Widening Digital Participation - The story and our impact

1. Widening
Digital
Participation
The story and our
impact

2. 11.9 million people in the UK do
not have essential digital skills
needed to use online health
information and tools.
These people are most likely to be
socially excluded, hard to reach,
and suffer from poorer health
and/or health inequalities.
We have been working to address
the barriers to health for those who
are most excluded and have the
most to gain through digital
health inclusion.

3. 11.9 million people lack the Essential Digital Skills for life
4.1 million people are non-
users
7.3 million people are limited users
Demographic Of non-users (%) Of limited users (%)
Social class DE 49.5% 38%
Under 65 36% 62.5%
Over 65 64% 37.5%
Left school age 16 or under 78.3% 62%
Annual income under £17,500
Annual income under £11,500
62.3%
44.5%
41.7%
26.2%
Long standing illness/disability 47.7% 47.2%
Do not currently use the internet Do very little with the internet or use infrequently

4. There are large regional variations for non and limited users

5. 2013
WDP1
(2013-2016)
2016
WDP2
(2017-2020)
2017 2020
The timeline of Widening Digital
Participation

9. 221,941 people trained
8,138 volunteers
140,892 year 1 and 2
81,049 year 3
2013 - 2016 Widening Digital
Participation - Phase 1
In July 2013 Good Things Foundation and
NHS England began the three-year
Widening Digital Participation programme.
We worked with hyperlocal community
partners and provide them with tools and
resources to help local people to gain
digital health literacy.
These resources included new online
learning modules on Learn My Way, a web-
page that signposted local people to
specific NHS online services or resources,
and engagement materials to promote the
benefits of managing your health online.
£3.7m in GP
appointments
£2.3m in A&E
attendances
£6m saving for the NHS
In one year 2015-16
£
ROI £6.40
157,391 engaged either
through supported signposting
or through events

10. 221,941 people trained
8,138 volunteers
140,892 year 1 and 2
81,049 year 3
2017 - 2020 Widening Digital
Participation - Phase 2
In 2017 Good Things Foundation and NHS
Digital co-designed Phase 2 to work both
with health practitioners (CCGs, GPs, etc)
and community networks.
Models:
- Hyperlocal health, delivering digital
health literacy through online
resources and community partners,
- Deep dive pathfinders to
understand how best to help specific
groups.
Impact:
Confidence, health prevention, online
management of long term conditions,
engagement of community and health
professionals
£3.7m in GP
appointments
£2.3m in A&E
attendances
£6m saving for the NHS
In one year 2015-16
£
ROI £6.40
157,391 engaged either
through supported signposting
or in events

11. Widening Digital Participation 2: Some Example Pathfinders
Sheffield
Social Prescribing digital skills
● Marked patient activation
increases for LTC’s
● Delivering health in the
community where people feel
most comfortable
“Don’t say digital”
Islington
Young people and mental health
● Commissioned new counselling
service on the back of WDP.
● Improved journey through
CAMHS.
“The person who knows me doesn’t have
the knowledge, the person who has the
knowledge doesn’t know me”
Stoke
Social Media and Long Term Conditions
● 13% increase in Breast Cancer
Screening appointments
● 25% reduction in GP
appointments for LTC’s
“I wouldn’t have done it without
facebook”
Hastings
Digital Inclusion for the homeless
● Improved lifestyle activity
● Increase in engaging with health
system
● Decrease in poor medicinal
behaviour
“I think I’m going to get back in touch
with my Doctor”
Nailsea
Digital Health hub on the High Street
● Increasing well-being
● Reducing social isolation through
digital and connecting local
assets
“Dementia patient using Skype so that
family can read his facial cues”
Wakefield
Digital inclusion for the sensory impaired
● Improved customer service
● Reduction in anxiety over visiting
GP
“I didn’t do it straight away but I wish I had.
I can’t tell you how much easier it is now I
can make my own appointments. I can also
order repeat prescriptions online”

12. Themes across the Pathfinders
Older people
● Isolated older people in partnership with
Age UK in Sunderland
● Dementia support in partnership with Leeds
City Council
Disadvantaged groups
● The homeless community in partnership
with Hastings CCG and The Seaview Project
● Disadvantaged young people from the
Bangladeshi community in partnership with
Healthwatch Tower Hamlets
Health and care professionals
● Nurses in partnership with Redmoor Health
in Lancashire and South Cumbria
● A&E in partnership with Blackpool
Hospital
Long term conditions
● Breast Cancer Screening and Facebook in
partnership with Stoke CCG
● Diabetes and Social Prescribing in
partnership with Sheffield CCG.
13% increase in Breast
Cancer Screening
attendance
25% reduction in GP
appointments for LTCs
62% elderly isolated
people more informed
about health
Behaviour
change for 122
homeless people

13. Our Design Principles
Design with people, not for them
Go where the people are
Relationships not transactions
Work in the open
Understand underlying behaviour
Do it now
Synthesising and understanding the conditions needed for successful digital health
inclusion for the most excluded groups
Needs: Users and NHS
Timely
Support is needed when it is needed.
Not at a future appointment
Relevant
Support and information needs to be
relevant to users at that specific point of
their health journey.
Trusted
Trusted information from NHS and
peers.
Holistic view of me
A person isn’t just their condition. Their
priorities may differ from a GP’s.
Considerations to work within
Trust
What health practitioners trust is
different to what people trust.
Barrier & Context
Understand local infrastructure to
access and circumstance when
people need health support.
Behaviour
Isn’t fixed. Engagement varies
both in activation and digital
readiness.

15. Digital
Health
Hubs
Improving digital
health outcomes by
taking health to
people, not people
to health

16. The common
elements for a
pilot digital
health hub:
● Hyperlocal & informal: In a place where you feel
comfortable
● Whole person approach: Not just about transactional
online health services. What’s important to you is
important to us
● Not rushed: Spending the time to achieve goals
together
● Supported by someone ‘like me’: Recognising yourself
in the person helping you, ‘not lanyards’
● All about partnerships: Good care based on the
bridging and bonding of the community and the NHS

17. Original pathfinders gave us the
inspiration, especially in Nailsea,
Sheffield, and West Yorkshire
We then reduced the investment to
create 5 digital health hubs in Blackburn,
NW London, Saltburn, Wirral and
Staffordshire based on the common
elements we had synthesised from the
pathfinders.
We then reduced the investment
further to test if we could scale the model
in ‘mini’ digital health hubs in 22 more
communities
Digital Health Hubs
.
..
Digital Health Hubs
Mini Health Hubs.

18. Patient Activation
57% feel more
confident about using online
tools to manage their health
51% feel more informed
about their health
Digital Health Hubs help people to
be use online tools and
information, so they feel more in
control and informed
Supporting greater self management of
health is beneficial to both people and
services.
Health Hubs help people to search for and
access a range of online health information
safely, and build skills to understand what
are useful and trustworthy resources.
This means people can play a more active
role in understanding day to day health and
health related issues, be resilient, cope
better with diagnosis and be empowered in
their management of long term health
conditions.

19. Wider Social Benefits
50%feel less lonely
57% feel happier
Digital Health Hub impact reaches
beyond improved digital skills and
health transactions
These longer term benefits underpin the
value of Digital Health Hubs as a social
resource for communities building strength
and capacity from within.

20. 22 ‘mini’ health hubs*
● 7 in 10 attendances spent time accessing some
kind of health information
● 6 in 10 attendances included finding
information about a wellbeing activity
● 5 in 10 attendances included finding
information about local support
● 4 in 10 attendances arrived via social
prescribing
5 ‘main’ health hubs:
Getting help with developing digital skills (219)
Being introduced to national NHS website/app (168)
Being introduced to local GP online system (88)
Getting online information on medical conditions incl
mental health (62)
Volunteering to get involved/become digital champion
(46)
Getting online information on wellbeing activities (25)
Getting online information about local health service,
pharmacy, dentist (13)
Getting online information on healthy activities (10)
Other (66)
27 pilot Digital Health Hubs: what people attended for

21. Finding Local support includes
● Using digital champion knowledge of activities
and groups
● Searching for local support or activities on line
● Referring to groups / scheduling in
Well being activity including
● Using the internet for what interests you
● Social media to keep in contact with family and
friends
● finding out local information for activities
Other
● Other related Digital Health Activity
● Supporting registering on to NHS App
Digital skills training - Any Courses in ‘Improve
your health’ section of Learn My Way
● GP services online a how to guide
● NHS website a how to guide
Finding health information and tools includes
● Using NHS.UK
● Finding Trusted Apps (NHS Apps Library)
● Searching condition specific websites
● Forums of support (condition specific
forums or groups)
Transactions Online - Practical Application,
doing it live
● GP appointment online
● Repeat prescription online
Health Hub funded activities

22. Digital isn’t working for
everyone
“It’s the new Universal Credit.
Marginalised people are being
marginalised further because
they don’t have the basic digital
skills to get an appointment with
their GP.”
Looking for what happens next
“Some of the doctor's practices (St
Martin's Practice in particular) were
asking if the course will run again, as
they would like more of their patients to
get online and access the health
services.
They really enjoyed the courses and
some registered while doing the GP
services course. The doctors were saying
it's so much easier and quicker for their
patients to register and encourage them
to do so.”
Quotes from Digital Health Hubs

23. Thank you!
Helen Milner
Twitter: @helenmilner Email:helen.milner@goodthingsfoundation.org
Pete Nuckley
Twitter: @Pics_in_clouds Email: pete.nuckley@goodthingsfoundation.org