The impact of digitalisation of GP services on minoritised ethnic communities

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.