A qualitative focus group study exploring how older adults from South Asian, Black African and Caribbean backgrounds experience the digitalisation of primary care services since COVID-19.
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Commentary
This study provides insight into how digital primary care is experienced by older adults from minoritised ethnic backgrounds. While some participants were able to engage with digital systems, many described practical and emotional barriers linked to language, confidence and system design.
The findings show that digitalisation can increase existing pressures rather than ease access. Stress, reduced trust and a sense of being marginalised were common where digital routes replaced familiar ways of contacting services. Preferences for face-to-face or video consultations reflected a desire for clarity, reassurance and human connection.
Racial discrimination emerged as an important contextual factor. Past experiences influenced how participants interpreted digital change and whether they felt services were designed with them in mind. This highlights how technology interacts with wider patterns of exclusion rather than operating in isolation.
Overall, the study suggests that inclusive digital care requires more than technical solutions. Maintaining non-digital options, improving language support and addressing experiences of discrimination are central to ensuring that digital transformation does not widen gaps in access for older adults from minoritised communities.
Analysis examining how technology and care are represented in English government policy texts.
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Policy implications
Commentary
This paper draws attention to the way technology is positioned within English care policy, not through outcomes or implementation, but through language. By framing technology as a solution to the challenges of ageing and care, policy discourse promotes ideas of independence, efficiency and innovation as dominant goals.
These narratives matter because they shape how problems and solutions are understood. When technology is consistently presented as enabling older people to live independently, the relational, social and material aspects of care risk being sidelined. The analysis suggests that care is often depicted as something that can be optimised or substituted, rather than supported.
From a care equity perspective, the discourse identified in this study raises concerns about who is implicitly included or excluded. Policy language frequently assumes access to technology, digital confidence and supportive environments. This can obscure the realities faced by people with limited resources, lower digital literacy, cognitive impairment or unstable support networks. When these assumptions go unchallenged, inequities in access to care can become normalised rather than addressed.
The study also highlights how equity considerations are rarely made explicit in policy narratives. By focusing on independence and innovation, less attention is given to structural barriers, unequal access to technology, or the additional support required by some groups if they are to benefit from digital care.
Overall, the paper demonstrates that equity in the use of technology in care is shaped not only by implementation, but by the stories policymakers tell about what technology is for and who it serves. Making care equity explicit within policy discourse is therefore a necessary step toward more inclusive and realistic digital care strategies.
An evidence review examining digital technology developments in health and social care, the barriers to adoption, and actions needed to support effective and inclusive use.
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Commentary
This review provides a system-level view of why digital transformation in health and social care often falls short of its potential. Rather than focusing solely on technology, it highlights the importance of leadership, culture and investment in shaping how digital tools are adopted.
Barriers such as inconsistent strategic direction, digital skills gaps and weak data infrastructure are shown to limit progress. These constraints mean that even well-designed technologies may fail to deliver benefits in practice.
The review also draws attention to the consequences of neglecting inclusion. Without adequate support, digital change can exacerbate existing disparities, particularly for people with limited access, skills or confidence.
Overall, the report reinforces that effective use of technology in care depends on system readiness as much as innovation. Aligning leadership, funding and user-centred design is critical if digital technologies are to improve care without widening inequities.
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.
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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.
Survey analysis from the State of Caring 2025 report examining how unpaid carers use digital technology and online resources to access information, support services and manage caring responsibilities.
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Commentary
The State of Caring 2025 report highlights the increasing importance of digital information and technology in supporting unpaid carers. Online platforms are widely used to access guidance on benefits, services and caring responsibilities. This reflects broader shifts in health and social care systems, where information and service navigation increasingly take place through digital channels.
However, the report also suggests that digital access alone cannot address the practical and emotional challenges carers face. Technology may support information access, but carers continue to rely on professional advice, community services and peer support to manage complex caring responsibilities.
The findings also raise important issues relating to care equity. When support systems rely heavily on digital access, carers who lack reliable internet access, digital skills or confidence may struggle to obtain the information and assistance they need. This can create uneven access to support, particularly for older carers or those experiencing financial disadvantage.
Overall, the report reinforces the role of digital information as an important component of support for carers, while highlighting the need for inclusive design and multiple routes to assistance to ensure carers are not excluded from essential services.
A review exploring how digital technologies are transforming mental health care, including their potential to improve access alongside barriers related to workforce readiness, trust, and unequal access to digital resources.
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Commentary
This paper looks at how digital technology is changing mental health care. It shows that more people are using the internet and smartphones to find information, track their symptoms and access support. For some people, this can make it easier to get help, especially if they feel uncomfortable with face-to-face services or live in areas with limited provision.
However, access to digital care is not equal. While many people now use the internet regularly, not everyone has the same level of access, confidence or skills. Some people may not have reliable internet or devices, while others may struggle to use digital tools. This creates a risk that digital approaches could widen existing inequities if they are not designed and implemented carefully.
The paper also highlights concerns from staff and service users. Some worry that digital tools could reduce human contact or be used as a cheaper alternative to proper care. Others are concerned about how personal data is collected and used. These concerns can affect trust and willingness to engage with digital services.
Another key issue is the gap between how quickly digital tools are being developed and how slowly they are evaluated. Many tools are introduced before there is strong evidence on how well they work or who they work best for. This makes it harder for services to know which tools to adopt.
From a health and social care equity perspective, digital technology has both potential and risk. It can improve access by reaching people in their everyday lives and offering flexible support. At the same time, if issues like digital exclusion, workforce readiness and trust are not addressed, it may reinforce existing inequities.
Overall, the paper suggests that digital mental health care should be developed alongside, not instead of, wider investment in services and support. A balanced approach is needed so that technology improves access without reducing the quality or equity of care.
