Work in progress: Mind the Gap: Understanding the implications of the digital divide on healthcare inequalities during the NHS digital transformation, for patients with long-term conditions.

Talk Code: 
Ben Ainsworth
Charlotte Dack, Kate Binnie, Laura Colebrooke, Harry Evans, Sabrina Grant, Gemma Lasseter, Jiedi Lei, Barbara Silarova, Sophie Turnbull
Author institutions: 
University of Bath, University of Bristol, University of Cardiff, University of Exeter, University of Kent, NHS ENGLAND and Improvement;


The recently published NHS Long Term Plan aims to ‘transform healthcare in the digital age’ – to deliver world-class healthcare in the 21st century focusing on personalised medicine in GP practices and social care. With 307 million face-to-face patient consultations conducted annually in GP practices, using digital tools such as patient self-management interventions and online consultation tools promise cost- effective solutions to support patients with long-term health conditions. However, people with low socioeconomic status (SES) are more likely to lack the basic digital skills required to benefit from digital transformation. 15.6 million people in the UK have limited or no digital skills, and are more likely to have low SES. Furthermore, people with low SES are 50% more likely to have a long-term health condition, and those with chronic conditions tend to experience more symptoms and worse health outcomes. Utmost care must be taken that the ‘digital divide’ – between the people who have the digital skills to engage with digital transformation, and those who do not – does not cause or exacerbate healthcare inequalities.The aim of this research is to 1) understand how and when healthcare professionals (HPs) are using digital healthcare tools with patients and 2) to identify barriers and opportunities that can be addressed in order to prevent digital transformation widening healthcare inequalities.


Study 1: We are conducting telephone and in-person semi-structured interviews with 15-30 HCPs in primary care, to explore their experiences of using digital healthcare tools for patients in practice and the barriers and opportunities in relation to the digital divide. HCPs will be recruited through snowballing advertising and opportunistically through professional networks. Participants will be purposively sampled in order to ensure appropriate representation of HPs working in areas of social deprivation. Data Analysis: Interview transcripts will be anonymised. Data will be coded by the research team independently and discussed to reach a consensus. Coded data will be organised and analysed using thematic analysis. Study 2: The results of study 1 will inform the development of a quantitative online survey to explore the key themes (barriers, issues, opportunities etc.) identified in a larger sample of HCPs. HCPs will be recruited using advertising on social media(‘snowballing’), and through HCPs networks.


Current project status: We are currently recruiting and interviewing HCPs until the end of December 2019. Analysis of the data is planned to be completed by February 2020.


We plan to discuss our findings with HCPs and healthcare commissioners and with voluntary and community sector organisations. This will help us identify key priorities to conduct further in depth mixed-methods research to explore this topic in more detail, with the ultimate aim of informing materials that will help the digital transformation benefit all patients.

Submitted by: 
Ben Ainsworth
Funding acknowledgement: 
This project was funded by a GW4 Crucible grant.