Event Report: Digital Inclusion and Healthcare

On Wednesday 15th April 2026, the Digital Inclusion APPG held a panel session on Digital Inclusion and Healthcare. The event was hosted and chaired by Digital Inclusion APPG Officer Baroness Verma.

Baroness Verma opened the session by noting that many attendees will have witnessed exclusion within their own communities. She stressed the importance of reaching those individuals and enabling them to access and maximise available support. She observed that many people do not make use of public resources simply because they are unaware of what is available. She thanked the panellists and emphasised that the APPG is seeking to understand how to ensure that everyone is included in the wider debate. Baroness Verma then invited each of the panel members to introduce themselves.

Following Baroness Verma’s welcome, the panel introduced themselves:  

Sue Lacey Bryant introduced herself as past President of CILIP, highlighting her work with the Health and Digital Literacy Partnership alongside Arts Council England. She spoke of her long-standing interest in health inequalities and in supporting people to better understand the information shared with them.

Vicki Sellick, Chief Executive Officer of the Good Things Foundation, described the organisation’s network of 8,000 hubs across the country, located in libraries, GP surgeries and community organisations. These hubs support people to get online by providing access to data, devices, skills and confidence.

Dr Felix Greaves introduced himself as a civil servant at the Department for Health and Social Care, where he leads the Digital Policy Unit, and as an academic at Imperial College London. He explained that his work focuses on evaluating digital technology through the lens of inequality and expressed his interest in learning from fellow panellists and attendees.  

Max Marulli De Barletta outlined his role as Inclusive Design Lead at NHS England, where he works on ensuring that the NHS digital suite, including the website and app, is as inclusive as possible. He emphasised his aim to involve as many people from excluded groups as possible in the design process.  

Max then handed over to Mary Hill, Deputy Director in NHS England’s Health Inequalities Programme. She explained that her work focuses on improving digital inclusion and access for underserved population groups.  

Elizabeth Anderson, CEO of the Digital Poverty Alliance, described the organisation’s dual focus: advocacy, research and awareness-raising on digital exclusion, and direct support for families. She also noted that the Alliance is undertaking a health inquiry examining the intersection between digital and health inequalities.  

Karol Kuczera, Senior Manager in NHS England’s Health Inequalities Improvement Programme, introduced his role leading on digital inclusion.  

Baroness Verma then provided an introduction to the event’s theme. She described the APPG on Digital Inclusion as a cross-party group of parliamentarians working to eradicate data poverty in the UK, and highlighted upcoming workstreams, including sessions on digital inclusion and economic growth, and the annual State of the Nation review. She encouraged attendees to engage with the secretariat on future plans.  

Turning to digital inclusion and healthcare, Baroness Verma noted that the adoption of digital technologies by patients and staff has increased significantly in recent years, accelerated in part by the Covid-19 pandemic. She highlighted that the NHS App now has more than 39 million registered users, with 62.3 million logins recorded in November alone. She observed that digital tools can free up staff time and enable patients to manage appointments and prescriptions more effectively from home.  

She outlined the NHS 10-Year Plan’s vision for a digitally enabled health service, including ambitions for virtual hospitals, digital-first communication, and the embedding of inclusive design. From 2027, NHS Online is expected to offer patients the option to receive planned care via the NHS App, connecting them with specialist clinicians across the country. While these developments promise greater efficiency and access, she cautioned that they risk deepening inequalities if digital exclusion is not addressed in parallel.  

Baroness Verma cited estimates that 1.6 million people in the UK remain offline, and that around a quarter of the population have low digital capability. She added that around 30% of people who are offline find the NHS particularly difficult to engage with. She emphasised that digital exclusion can exacerbate health inequalities by limiting access to services and the skills needed to navigate them. She noted that the Government’s Digital Inclusion Action Plan identifies health as a key area affected by digital exclusion.  

She also highlighted that some groups face a higher risk of being digitally excluded, including older people, socially excluded groups, disabled people and the socio-economically disadvantaged; and that these groups also generally face a higher risk of health inequalities. In September 2023, NHS England published ‘Inclusive Digital Healthcare: a framework for NHS action on digital inclusion’, setting out how the NHS can enable greater access to, and improved experiences of, healthcare through inclusive digital transformation. She said that the framework aligns with the Health and Care Act 2022, which requires NHS England and Integrated Care Boards to actively reduce inequalities in access and outcomes. The framework identifies five domains for action – ensuring access to devices and data, designing accessible technology, building digital skills, fostering trust and confidence, and strengthening leadership and partnerships. She said that central to the framework is the belief that digital inclusion is a shared societal responsibility, demanding meaningful collaboration with professionals, partners and service users to design services that are equitable, inclusive and effective.  

Baroness Verma then posed the central question to the panel: how can the Government embed digital inclusion within the NHS 10-Year Plan’s transition from analogue to digital?  

Sue Lacey Bryant responded first, focusing on the concept of “digital carers”. She posed the question of who would support individuals digitally when they lose capacity as their digital carer, noting the absence of a clear framework, evidence base or guidance in this area. She highlighted the lack of consistent protections across sectors such as law, finance and healthcare, and called for a cross-sector Government review. She argued that digital carers should be recognised as essential infrastructure within the digital transition.  

While describing herself as a digital optimist, Sue stressed the need for safe and robust systems. She shared examples of how system failures can damage both productivity and trust. She called for stronger governance, formal recognition of the digital carer role, and the development of training and qualifications. She also raised the need for clearer mechanisms to establish authority for digital carers across institutions, including banks and healthcare services. She said she would like to see safety for vulnerable people embedded into inclusive design, including improvements to existing data.  

Sue emphasised the importance of public libraries as trusted community hubs, noting that they often act as informal points of support for digitally excluded individuals. She argued that the UK risks undermining its own digital ambitions if these issues are not addressed. She pointed to the Digital Exclusion Risk Atlas as evidence of the scale of the challenge and stressed the need to adapt people-facing roles within healthcare. She argued that digital caring should be at the heart of the Government’s plan for neighbourhood NHS hubs. She concluded by calling for cross-government alignment across policy, legal and technical systems, and invited the APPG to support efforts to formalise recognition of the digital carer role.  

Vicki Sellick followed by highlighting the divide between those who can readily access and use digital technologies, like many in the room, and those who cannot. She argued that digital exclusion is a fundamental barrier to addressing health inequalities and must be tackled as a priority.  

Vicki identified three key areas for action. First, digital connectivity: she noted that 1.5 million people lack a smart device and 2.2 million cannot afford internet access. She argued that connectivity should be treated as a universal basic right and called for a coordinated effort to raise awareness of the issue in the public sphere. She said examples of the necessity for practical intervention come alive in the healthcare system, highlighting the example of people that come into libraries and ask questions about the NHS App. She highlighted practical interventions like the Good Things Foundation’s work with 60 midwives in Trusts across the country, helping them to spot vulnerable families, and offer free SIM cards and a device. Connection, she argued, should be a priority healthcare intervention.  

Second, digital skills: she emphasised that access alone is insufficient, with many people lacking the confidence or knowledge to navigate online services, as 8.5 million people report a lack of confidence and feeling of safety when navigating the internet. She pointed to the complexity of NHS systems compared to when Gov.UK was launched, and called for a user experience that accommodates those with the lowest levels of digital literacy. She spotlighted local initiatives such as Digital Leeds as examples of coordinated, community-based support. She pulled out digital training and the availability of trusted confidants as useful tools and argued that there should be a clearer focus on community-based support in the design of statutory services.  

Third, disinformation: Vicki raised concerns about the growing prevalence of inaccurate health information online and the lack of clear accountability for addressing it. She called for regulation and industry investment in digital health literacy, including cross-sector collaboration.  

Mary Hill then spoke about the NHS 10-Year Plan as a positive mandate for action, noting its emphasis on tackling health inequalities. She highlighted the importance of understanding patients holistically, including their digital capabilities and wider social determinants such as housing. She stressed the need to address data gaps and highlighted the work of the Health Inequalities Improvement Unit to use quantitative data alongside working with communities to better understand who is not using digital services like the NHS App, and what their needs are. Mary outlined ongoing work to update the digital inclusion framework, including consideration of AI and translation risks. She also highlighted the importance of maintaining equitable access to face-to-face services for those who prefer them, including in the new neighbourhood health centres.  

Max Marulli De Barletta noted his work with the teams that are developing the digital tools that people use in the NHS. He focused first on digital accessibility in NHS products, noting the challenges posed by both in-house and third-party systems. He called for stricter accessibility requirements in procurement processes, as issues for digital inclusion are often identified too late. Second, he emphasised the importance of involving people with lived experience of poverty and exclusion in the design process for NHS digital products and noted the difficulty he has found in reaching those in minority groups who are digitally excluded. He expressed his desire for that engagement to go further, as well as his interest in taking the conversation further with the stakeholders present.   Karol Kuczera then responded by emphasising that digital inclusion should not be viewed as a fixed or static issue, but as a complex and continually evolving challenge. He said the issue requires coordinated action across sectors, with no single intervention sufficient on its own. Reflecting on NHS England’s Inclusive Digital Healthcare framework, published in September 2023, he noted that even within two years the digital landscape has shifted significantly. As the framework is updated, he highlighted the need to account for emerging developments in the NHS including AI and to carefully balance the opportunities for improved access with the risks of deepening existing inequalities.  

Karol mentioned this his team has been feeding into the cross-Governmental group on languages and AI translation. He also drew attention to the launch of the NHS Digital Exclusion Risk Atlas earlier that day, explaining that it maps patterns of exclusion across the country using indicators such as access to devices, affordability, digital skills and confidence to see how the NHS can support people. He highlighted ongoing partnership work with the Good Things Foundation, including the development of e-learning resources, and emphasised the importance of building capacity at a local level through community champions. He concluded by noting the importance of understanding the difference between digital inclusion and exclusion and keeping both in mind.  

Elizabeth Anderson followed by reflecting on the discussion and reinforcing the point that access and inclusion are not the same, though they are often conflated. She illustrated this with the example of a woman in her 60s who had lived in the UK for decades and owned a smartphone but lacked the knowledge to use even basic functions such as adjusting the volume. Elizabeth argued that this type of experience is far more common than is often assumed, and that many people who are technically “included” still struggle to engage with digital services in practice which represents a big challenge.  

She went on to describe the sense of disempowerment that can arise from these challenges, linking back to Sue Lacey Bryant’s earlier point about digital carers. For many individuals, she suggested, digital advancements can reach a point where they outpace people’s skills, leaving them reliant on others for support. However, she stressed that many of these individuals would prefer to retain independence, for example, by contacting their GP themselves, if systems were more accessible.  

Elizabeth emphasised the importance of maintaining choice and empowerment in how people access services, noting that for some individuals, digital channels will never be the preferred option. She argued that alternative routes and safeguards remain just as important today as they were a decade ago. Elizabeth pointed out some statistics: 19 million people are struggling, 2-4 million people struggle with affordability, 11 million people struggle due to digital skills, and the rest struggle due to trust and feeling like digital isn’t for them.  

She further pointed out that health information is particularly sensitive. Drawing on her own experience, she described changes within her GP practice that limited in-person access, illustrating the tension between system pressures and patient needs. She argued that both clinical and administrative staff require better training to support patients through the digital transition, and that this training should include in-person, peer-based learning where possible, as well as a clear explanation of why new systems are being introduced.  

Elizabeth also stressed that these challenges extend across the healthcare system, not just within primary care but also in areas such as maternity, perioperative care and day-case services. She highlighted the practical difficulties patients face when they receive communications such as texts and links without sufficient support. Turning to funding, she raised concerns about the burden placed on voluntary, community and social enterprise organisations, as well as on friends and family acting as informal digital carers. She called for a more structured, long-term strategy that brings together the Digital Inclusion Action Plan with health policy.  

Finally, she addressed the issue of e-health literacy, expressing concern about the growing reliance on online sources of information. She noted a study showing that 40% of digitally excluded teenagers use TikTok before Google, where only 2% of information is accurate. She concluded by emphasising the need to build a package for digital skills and confidence, including the ability to identify reliable sources of information.  

As the final panellist, Dr Felix Greaves then opened by re-stressing his interest in learning from and listening to the speakers in the room. He spoke about the level of ambition set out in the NHS 10-Year Plan for digital advancement in the health space, describing it as exciting and recognising that inclusion is also a strong theme in the Plan. He reflected on his experience working and studying in the field, saying he has found a tension between advancing digital innovation and ensuring inclusion.  

While acknowledging the impressive scale of digital uptake - for example, that the NHS App has more users that Netflix - he shared a contrasting experience from his work at the Department of Health and Social Care. He described receiving a handwritten letter from an individual who was unable to use the NHS App and therefore unable to access their health services. He suggested it is easy to say that there will be a route available, but the Department needs to make alternative routes possible. He recognised that solutions may be more money and people intensive. While acknowledging that such approaches may require additional resources, he argued that structured thinking is needed to embed inclusion systematically within policy and service design.  

He also reflected on a visit to a digital inclusion lab in Leeds, where he observed a thoughtful approach to the central design of products. He noted that the most impactful work often takes place at the local level, in libraries, community settings and through NHS app champions. He highlighted the Department for Health and Social Care’s research on app usage and adoption, indicating that the most effective interventions often involve human support, with individuals guiding others through digital processes gently and understandingly. He acknowledged that this can be time-intensive and expensive but stressed he at this event to listen and think about how they can get these resources to the appropriate scale, including scaling that human connection.  

Baroness Verma then brought the panel discussion to a close and opened the floor to questions from the audience, taking three initial contributions.   President of the National Pensioner’s Convention Jan Shortt introduced herself as President of the largest campaigning organisation for older people in UK. She raised the issue of digital ageism, referencing research from the Older People’s Commissioner for Wales. She argued that digital exclusion often leads to social exclusion, which can be particularly acute for older people at a time when health and independence mean a lot to them. She also stated that she does not use a smartphone and has no intention of doing so and finished by challenging the panel on whether a “digital by default” approach is acceptable.  

CEO and Co-Founder of SafetyPhone and incoming CEO of Chatsie Bertie Aspinall introduced his companies as building phones for marginal communities, including children and senior citizens. He raised concerns about operating systems, like the Apple and Google home screen and called for greater flexibility to allow third parties to simplify interfaces, including improving access to services such as the NHS App. Bertie also raised a concerns about scams and digital confidence, highlighting that the NHS system relies on texts from withheld numbers. He invited panellists to respond on either point.  

Third, Amrit Verma, a member of staff for Baroness Verma asked the panellists, which concern keeps them awake at night.  

Baroness Verma then invited panellists to answer any of the questions raised.   In response, Sue Lacey Bryant highlighted a lack of expertise as an issue that keeps her awake at night, arguing that digital exclusion is too often treated as a single issue rather than a complex, cross-sector challenge. She offered an example of a person with cognitive decline looking for a digital carer, who might look online, go to what they think is 111, and end up getting scammed and charged by a private company. She argued the example demonstrates that industry and Government’s approach needs to be cross-sectoral, working across public services.  

Vicki Sellick said that she is kept up at night by the perception of digital exclusion as a marginal issue, arguing that people still link digital exclusion to social exclusion, but for many, digital exclusion creates a barrier that means people are not given opportunities to gain access to the latest information, access to the workforce, banking, healthcare and other essential services. She stressed that the problem is growing and changing as more people are becoming digitally excluded and the gap is getting wider, but public attention focuses on technological innovation.  

Dr Greaves said that he is kept up by cyber-security concerns and scams. He reflected on the challenge posed by the concept of “digital by default”, noting that many would not stop to think about it as they are caught up by technophoria. Jan responded by saying she hates the constant changes, and she worries about health disinformation that is AI-generated, asking what the panel think can be done to prevent that?  

Max Marulli de Barletta said he is kept up by the unintended consequences of digital evolution. As an example, some people are being told by GPs that they have to access services through the NHS app as its easier for the GP. He highlighted that this isn’t the GPs fault, he said, as they are under pressure, but it requires thought. To the points on AI and older people, he stressed that the programme of work he oversees aims to help as many people as possible, but that inclusive design is only needed because the NHS has not included everyone by default. He emphasised the need for more engagement with users and older people at the beginning of the project so that an understanding of the problems is embedded.  

Mary Hill responded to the question about digital agism, mentioning her engagement with the ‘Digital by Default’ team about coproduction and user acknowledgement. She said they want to equip NHS commissioners with data on digital access on a national and local level, to help them design the appropriate care. She recognised the important effects of digital exclusion on people’s lives and said that misinformation keeps her up at night.  

Elizabeth Anderson then responded to Jan’s question, saying that more services are being moved online to be digital by default with the expectation that people will get online when forced, which is not the reality. She cautioned that for health services people find a way to be resilient, but research shows everyone will age into digital exclusion as technology continues to develop. She argued that hoping people will age out of digital exclusion will only save problems for future. Second, on operating systems, she noted both agreement and disagreement with Bertie. She challenged his question noting that increasing the range of operating systems creates additional complexity for both users and those providing support, particularly in terms of training digital carers and frontline staff to navigate multiple systems effectively.   Baroness Verma then opened up discussions for three more quickfire audience questions.  

Clio Wood, Co-Founder of CensHERship, introduced her company’s focus on tackling online bias around women’s health. She cited research showing 2% of health information shared on TikTok is accurate, whilst 95% of women’s health organisations have been suppressed online from sharing lifesaving content. She challenged the panel to consider how the suppression of women’s voices online can be addressed as part of wider digital inclusion efforts, particularly in the context of the Women’s Health Strategy.  

Second, PJ Annand, Senior Research Fellow in Digital Care at the University of Sheffield, asked how industry can use the digital poverty heat map and what is the tool like, with both national strategy and local data in mind. She also raised challenges around co-production and a lack of inclusion when developing health services, noting that some individuals may not have the ability or willingness to engage in digital design processes, either due to lack of skills or concerns around privacy and data sharing. With regards to co-production and design, she said it is hard to find people that are able and want to help and asked how Government Departments tackle that problem.  

Annie Radcliffe from the Local Government Association addressed her question to the team in digital health from the NHS. She asked how they are working with local government to build digital inclusion initiatives, highlighting the current gap in this space that is affecting health outcomes.  

Finally, Sophie Lancaster from Arts Council England (ACE) invited Max come to ACE’s libraries for opportunities for co-production and collaboration. She also raised the need for legislative change, particularly in relation to the digital carer role, arguing that there is currently a lack of alignment across sectors and that clearer legal and training frameworks are needed.  

In response, Vicki noted that there are areas that have a mature digital world, with local government and community infrastructure, yet there are plenty of places that do not. She said that progress will depend on collaboration and more local demonstrators showing what is possible in practice.  

Dr Greaves added on social care that conversations are happening with the Local Government Association, and he would be happy to talk to Annie about this.   Max reflected that his original goal is to shift everything left so that if intended users indicate that a service does not meet their needs, this can fundamentally reshape the direction of the project. With regards to Arts Council England's invitation for him to visit their libraries, Max said he would love to come and that Sophie should hear from his colleagues.  

Elizabeth addressed the issue of bias noting women are more likely to be digital excluded, and there are more barriers for women. She also pointed out that many local authorities don’t have a digital exclusion function and until somebody can take that lead, the support won’t be there.  

Mary responded to Annie’s question on local government by emphasising the importance of cross-sector partnerships, noting that collaboration with local authorities is essential to addressing health inequalities. On PJ’s point on data, she said granularity of data is very important, highlighting the recent launch of the NHS Digital Exclusion Risk Atlas, which she hopes will provide a national and local overview of the problem. The data includes the primary care level, local authority level, ICB level and so on, and can be found here.  

In closing, Baroness Verma reflected that the discussion represented only the beginning of what needs to be a much broader and ongoing conversation. She said we need to look at legal frameworks, and to keep pace with the shifting sands as digital technology keeps moving forward. She expressed her thanks to panellists and guests and formally brought the session to a close.