How we can support digital inclusion

There are several useful tools you can use to check levels of digital exclusion locally. 

The digital exclusion heatmap shows overall likelihood of digital exclusion by local authority. It does this by combining indicators including infrastructure (broadband and 4G), access (percentage of adults online), basic digital skills, and social indicators (age, education, income and health). The heatmap was last updated in 2017.

The Consumer Data Research Centre has produced a detailed mapping of neighbourhoods by internet user classification.

Once you’ve mapped levels of digital exclusion locally, there are several approaches you might consider to tackle the problem, such as:

• Widening Digital Participation 
• digital skills training
• digital champions
• intergenerational mentoring
• assistive technology
• free public wi-fi
• social prescribing
• digital skills of staff
• raising awareness

The Widening Digital Participation (WDP) programme has been running since 2013, originally managed by NHS England and now by NHS Digital. WDP is being delivered through the Good Things Foundation. 

In phase one (2013-16), WDP focused particularly on helping people develop digital skills so  they can take a more active role in their own health. Over three years:

• 387,000 people were involved in the programme
• 221,000 people received digital skills training

You can read more about phase one of Widening Digital Participation. 

WDP phase two runs from 2017 to 2020. Rather than necessarily adopting a digital skills training approach, phase two is using discovery, service design and co-production methods. This involves working with Pathfinders in local communities to take a fresh look at the barriers to digital inclusion and how they might be overcome. Pathfinders are based in areas with particular digital inclusion challenges, working with groups including homeless people, young carers, people with long term conditions, isolated older people, and people in social housing. 

Full details of all the Pathfinder sites, with descriptions of how the service design has been implemented, case studies and practical how-to-guides based on the lessons learned are published on the WDP digital health lab.

WDP Pathfinder sites are fully allocated to 2020, but there are still plenty of ways in which you could implement digital inclusion support locally, such as the following.

There are Online Centres in most communities which provide places where people can go to get online in supported environments. Most also provide training in digital skills. You can read real life case studies of the support provided by Online Centres. 

Learn My Way is a set of free online courses which help people develop digital skills to make the most of the online world, from digital beginners to courses focusing on specific topics, including improving your health online. 

The government’s essential digital skills framework has been designed to support providers, organisations and employers across the UK who offer training for adults in essential digital skills.

It is also worth taking a look at Scotland’s essential digital skills toolkit. It gives a clear description of the skills we all need to make the most of new digital opportunities. It contains simple checklists for measuring digital skills, and guidance on how to interpret the results.

The Digital Skills Partnership brings together public, private and voluntary sector organisations to boost skills for a digital economy.

Many organisations have trained staff and volunteers as digital champions. Digital champions help others to develop their digital skills and understand the benefits of getting online. Digital Unite’s digital champions network provides learning resources, practical tools and an online community.

A new online training platform for digital health champions has now been developed by Digital Unite with support from NHS Digital. Using CPD accredited training resources on the platform, digital health champions can understand and help overcome people’s barriers to managing their health online, use popular digital health tools including the NHS website and NHS app, and help people with key tasks such as booking appointments online.  

The North West London Collaboration of Clinical Commissioning Groups has established a digital citizen education programme. Volunteers are trained as “digital ambassadors” who in turn are responsible for training residents who need support using digital health services.

This video describes the Digital Citizens Education Programme and the role of digital ambassadors in North West London:

Younger people who have grown up in the digital age can be a great resource to introduce older people to digital devices and all the things they could do online. The North West London Digital Citizens Education Programme is beginning to link up local schools with care homes.

The best developed example of intergenerational digital mentoring is the digital heroes programme in Wales. This inspirational video shows how children from a primary school in Tredegar have buddied up with a local care home. Visits from the schoolchildren have enthused older residents about digital technology, and led to measurable reductions in medication and falls in the care home.

Older people and people with disabilities may be able to use assistive technologies to help them to stay independent and manage their daily lives. Technologies include telehealth and telecare, remote monitoring systems, wearable devices and smart home devices. This review provides an overview of assistive technologies and the latest research into their use.

Some people may find it difficult to use a computer keyboard because of reduced eyesight or lack of digital skills and confidence. Voice activated systems or “virtual assistants” such as Amazon Echo (Alexa) and Google Home can open up new opportunities for people who might otherwise be digitally excluded. Local authorities, including Hampshire and Oxfordshire, are now using virtual assistants successfully in care homes. In Cornwall, a partnership between Age UK and the University of Plymouth is improving digital inclusion through provision of Echo Spots. Online health information, including Start4Life on breastfeeding, is increasingly available for access via Alexa. 

The government’s new Digital Inclusion Fund has provided support for care homes in rural Essex to install smart technology, and train home owners to become “digital boomers” to help others improve their digital skills.

Access to free wi-fi can be crucial for people who might find it difficult to afford data costs on their digital device. Free public wi-fi hotspots are increasingly available dotted around towns and cities (although less in rural areas). This handy guide outlines where you can find free Wi-Fi and how to access it, what to watch out for when you're using it and the free Wi-Fi options you may be able to access via your mobile or broadband provider.

Free wi-fi on NHS premises makes it easier for patients to use information and services when they most need them. Nearly all GP practices now provide free wi-fi for their patients, as well as most hospital trusts. The following examples show how free wi-fi is improving the experience of patients and their families.

NHS WiFi case studies.

Social prescribing is a way for local agencies to refer people to a link worker. Link workers give people time, focusing on ‘what matters to me’ and taking a holistic approach to people’s health and wellbeing. They connect people to community groups and statutory services for practical and emotional support. Find information on social prescribing and links to further resources. This animation shows how GPs are using social prescribing in primary care. A social prescribing network has been established to share good practice. 

In some areas social prescribing is being used to link up with organisations providing digital inclusion support. In this video, Sheffield GP Dr Ollie Hart talks about how he refers patients to the Heeley Development Trust for help with getting online. Good Things Foundation has produced a how-to-guide on using social prescribing for digital inclusion in health.

Health and care staff do not always have knowledge and confidence in using digital health resources themselves. This means that they are unlikely to act as digital champions and recommend digital tools to their patients. This can be one of the biggest barriers to digital inclusion.

Health Education England is leading work on digital literacy for health and care staff, as part of the building a digital ready workforce programme. This video explains why digital literacy is important to the health and care workforce. A health and care digital capabilities framework has been produced which can be used to support digital literacy training for staff.

Digital inclusion now forms part of module 4 (User-centred design and citizen-driven informatics) of the NHS Digital Academy.

Many people are not aware of the support available to help them get online and improve their digital skills. Health and care organisations can get involved in awareness raising campaigns, including the annual Get Online Week which takes place every October.

Good Things Foundation has downloadable marketing materials on digital health.

A digital training and support framework is available for use by public sector organisations (including clinical commissioning groups and local authorities). The framework includes over 50 companies, social enterprises and voluntary sector organisations that specialise in providing digital skills training and assisted digital support. Using the framework can provide a simpler and quicker route than carrying out a full-scale procurement exercise.

A range of quantitative and qualitative methods could be appropriate for evaluating digital inclusion. These include activity measures (such as numbers engaged or trained), surveys, user interviews, stakeholder interviews, observation, and case studies.

The Department for Digital, Culture, Media and Sport has produced a practical toolkit evaluating digital inclusion initiatives to demonstrate social impact. The Digital Inclusion Evaluation Toolkit contains a range of resources which you could use to measure the impact of digital inclusion initiatives. 

The patient activation measure is being used in the NHS to measure the knowledge, skills and confidence a person has in managing their own health – and the improvement in activation following an intervention. It may be appropriate to use as a tool for measuring the impact of a digital inclusion intervention such as digital skills training.

Look at the digital health lab to see how different evaluation methods have been used in Widening Digital Participation pathfinders. 

You can reflect the approach of the NHS commissioning cycle by following these steps to implementing digital inclusion support locally:

1. Assess need – map the digital inclusion status of local population
2. Review digital maturity – enablers including public wi-fi and staff capability
3. Review local existing resources/plans 
4. Review any existing digital inclusion support – including local Online Centre, voluntary organisations and libraries.
5. Work with local stakeholders to identify needs and co-design the best approaches to digital inclusion support
6. Identify potential delivery partners
7. Develop appropriate evaluation mechanisms
8. Establish targets and performance indicators
9. Commission appropriate digital inclusion support
10. Evaluate, refine and scale