What the public want: more digital home care
There have been several surveys of public attitudes to digital health this summer that make fascinating reading, and the conclusion is that the public is much more up for this than many in the NHS might imagine.
The first was a large survey undertaken by Ipsos and released at this year’s Confed in June 2023. This was a survey of more than 1,000 adults in the UK - a third of whom live with one or more long-term conditions - commissioned by the NHS Confederation and Google Health. The second was another large 1,000 person study by PublicFirst for the Good Things Foundation and the third is research by the Health Foundation which included over 7,000 members of the public and 1,250 NHS staff on virtual wards.
Taken together the message is very clear; the Great British public want more digital home care and the appetite to use tech to stay at home instead of in hospital looks to increase with age and when long term conditions are acquired.
It is very interesting in terms of the public’s perception of health tech - and their appetite for more of it - and eagerness to be able to recover at home. The strength of feeling appears to be even stronger in those who are older than 75 - busting that myth that older people prefer not to use technology. If it keeps them out of hospital they are very keen to use it - even more so than younger people. Most people want to see the Government do more to close the digital inclusion gap and they are very much up for new models of care at home.
Some highlights from each report follow with links supplied to the full reports and related publications that are well worth reading in full. The Ipso report is here - and data packs are linked to in Further reading.
Ipso made sure they had a good range of ages involved in the research and these were some of the top findings:
Across all age groups more than 7 out of 10 (72 per cent) would use technology to avoid a hospital admission, with a similar proportion happy to use technology to monitor their health and share information and data with their doctors.
Nearly 4 in 5 people (78%) also said they would be happy to use different types of health monitoring equipment to help manage their health if an NHS professional recommended it to them, with this being a readiness that increased with age - a whopping 89% of people aged over 75 being willing to do so.
The enthusiasm of those over 75 meant that this was the top category of any age group, a really unusual finding and one we must take on board.
When looked at through the lens of living with an LTC, those with COPD were the most keen, with 88% of those of all ages saying they would use health tech if recommended to by an NHS professional, similarly this group was top at 81% of those who wanted to use tech to keep them out of hospital.
This is a really important message as currently most people living with COPD do not have access to tech to keep them well, but those sites that have extended this furthest are seeing up to a halving of emergency admissions, as covered in previous blogs. This impact combined with patient enthusiasm make it an area ripe to do more and create Health Hubs to provide proactive support to those living with COPD.
More than half of those surveyed with LTCs are using the NHS App for accessing personal health info - 53% against just 33% of those surveyed without an LTC.
89% of those surveyed said they are already using some sort of health technology to support their health - which really is massive - even if the most common use is using online search ahead of contacting the NHS, with the second most popular being wearables and apps. You may be aware that following work done by my team a few years ago, the validated health content within NHS.uk - the main NHS website which gets astonishing numbers of views each month - is now served up prominently in Google searches and through “knowledge panels” which are those handy nuggets of useful info when you search a topic, that direct you back to NHS.uk for more. This is all helpful in combatting misinformation and helping provide high quality patient information.
The report says
“Opportunities to build approaches to increase digital access did start to emerge from the research. We found that older adults really take note of what their doctors say: 81% of the over-75s surveyed said doctors would have the greatest influence in encouraging them to use health technologies; and 9 out of 10 (89 per cent) would be willing to try technology if recommended by the NHS. It is clear, therefore, that any pathway redesign that includes older patients cannot just be digital; the personal connection with a healthcare professional remains critical.”
Other findings included
* Many individuals are not confident about using technology to manage their health, leading to a fear that they may be locked out of healthcare if they cannot access or use digital tools.
* People think there is a larger role for health technologies in the future; many are not confident in using them now.
* Three areas emerged as necessary building blocks that could enable greater patient empowerment: digital access and inclusion, patient satisfaction, and user confidence.
* This first report concludes that the health service must design services in collaboration with patients to address these issues and empower patients.
The next fascinating survey came from the excellent Good Things Foundation that has been doing such great work to help narrow the digital divide. Again this had striking findings
The PublicFirst poll for Good Things Foundation, shows:
This again was a large survey of over 1,000 UK adults in May 23 undertaken by PublicFirst demonstrating a real eagerness to getting hands on in tackling the digital divide and a clear view that government has a role in this.
CEO Helen Milner’s blog Calling for Action on Digital Exclusion is a recommended read
Recommended by LinkedIn
Finally at the end of July, the Health Foundation published their research
“How do the public and NHS staff feel about virtual wards?”
This was a huge study, surveying over 8,000 people. 7,100 were members of the public over 16 in representative age groups and the remaining 1,251 were NHS staff.
Nearly three-quarters of the UK public (71%) are open to being treated through a virtual ward under the right circumstances, while 27% said they would not be. An almost identical proportion to those who expressed this in the Ipso survey in answer to the question about using technology to stay out of hospital (71%).
The study explored the level of public knowledge of terms like virtual wards and hospital at home, and understandably, these are new to many and not self explanatory. As I’ve written about before I’d love a virtual ward to feature in a major soap or hospital drama. The huge increase in public understanding of sepsis has been largely due to an amazingly effective campaign by the Sepsis Trust getting coverage from the Archers to Call the Midwife, with over 20,000 calls to the BBC action line as a result of much loved characters dying of sepis in these two programmes alone.
So there is further to go in raising awareness and in understanding and addressing the public’s concerns as this model of care is developed.
In some ways, it doesn’t hugely matter what the services are called locally, the main thing is that they are successfully offering people the option to spend much more time at home rather than in hospital, but with hospital level supervision.
The Health Foundation also found -
“Support for virtual wards is higher among disabled people and those with a carer – groups that typically have greater health needs and who might therefore be expected to be more intensive users of virtual wards.”
They also found even higher public support for home monitoring when they didn’t use the term virtual ward, getting a very similar result as Ipso had -
“Interestingly, a higher proportion of the public, 78%, told us that they would be happy ‘to monitor their own health at home using technologies, instead of in a hospital”
They also asked are you supportive of virtual wards. The finding was yes the UK public is, overall, supportive of virtual wards (by 45% to 36%). But this support is finely balanced – with a further 19% unsure whether they are supportive or not, which likely relates to the point about knowing what is being referred to.
“NHS staff in our survey were, on balance, clearly supportive of virtual wards (by 63% to 31%). When asked what will matter for making sure virtual wards work well, their top two factors were the ability to admit people to hospital quickly if their condition changes, and the ability for people to talk to a health professional if they need help.
What the Health Foundation research also found was a difference between socioeconomic groups -
“Those in socioeconomic groups D and E are on balance unsupportive of virtual wards, so it will be important to understand and address needs and concerns here. Notably, survey respondents in these socioeconomic groups who said that they would not want to be treated through a virtual ward were also more likely to say that their home would not be suitable for a virtual ward compared with those in other socioeconomic groups.” We know that the awareness issue will also have played in to this response.
The upshot though, is that the public is asking for more digital home care and is expecting to be offered more of it. It’s really important it is an offer for everyone which is why tech partners who make no expectation of what technology people have at home (providing devices and SIM enabled data cards) as well as strong customer support to build up digital confidence, really matter. That way everyone can take advantage of the digital home care revolution and we make a real difference to digital and health inequalities.
What also matters is the terrific campaigning and practical work of the Good Things Foundation who, in partnership with Telcos and businesses are providing technology and skills to those who need it most through the national data and device banks. If your business could sign up the details are here
The findings are exciting, demonstrate real appetite across the Great British Public for more care at home supported by technology and less time spent in hospitals; let's do what we can to make this the case.
Further reading
There is a 70 page data pack sharing the original Ipsos research -
Managing Director and Owner at MediMax Global UK Ltd
1yStrange, that is the complete opposite of what patients are telling me. Many elderly patients don't have smart phones, don't use the NHS app or even own a computer so how do they interact digitally? We know for a fact the something as simple as taking an upper arm blood pressure measurement isn't done correctly by medical staff so how do we expect to be able to rely on patients with very little training to provide accurate data from monitoring?
Senior Communications & Engagement Strategist & Practitioner
1ySome great insights here, Karen Shukla