly through increased use of online services and reduced demand for in-person appointments. This reflects the growing role of digital channels in accessing health information, services and administrative processes.

From a care equity perspective, the report highlights the risk that digitalisation of services may disadvantage people without access to digital skills, devices or connectivity. Older adults and individuals with lower digital literacy are projected to make up a significant proportion of those who remain digitally excluded in the future. Without targeted support, these groups may face increasing barriers to accessing health and social care services that are delivered or coordinated through digital systems.

Overall, the analysis reinforces the argument that digital inclusion should be treated as a core public infrastructure issue. Investments in digital skills, connectivity and support services may help reduce exclusion from digital health and care services while improving the efficiency of public service delivery.

The impact of digitalisation of GP services on minoritised ethnic communities

A study examining how the shift to digital primary care affects access for minoritised ethnic communities, highlighting digital exclusion, language barriers and structural inequities.

Key statistics 

  • the study is based on interviews with 100 adults from minoritised ethnic communities across four UK locations 
  • 20% of participants were aged over 65 and 60% were female 
  • participants represented a range of ethnic groups including Bangladeshi (23%), Black African (21%), Pakistani (17%), Indian (13%), Black Caribbean (12%) and Chinese (9%) 
  • participants reported wide variation in digital access, from high competency to complete non-use of the internet 

Key messages 

  • digitalisation of primary care can replicate and worsen existing barriers for minoritised ethnic communities 
  • digital exclusion is driven by limited access to devices, poor internet connectivity and low digital literacy 
  • language barriers remain a major obstacle, with most GP platforms only available in English 
  • some GP staff lack cultural competence and resources to effectively support ethnically diverse populations 
  • reliance on informal interpreters reduces privacy and can delay access to care 
  • women in multi-generational households often carry a disproportionate burden managing digital access to care 
  • over-reliance on digital tools and limitations in clinical training on different skin tones can contribute to misdiagnosis or delayed treatment 
  • concerns about data privacy and confidentiality can deter engagement with digital GP services 

Policy implications 

  • develop inclusive digital primary care systems that account for digital access, literacy and device limitations 
  • embed language support and translation options within GP platforms and services 
  • provide training for health professionals on cultural competence and anti-racist practice 
  • maintain non-digital access routes to avoid excluding people unable to use online systems 
  • design digital services with input from minoritised ethnic communities to reflect real needs 
  • improve data governance transparency to build trust in digital health systems 

Gaps 

  • the study focuses on qualitative experiences and does not quantify the scale of exclusion across the wider population 
  • limited exploration of how digital exclusion varies across different regions beyond the selected case sites 
  • does not examine long-term health outcomes associated with digital exclusion 
  • limited focus on how policy changes could be implemented in practice across the NHS 
  • further research is needed on how digital solutions can reduce rather than reinforce inequities 

Commentary 

This study explores how the move towards digital GP services is affecting people from minoritised ethnic communities in the UK. It shows that while digital systems are intended to improve access, they can create new barriers for people who already face disadvantages. 

Many participants described what the authors call “digital precarity”. This includes not having reliable internet, lacking suitable devices, or not having the skills to use online systems. For some people living on low incomes or in temporary housing, even downloading GP apps or maintaining mobile data was difficult. 

Language is another major issue. Most GP apps and online systems are only available in English, which makes it difficult for people who are not confident in reading or writing English. Some rely on family members or friends to help, which can reduce privacy and delay care. 

The study also highlights how care responsibilities are unevenly distributed. Women in multi-generational households often manage multiple GP accounts for children, parents and relatives. This creates additional pressure and can slow down access to services. 

There are also concerns about how digital systems are used in clinical care. Some participants reported that sending photos or describing symptoms online did not work well for people with darker skin tones. This reflects wider gaps in clinical training and risks delaying diagnosis or treatment. 

From a health and social care equity perspective, the findings show how digital transformation can widen existing inequities if systems are not designed inclusively. People who face barriers related to income, language, ethnicity or housing are more likely to be excluded from digital services. 

Overall, the study highlights that improving access is not only about introducing new technology. It requires designing services around the needs of different groups, maintaining alternative access routes, and addressing structural inequities that affect how people engage with care.