Key Messages 

• Language and cultural barriers: Many GP staff lack training and resources in cultural competency, and individuals from ethnic minority communities often rely on informal interpreters, limiting privacy during consultations. 
• Digital exclusion: People from low-income and ethnic minority backgrounds face challenges accessing and using digital health tools due to limited internet access, device storage, and digital skills.  
• Carer burden: Female carers in multi-generational households struggle with managing multiple GP app accounts, leading to delays in accessing healthcare services. 
• Racial stereotypes and digital barriers: Over-reliance on technology and racial bias in assessing symptoms through skin colour can lead to misdiagnosis and delayed treatment for people with darker skin. Sending photos for appointments may not be effective for all skin tones. 

Commentary 

This study highlights how many GPs are directing patients, who already face digital barriers, to use online platforms to access services. These include booking appointments, ordering repeat prescriptions, and receiving test results. Some participants in this study were living in temporary housing, sharing that they often lack access to long term broadband which makes digital engagement even more difficult especially when telephone access is no longer an option. Additionally, GP apps tend to default to English with limited language options, which creates further barriers for migrants. 

Concerns around digital privacy and data security also emerged, in this study, with participants expressing unease about how their information is stored and shared. The findings revealed here highlight deep digital and structural barriers in healthcare, especially for marginalised groups. There is an urgent need for inclusive digital design, language support, staff training in cultural competency, and alternative access routes to ensure fair and equitable healthcare.