A study examining the impacts of assistive technology using a capability-based framework, focusing on person-centred outcomes beyond device provision.
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Commentary
This paper reframes the use of technology in care by focusing on what assistive technology enables people to do and be, rather than on the devices themselves. By applying a capability-based approach, it highlights outcomes such as independence, safety and social participation that are often overlooked in standard evaluations.
From a care equity perspective, this shift is important. Measuring success through device provision alone risks masking unequal experiences, where some users are unable to benefit due to affordability, usability or lack of training.
The findings suggest that person-centred evaluation could support more equitable commissioning and service design. Understanding which capabilities are enhanced, and for whom, may help identify where assistive technology is failing to meet needs.
However, the study also highlights systemic limitations. Without standardised capability measures embedded in routine practice, these outcomes remain difficult to track or compare. Addressing this gap is essential if assistive technology is to contribute meaningfully to equitable care rather than reinforcing existing barriers.
A qualitative study exploring how carers of people with dementia use assistive technology at home, focusing on awareness, burden and changing needs.
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This study highlights the complex role of assistive technology in home-based dementia care. Carers often assemble multiple technologies to manage safety and daily support, reflecting both the potential value and the burden of technology use.
From a care equity perspective, information and affordability barriers are central. Carers with less access to advice or financial resources may struggle to identify suitable technologies or sustain their use as needs evolve.
The frequent abandonment of technologies underscores the importance of adaptability. Static solutions are poorly suited to the progressive nature of dementia, placing additional emotional and practical strain on carers.
Overall, the findings reinforce that the use of technology in care must be supported by clear information, ongoing advice and flexible provision. Without this, assistive technology risks increasing burden rather than supporting carers and the people they care for.
An evaluation of a city-wide, voluntary sector-led digital inclusion programme examining impacts on digital health service use.
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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.
Analysis reviewing evidence and practice cases on how community co-design can improve the inclusivity and trustworthiness of digital health services.
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This analysis argues that the use of technology in care often falls short when digital services are designed without the active involvement of the communities they aim to serve. It highlights how exclusion can be embedded through design choices that assume access, confidence and trust.
In terms of care equity, the emphasis on ‘margins-first’ co-design is significant. By centring people most at risk of exclusion, digital services are more likely to address structural barriers rather than reproduce them.
The report reframes success in digital health away from simple uptake metrics. Confidence, trust and perceived usefulness are presented as equally important indicators of whether technology supports equitable access to care.
Overall, the analysis reinforces that inclusive digital health requires cultural and organisational change, not just better technology. Without genuine community involvement and power-sharing, digital transformation risks widening inequalities rather than reducing them.
A public data tool and methodology designed to identify areas and populations at highest risk of digital exclusion to support targeted inclusion investment.
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The Digital Exclusion Risk Index (DERI) provides a practical way to make digital exclusion visible at place level. By combining multiple indicators into a single framework, it enables decision-makers to move beyond assumptions and identify where exclusion is most likely to affect access to services.
In the context of technology-enabled care, this kind of tool supports more deliberate targeting of support. Rather than distributing resources evenly or reactively, DERI allows local systems to prioritise areas where lack of access, skills or connectivity is most acute.
The emphasis on publishing metrics is particularly important. Making digital exclusion risk transparent creates a basis for accountability and supports alignment between digital strategies and wider work on inequality across health and social care.
Overall, DERI shows how data infrastructure can underpin more equitable use of technology in care. Its value lies not in replacing local knowledge, but in strengthening the evidence base for place-based action on digital inclusion.
A study examining the association between local authority digital front doors and social care service uptake among adults in England.
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This study offers early quantitative insight into how digital front doors may shape access to social care. By analysing patterns of uptake across local authorities, it highlights that digital access points are not neutral tools and may influence who comes forward for support.
Variation by age group suggests that digital routes may work better for some populations than for others. Without accompanying qualitative evidence, it remains unclear whether observed differences reflect convenience, exclusion, confidence or awareness.
The short timeframe is also important. Digital front doors were widely introduced during and shortly after the COVID-19 pandemic, a period of rapid service change. Their longer-term effects on access, prevention and unmet need remain uncertain.
Overall, the study highlights the importance of treating digital front doors as part of a broader access system. Understanding how different groups experience and navigate these tools will be essential if technology is to support fair and effective access to social care.
A national assessment examining the scale, drivers and impacts of digital poverty in the UK, with implications for health and social care access.
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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.
A qualitative study exploring how digital financial systems have changed money management for people living with dementia and their family carers since the COVID-19 pandemic.
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This study illustrates how the digitalisation of financial management brings mixed consequences for people living with dementia and those who support them. While automated payments and card-based systems can reduce day-to-day burden, they can also obscure oversight and increase dependence on others.
The findings show that digital change often shifts responsibility rather than removing it. As systems become harder to navigate, unpaid carers frequently absorb additional financial tasks, adding to existing caring pressures. These dynamics are particularly pronounced where platforms are not designed with cognitive impairment in mind.
Usability emerges as a central issue. Digital finance tools that assume high levels of confidence, memory and comprehension can inadvertently exclude people living with dementia, even when intended to simplify processes.
Overall, the study highlights the need to treat financial digitalisation as part of care infrastructure. Ensuring that systems are accessible, supported and adaptable is essential if technology is to reduce burden rather than redistribute it onto carers.
A qualitative study examining how the digitalisation of social care affects older unpaid carers, focusing on choice, coercion and exclusion.
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This study shows how the digitalisation of social care reshapes everyday caring work for older unpaid carers. While digital tools were sometimes seen as useful, many carers described a loss of choice as non-digital routes were reduced or removed.
Affordability and skills gaps emerged as central barriers. For carers already managing significant responsibilities, the need to pay for devices or data and to develop digital confidence added pressure rather than relief. These constraints meant that digital systems often worked better for those with existing resources, leaving others struggling to engage.
The findings also highlight the importance of how digital change is implemented. Where carers were not involved in design decisions, digital services were more likely to feel imposed and poorly aligned with real-world caring contexts. In contrast, co-produced approaches were seen as more responsive and respectful of carers’ needs.
Overall, the study illustrates that digital social care can either support or undermine access depending on the choices made around funding, design and delivery. Retaining offline options and providing practical support for connectivity and skills are not transitional measures, but essential conditions for fair and workable digital care.
A randomised controlled trial evaluating whether a comprehensive telecare package improves outcomes for people with dementia compared with a basic telecare offer.
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This NIHR trial provides some of the strongest evidence on the limits of telecare effectiveness in dementia care. By comparing a comprehensive telecare package with a basic offer, it challenges assumptions that more technology necessarily leads to better outcomes.
From a care equity standpoint, the findings highlight risks in technology-led approaches that do not account for individual context. Standardised packages may fail to support people with dementia whose needs, capabilities and environments vary widely.
The results align with qualitative evidence showing that personalisation, support and fit with daily life are critical to successful technology use. Without these elements, telecare may add complexity without delivering meaningful benefit.
Overall, the study highlights that the use of technology in care must be grounded in person-centred assessment and ongoing support. Technology alone is insufficient to improve outcomes, and poorly matched interventions risk diverting resources from more effective forms of care.
