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The Department of Health and Social Care invited Healthwatch Kent to participate in a consultation on the creation of the NHS Online Trust. The Online Trust will be a digital only service available nationwide, with the first patients receiving care in 2027. As part of this consultation we reviewed all the feedback we have received on digital systems in health and social care since 2023.
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.
