Bringing Care Online: People's Experiences of Digital Services in Health and Care, Healthwatch Kent and Medway

Why this matters

As demand increases on our healthcare system, digital systems and software are increasingly being used to increase capacity and efficiency. It is important that a new digital only NHS Trust maximises the strengths of digitally delivered healthcare, but also that individuals do not face digital exclusion 

Within the feedback we found 4 main themes:

• Acceptance of digital systems in healthcare
• Digital Barriers
• Experience of Digitally Delivered Care
• Issues with Digital Systems 

Digital systems can increase convenience and improve patient experience

47 people have told us how using digital systems as part of their healthcare has been a positive experience, including the use of the NHS App to increase patient advocacy and making booking appointments a simpler process

“I really like using the NHS app as well. Hadn't needed to use it before but it is very simple to use and a lot faster than waiting for a letter”
 

Issues with digital systems

We found that 97 people had experienced issues with digital systems, which included:

• Booking difficulties using Anima/eConsult
• eConsult not being available
• eConsullt used but a lack of appointments or response

“Very difficult to get an appointment. Having to fill in the Anima form is very offputting as questions are not always relevant. It would be nice to have an appointment, be listened to and feel more confident about the outcome"
 

Digital Barriers are still an issue

We heard from 36 individuals about how they are experiencing digital barriers which could be split into 3 groups

• Barriers through a disability
• Barriers due to a lack of resource
• Barriers through a lack of understanding and confidence of using digital software

“The service is a total disgrace. They have introduced an online booking system name Anima… For myself it means prolonged typing, which causes me significant pain as I have a disability”

We found that within the group that told us about digital barriers, 75% were aged over 55.

Digital Care Delivery 

We heard from 70 people who have received care delivered online. From this theme there were 3 subthemes:

• Feedback on Pharmacy and Physical Health
• Feedback on mental healthcare delivery
• Feedback about digital care delivery 

Positive Feedback 

We heard positive feedback on a range of services. The most common digital service that was mentioned was the Virtual ward, where individuals noted it was beneficial to be back within the home environment.

“I thought this was brilliant, the care was first class in the comfort of my own home. I felt more “looked after” than when I was an in patient"

Negative Feedback on Mental Health

The majority of feedback we received from individuals that had received mental healthcare online was negative in sentiment. A common issue raised was that interventions were being delivered within a group setting rather than on a one-to-one basis.

“She [Mental Health Nurse} put me in touch with talking therapies for CBT, but that turned out to be another waste of time. It was a six-week course, one hour a week, with a group of people on a Teams call. I spent most of my time just listening to someone else talk. I didn't address any of my issues. It wasn't person cantered.” 

What’s happening next?

This report has been sent to the Department of Health and Social Care, who will use it to help inform the creation of the NHS Online Trust. This includes the following highlights of:

• Clear communication of how the new service works
• An alternative pathway is always available for those that cannot access digital healthcare
• Form filling should be kept succinct and convenient for individuals to complete at different times

Healthwatch will continue listening to people and making sure their experiences shape this work.