Widening the gap: are we guilty of ostracising those who need it the most?


Hilary Stephenson, managing director of user experience agency, Sigma worries that the very people who need medical technology’s help are those who may not be able to access it


In its Digital Strategy, the NHS recognises a ‘desperate need for health and care services to be better integrated and for people to better manage their own health and wellbeing’. And there are countless opportunities for the medtech community to engage with – and help deliver on – this aim.

Encouragingly, it’s something that the government seems to be taking seriously, having recently pledged £9 million to fund revolutionary digital healthcare projects in the UK. Another £37.5 million is also currently being invested in Digital Innovation Hubs to drive transformation across the sector.

Through devices such as personal wearables and patient-facing apps, medtech is helping to maximise the availability, scope and quality of traditional patient care. The recently-developed NHS app, for example, has been successful in allowing patients to carry out a variety of health management tasks, such as booking doctor’s appointments and submitting repeat prescriptions. Clearly, digital technologies are helping to bridge gaps and drive integration across the NHS, while also providing individuals with more control over their own healthcare journey. And they will bring unparalleled benefits to the vast majority of digitally-savvy patients.

But a key issue remains around accessibility. Digitisation is all well and good, but what about the one in 10 people in the UK still lack basic digital skills. Or the 13.9 million people in the UK who live with some form of condition or disability? What of the growing homeless community? Or elderly citizens?

We are a growing and ageing population, and one in which health issues related to poor lifestyle are becoming ever-more apparent. So, considering that these more vulnerable members of society are – by default – most likely to require support from the NHS, it’s vitally important that digital healthcare projects are created with inclusivity at the forefront. How can we ensure that all products and services, designed to tackle the problem, are not designed in a way that inadvertently excludes them from the process?

Digital technology is beginning to make real inroads into the healthcare system. At every stage of the journey, we are encouraged to use apps, activity trackers, health tags and other wearables, the NHS website, GP appointment booking systems, electronic health records and more. These aspects of the evolving medtech landscape are driven by digital self-service and patients taking more control of their own day-to-day wellbeing. The idea is one based on empowerment – and it’s something that will directly transform the way that people access the NHS in future. However, while digital technology has great potential, it is not a silver bullet. It can, in fact, create new and different problems. This often takes the form of usability issues, with some systems difficult to access and time-consuming to navigate. Perhaps most importantly, digital technology can leave certain members of society out in the cold – unable to use the very systems that are designed to help.

Who do accessibility issues affect and why? 

In essence, those sectors of society who are marginalised in other ways can be further disadvantaged by barriers to healthcare services and poor health outcomes. This includes people with learning difficulties, those affected by mental illness, the elderly, people living in deprived areas or the homeless community. When considering the healthcare ‘journey’, there are many traditional and digital services that are unnecessarily complex and difficult to use. This results in people not seeking healthcare when they need to, and missing booked appointments once they have actually sought care.

Systems and services are also often not designed with users in mind – something that will disproportionately affect some of the marginalised users who already face challenges. A study from Mencap, for example, found that the number of people with learning difficulties reporting issues in using health services was more than double that of those without an impairment or health condition.

How can digital services be designed inclusively?

The process is varied and complex, but there are a few key principles that should be applied to any digital platform to ensure it can be used by every UK citizen, without exception. While it may sound obvious, this includes involving a wide range of patients and healthcare professionals as early as possible within the design and testing process. This ensures that ‘accessible’ features or unnecessary additions are not simply retro-fitted, but that the entire technology is designed inclusively from the ground-up.

An example of this is a recent project we worked on with NICE to help implement its medtech horizon scanning system, HealthTech Connect. The platform allows technology developers to engage with service commissioners and clinicians early in their development cycle, encouraging a much closer collaboration around the supply and demand of apps used in healthcare.

More than ever before, the UK healthcare system is embracing the notion of empowerment; investing in innovative technology that enables patients to take control of their own health. There is much to be commended in this approach. However, it will only be effective in the long-term if everyone is able to use and access that technology.

The digital community must remain conscious of both the opportunity to improve millions of lives across the UK, and the responsibility to ensure that those who need it most don’t get left behind.

The patient is key

A new champion for patient engagement in the design of digital health technologies has emerged from the NHS’s top management. Check out NHS director Matt Swindells' call for more patient-centred innovation at the King’s Fund Congress


Hilary Stephenson






About Sigma

Established in 2007, Sigma is a leading digital User Experience (UX) agency, which

designs services and digital products that help people to live and work better. By putting users at the heart of its solutions, Sigma helps to add genuine business value and bring people together.

Sigma works with companies large and small, in the public, private and not-for-profit sectors, nationally and internationally. The team believes strongly in developing long term, mutually beneficial strategic partnerships with its customers, with key clients including InterContinental Hotels Group, Sport England and the BBC.

In addition, Sigma also runs the North’s leading digital UX event – Camp Digital. Now in its eighth year, Camp Digital attracts world-class speakers who discuss the most important topics and trends in the UX and digital community.

Sigma is part of Sigma IT Consulting – a Swedish IT Services firm with over 4,000 staff throughout the world.

About the author

With well over 100 years experience between us, we've been around the editorial and medical blocks a few times. But we're still as keen as any young pup to root out what's new and inspiring.

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