Digital health skills: Reducing inequalities, improving society

Today I’ll be at the House of Lords, launching our final report on the NHS Widening Digital Participation in Health programme.

Over the last three years of the programme, our aim has been to help people improve their digital skills, learn more about digital health, and improve their own health and wellbeing as a result. We have targeted those with least digital experience and most health needs in the heart of their communities.

With all of the challenges we currently face as a society, and with all of the pressures on the NHS, giving people digital health skills may seem like it’s not that much of a priority.

I’ll try and explain why it is.

There are 12.6 million people in the UK who don’t have basic digital skills and these people are those who are most likely to be suffering from poor health. They are also those most likely to be further disadvantaged by age, education, income, disability, or unemployment.

The fact is that there is a huge crossover between those who are digitally excluded, those who are socially excluded, and those at risk of poor health. The Widening Digital Participation programme aimed to see how action on one front could influence the others.

Ron

Ron Dale from Inspire Communities

Ron first went into Inspire Communities – a UK online centre in Hull and one of our pathfinder centres for this programme – because he was about to be sanctioned by Jobcentre Plus for not meeting his job search commitments. Ron was homeless, had a gambling habit, as well as serious mental health issues, including anxiety and depression. He was living in a tent on the motorway, on the occasional Pot Noodle and coffee. He was often hungry and cold, and his physical and mental health were going downhill.

Part of the problem was that Ron’s relationship with his GP surgery had deteriorated, and he refused to go. With the help of Inspire Communities, he was able to look at NHS Choices for advice on managing his symptoms, and to find a new GP. He was able to register and make an appointment online without having to run the gauntlet of travel, receptionists, and other patients.

Plugging him back into the healthcare system was key in helping to connect him to the wider support he needed – and digital was key in doing this. Now he’s found new housing, taking an active role in his own healthcare, meeting his Jobcentre Plus obligations and dealing with his gambling addiction.

Digital matters. Digital health matters.

And Ron’s story isn’t just a one off. Throughout the programme, we’ve found that giving people the digital health skills they need means they’re empowered to take control of their health, improving the ongoing management of chronic health conditions, and helping them to interact better with health and social care services.

We’ve also seen how digital inclusion can improve the social determinants of health – with better digital skills improving prospects for employment, income generation, educational achievement, and social connections. 52% of participants said they felt less lonely or isolated, and 62% stated that they felt happier as a result of more social contact. More than half said they have since have gone on to use the internet to improve their mental health and wellbeing.

On top of this, the programme has also shown that improving digital health skills has the power to reduce the pressure on frontline NHS services. By helping people to move non-urgent medical queries from face-to-face and emergency channels to online ones, we found we could potentially save the NHS an estimated £6 million a year, representing a £6 return on investment for every £1 spent on the programme over the last three years.

In summary, The Widening Digital Participation programme – and the local partnerships between UK online centres and local health and care providers that it has nurtured – has been proven to drive up the quality of care and drive down both health inequalities and health costs, ultimately improving society as a whole. And that’s definitely a result worth celebrating.

You can read more about the programme and download a copy of the report here: nhs.tinderfoundation.org.

Calling England’s libraries, the time to plan for the future is now

Back in October 2015 we launched a six-month project called the Library Digital Inclusion Fund in consultation with the Leadership for Libraries Taskforce, funding 16 library services in our network of community partners to run innovative schemes with the aim of increasing their digital inclusion activities, thus increasing their potential and cementing their place in society. Yesterday we launched our research findings from that project, proving that libraries’ community roots and partnerships can address social and digital exclusion – but that more needs to be done.

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The library sector seems to be suffering an existential crisis. They are facing tough times. This new project has established that libraries can, with help, reach those most in need (the 12.6 million people in the UK lacking basic digital skills), helping to connect them to digital information and skills. They work from the ground up and often have the resources – free-to-use WiFi and technology, such as laptops and tablets – that learners need. This makes them an integral part of communities everywhere and to lose any one of them is a great loss. Libraries need to live up to their enormous potential before time runs out. But what can we do?

England’s libraries need a solid digital inclusion strategy

The library sector needs to look ahead and develop a plan for the future. A key element is securing investment to make sure they have the most up-to-date equipment and services. During this year’s Be Online campaign I visited Leeds Libraries and went with them on an outreach session to visit a lovely lady called Molly. It was Molly’s first day with the project – she was learning about the internet through the Libraries@Home service and borrowing an iPad with a SIM card (which was developed as part of the Libraries Digital Inclusion Fund project). Without the proper investment, services such as this will no longer exist, and those already suffering social exclusion will be worse off as a result.

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We also need to think about how libraries can plug into other services to help communities and individuals to thrive. For example libraries could work together with local social housing providers to bring their outreach services to tenants who are otherwise unable to access technology and the online world. This kind of partnership would benefit libraries in so many ways, not least by helping them to prove their worth to local authorities, funders and the wider world, in terms of social impact and economic, digital-by-default support.

Now here comes the stats bit (you knew it would be in here somewhere). We’ve done a few calculations to work out the potential savings to local and national government in the areas where the library services participating in the project are based. Based on what we know about the way our learners shift from using face-to-face and telephone services to online channels, we would expect potential cost savings of more than £800,000 per year just through the project beneficiaries alone. If similar low-scale activities to those which took place throughout the project were implemented across all 151 library services in England, a potential £7.5 million per year of cost savings could be achieved.

Utilising technology and making plans to advance their digital work shows that libraries aren’t just about books any more – it shows that they’re moving with the times and planning for the future. I believe that libraries are not out-dated and not a thing of the past; I believe that libraries are an essential part of communities all across the UK and that they all have the potential to mould themselves and adapt to the developing technological world.

Our project supported more than 1,600 people to improve their digital skills at over 200 branch libraries. Target audiences included elderly people, families in poverty, disabled people and the long term unemployed, with activities ranging from job search skills to keeping in touch; connecting with essential government services to managing long term health conditions; understanding benefits to following hobbies.

Libraries may be an old concept but they are by no means obsolete. At Tinder Foundation we believe that we can help libraries with investment and strategy and this research very much shows that. The time to start planning for the future is now – let’s do it together.

Read our Library Digital Inclusion Fund Action Research Project evaluation report here.

Giving evidence for the future of Jobcentre Plus

On Monday I was called as a witness to give oral evidence at an inquiry by the Work and Pensions Select Committee into the future of Jobcentre Plus (JCP).

It was an interesting and lively session, chaired by John Glen MP, with cross party members who were clearly passionate about making job centres a better place for jobseekers.

I was there alongside Kathy Corocan from the Cardinal Hume Centre – part of the Caritas Social Action Network and one of our UK online centres – and Tom Hadley from the Recruitment and Employment Confederation. We talked about our experiences of working with job centres on the ground – and the feedback I brought from the UK online centres network was invaluable.  

Together we drew a picture for the Committee of what is an inconsistent service – a postcode lottery for job seeking support.

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Giving evidence at the committee. Image courtesy of http://www.parliamentlive.tv

 

We had to submit our recommendations in advance of the committee and this is what we called for:

  • An extension of the Digital Champion role in every Jobcentre, with an increased number of roles and improved training.
  • Increased transparency of funding in local areas.
  • A digital skills assessment for all benefit claimants and mandatory digital skills training for all those without digital skills.
  • The UK online centre search and Learn My Way platform to be embedded on all DWP devices, both for advisors and claimants.
  • Significant investment from DWP in digital skills, providing funding to support jobseekers to improve their digital skills and move into employment.

At Tinder Foundation, we know very well that in some places JCPs really get it, and there’s brilliant relationships with community partners like UK online centres to help support people to meet their job seeking commitments.  

In other places those external relationships don’t exist, and there can be a real breakdown in the relationship between claimants and advisors.

For me, one of the key concerns is how commonly our network sees advisors who simply underestimate how difficult it is to use the internet if you don’t know how to.

I told the committee about an experience I had sat with a lady in a homeless hostel in London. Her JCP advisor had set her up with an email address and logged her onto Universal Jobmatch. She didn’t even know what the internet was, let alone what an email was, or what to do next. The assumption was she’d just ‘get it’. But in order to get there she had many other steps to go through – steps the JCP hadn’t counted and weren’t a part of her plan. That put her on the back foot from the get go, and she was struggling to keep ahead of sanctions.

It’s a story we’ve seen a lot of across the 5,000-strong UK online centres network – people are being sanctioned because they don’t have digital skills. We don’t know how many people, but it’s not a one-off comment from the network.

The good news is that 65,000 people were referred to the network from the JCP last year. Over that year, we actually supported 89,000 unemployed people looking for work to improve their digital skills. When Universal Jobmatch first came in, we identified the huge impact that had on our network with people flooding in to learn digital skills, and we’d worked with centres and claimants to build our online Universal Jobmatch guide within five weeks. Within two weeks, it had been used more than 5,000 times.

JCP has big changes planned. This should change the incentives local JCP staff work to. The expectations is the new Work Coach role will bring a culture change. Currently, the goals advisors set people are about getting onto Universal Jobmatch, making x number of searches or applying for x number of jobs in x time period. There’s sometimes a limited understanding of whether or not someone is job ready, what their digital skills are to start with, and a misunderstanding of whether or not someone having access to the internet actually means they can use it effectively.

Having Facebook on your phone doesn’t mean you can automatically job search, by yourself, confidently, every day of every week. We need to change how we diagnose those skills needs – and wider needs – and what checks and milestones we can put in place to track someone’s progress.

Here’s the thing. If someone has been unemployed and digitally excluded for a long time it’s unlikely they’re going to just magically get online and get a job. There’s something else going on, there are other factors there that need exploring. We need to look at the whole person, the routes of their issues and what their barriers are.

That’s not something I expect JCP advisors to do on their own. There are places out there that exist to fill in those gaps (some of them are UK online centres). It’s great many JCPs already refer successfully and we would like more to work with us on those referrals – to us and other support agencies – to help identify someone’s issues more effectively, and set their goals accordingly.

Fundamentally, DWP is planning a change in culture, a fresh approach. And that culture change at JCP needs to come from the top. I believe there needs to be a better understanding of the impact of digital exclusion. Job centres now have equipment, and they now have WiFi, but neither of those solves the very real digital skills gap that’s causing some very real pain on the ground.

As witnesses, we all agreed that new work coaches and new diagnostic tools aren’t enough by themselves – we need a universal commitment to addressing digital skills, and addressing each person as an individual.

We went on to talk about the physical job centre space, and how they could become more welcoming.

We were also challenged to go away and come up with six key questions to ask people to assess their skills levels and wider needs – something much deeper than Are you online? Tick or Do you have an email address? Tick.

Finally, I made the point that all the work UK online centres currently do is 80% funded by government – and mostly by the Department for Business Innovation and Skills, for whom we move people across the digital divide for around £15 a head. While we report to the Department for Work and Pensions through this programme each quarter, we don’t have an official nor funded relationship with them. We do value the informal relationships we have with committed and intelligent people who see the changes needed much more clearly than I do.

There is huge potential for us to take the models of good practice and seed them across the rest of the country. I’m looking forward to seeing how the Committee’s recommendations are developed, and how we can continue to help that process along. Hopefully, we’ll see the results on the frontline very soon.

If you’d like to see me in action at the Committee, you can do so here on Parliament TV.