Digital and Health
Executive Summary
The South West London (SWL) 2025 spring engagement grant fund focused on understanding how technology can improve access to care and what digital barriers people face. The engagement with local communities aimed to find out how they feel about digital services and what may support them to be ready for digital change. This included focusing on increasing uptake and use of the NHS App, how people felt about technologies and ambient AI to improve access to digital services supporting pressures in our health and care services. Across all funds people were keen to share their views about digital technologies.
26 local voluntary, community and social enterprise (VCSE) organisations were funded to deliver 82 activities and to have in-depth conversations with 983 people from a range of ethnicities, socio-economic and health backgrounds.
Key findings:
- Digital tools are giving people more control over their health, especially those with long-term conditions who can view and manage records online.
- Digital isn’t one-size-fits-all, some people still face exclusion, including older people, those with limited English, and people with low literacy.
- Choice is key to trust, people still value face-to-face care, particularly those with mental health needs or who rely on social contact. Technology should complement, not replace, clinicians.
Next steps:
This insight will:
- Shape our providers’ digital strategies, transformation programmes and investments.
- Inform a business case for ambient voice technology across South West London in our four acute hospitals.
- Be discussed at relevant digital meetings and networks.
The insight from this report is informing local and regional health strategies, with findings shared across public health teams and key planning meetings across South West London.
Introduction
This report summarises findings from Fund Two: Digital and Health, part of the 2025 Spring Engagement Programme across the six South West London boroughs: Croydon, Kingston, Merton, Sutton, Richmond and Wandsworth.
Across South West London, we funded 113 organisations, including 26 through the Digital and Health Fund. This fund focused on engaging local communities to understand how they feel about digital health services and what would help them prepare for digital change.
This fund involved working with community organisations who primarily work with our Core20 populations and in our more deprived areas, providing a voice to the most marginalised and underserved.
Grants of up to £550 were offered to voluntary and community groups working with people most affected by health inequalities, including those living in deprived areas, people with disabilities, asylum seekers and refugees, and residents with limited English or digital skills. The fund aimed to amplify the voices of those who are often underrepresented in conversations about NHS services.
Unlike the Winter grant programme, Spring focused on gathering in-depth, qualitative feedback rather than sharing messages. Conversations explored how people use digital tools such as the NHS App, their views on new technologies and Artificial Intelligence and ideas for what would make digital healthcare easier and more inclusive.
Across all boroughs, people recognised the benefits of technology but raised clear concerns about digital exclusion, accessibility and trust. This report summarises what they told us and what needs to change to make digital health inclusive for everyone.
We hear, across our community engagement projects, that people have enthusiasm for using technology in the health and care system but this is often caveated with concerns about digital exclusion and accessibility and trust issues about digital systems. We know that older people, people with disabilities, people who do not have English as a first language, people in low income households or with limited digital literacy face digital barriers. More information is included in appendix A.
We focused on engaging the following people to understand more about these barriers and their experiences of digital and health.
- People who face barriers using technology
- People from our most deprived areas.
- People from our health inclusion groups – including migrants and refugees, people who are homeless, people facing social exclusion.
Methodology
To support programme delivery and coordination, we worked in partnership with Croydon Voluntary Action, Kingston Voluntary Action, Merton Connected, Richmond CVS, Community Action Sutton and Wandsworth Care Alliance. Their trusted community links and local expertise were vital to delivering the programme successfully.
Grants were awarded based on who the organisation could reach and how closely their approach matched with people and communities we wanted to hear from, as well as their engagement approach.
We funded 26 organisations across Croydon, Kingston, Merton, Sutton, Richmond and Wandsworth reaching 2,537 local people from 38 ethnicities. Activities ranged from digital upskilling sessions, coffee mornings, yoga, Thai Chi, one to one conversations and surveys.
Successful organisations were invited to attend an online training session to support them to collect insight in inclusive and accessible ways. Each group was asked to explore topics using prompts to encourage conversation.
We built on our previous insight, including what we heard during our Winter Engagement Fund and our engagement on the 10-year plan, we asked four questions about people’s views and experiences of:
- The benefits of using technology in health and care
- Barriers to using technology in health and care
- Use of Artificial Intelligence
- How digital services can further support accessing health and care
Following their event, organisations were asked to submit a summary of what they heard, together with quotes and photos. Where it was identified that more insight could have been shared or additional support was needed CVS organisations followed up with one-to-one conversations with a sample of organisations.
Croydon
Six organisations in Croydon were awarded funding for the Digital and Health grant fund and delivered 17 activities.
| Organisation | Activities | Who they spoke to (e.g. ethnicities, age, gender etc.) |
| Club Soda provides opportunities for people with learning disabilities to access and enjoy music and the arts. | Ran a focused session, talking about people’s experiences of using digital tools to support their health. | 30 people aged 20-70 years old who identified as having learning disabilities, lived experience of mental health conditions or autism. People from Black British Caribbean, British South East Asian and Black British African communities. |
| Guiding Hands is a food bank community organisation that caters for low income disadvantaged families and people who are normally excluded and isolated in our communities. | Ran digital skills workshops, health awareness sessions and small group engagement sessions. | 64 people aged 45-64. People identified as having a long-term condition, deafness or patrial hearing loss or blindness or partial sight loss. People from Black African, Black Caribbean, White – British, Northern Irish, Welsh, Scottish, Mixed Black African & White, White – Eastern European, Pakistani and Chinese communities. |
| Turkish Youth and Community Association worked with Turkish speaking older people and women who face poverty, ill-mental health, domestic violence, loneliness and social exclusion. | Organised home visits and telephone calls to support women to better use their devices. Also put on digital skills workshops. | 30 people of who were mostly older and from Turkish, Turkish Cypriot and White Kurdish communities. People identified as being blind or having partial loss of sight, deaf or partial loss of hearing, having a learning disability, lived experiences of mental health conditions or a long-term condition. |
| Upper Norwood Association for Community Care (UNACC) runs an over 50s lunch club in South Norwood, alongside a range of different activities designed to keep bodies and minds active and healthy. | Held conversations at their weekly lunch sessions with people aged over 65. | 138 people aged 45-85 and older. People identified as being autistic, blind or having partial loss of sight, deaf or having partial loss of hearing, having a learning disability, lived experiences of mental health conditions or a long-term condition. People from Bangladeshi, Indian, Pakistani, Sri Lankan Tamil, Asian British, Black British, Black Caribbean, Black African, Turkish, Iranian, Japanese, Mixed Asian & White, Mixed Black Caribbean & White, White – British, Northern Irish, Welsh, Scottish, White-Italian and White Polish communities. |
| Babyzone Croydon provides holistic support to disadvantaged families with children under the age of 5 in England. | Held one open session for families and children. | 30 parents and families. |
| Christian Family Concern is a charity committed to supporting women and families in Croydon. | Two activities at one Q&A picnic session. | 30 people. People identified as being blind or partially sighted, having a learning disability, or having lived experience of a mental health condition. People from Pakistani, Asian British, Black British, Black Caribbean, Black African, Mixed Asian & White, Mixed Black Caribbean & White, Mixed Black African & White, White – British and Northern Irish, Welsh, Scottish communities. |
Kingston
Four organisations in Kingston were awarded funding for the Digital and Health grant fund and delivered eight activities.
| Organisation | Activities | Who they spoke to (e.g. ethnicities, age, gender etc.) |
| Korean Culture & Arts UK CIC is a community hub for the Korean community. | Held digital training sessions, specifically around the NHS app. | 15 people aged 65-74. People identified as having a long term condition or disability, being deaf or having partial loss of hearing. People from Korean and White British, Northern Irish, Welsh and Scottish communities. |
| Milaap Multicultural Day Centre is an organisation supporting older and disabled individuals, particularly from ethnic backgrounds | Held a focus group and also a small group discussion specifically for members who do not have English as a first language. | 55 people aged 55-84. People identified as having a long term condition or disability, being deaf or having partial loss of hearing, being blind or partially sighted, having a learning disability or lived experiences of mental health conditions People from Bangladeshi, Indian, Pakistani, Sri Lankan, Tamil, Fillipino, Sri Lankan Sinhalese, Asian British, Arab, Mixed Asian & White, Iranian, Korean, Afghan, White – British, Northern Irish, Welsh, Scottish and White – Italian communities. |
| New Malden Methodist Church supports older adults, individuals with long-term health conditions and socially isolated residents in the local area. | Held Tai Chi sessions and digital workshops. | 30 people aged 65-74. People identified as having a long term condition or disability, being deaf or having partial loss of hearing, being blind or partially sighted or having a learning disability. People from Indian, Chinese, Filipino, White – British, Northern Irish, Welsh, Scottish, Mixed Asian & White and Korean communities. |
| Kingston Advocacy Group | Held 1:1 interview sessions over 2 separate days. | 11 people aged 20- over 65. People identified as having a long term condition or disability, being deaf or having partial loss of hearing, being blind or partially sighted, having a learning disability, autism or lived experiences of mental health conditions Pakistani, Black British, Black Caribbean, Black African. Arab, Asian British, Mixed Black African & White, Mixed Black Caribbean & White, White – British, Northern Irish, Welsh, Scottish and White – Eastern European communities. |
Merton
Three organisations in Merton were awarded funding for the Digital and Health fund and delivered 12 activities.
| Organisation | Activities | Who they spoke to (e.g. ethnicities, age, gender etc.) |
| Commonside Community Development Trust works to improve the lives and environment of people living in Merton. It does this by managing a community centre, running community events and a number of community development programmes. | Ran five drop-in café sessions. | 76 people aged 55-85+. People identified as having a condition or disability, being blind or partially sighted, being deaf or having partial loss of hearing, having a learning disability, having lived experience of a mental health condition, having autism, or a long term condition. People from Indian, Pakistani, Sri Lankan Tamil, Asian British, Black British , Black Caribbean , Black African, Black Nigerian , Turkish , Afghan, Latin/South/Central American, Mixed Black Caribbean & White, White – British, Northern Irish, Welsh, Scottish, White – European, White Polish, White – Eastern European communities. |
| Merton Vision is a local sight loss charity, based in Colliers Wood. They are the only sight loss charity in the borough of Merton. | Held a talk on the NHS app and IT. | 35 people aged 35-85+. People identified as having a condition or disability, being blind or partially sighted, being deaf or having partial loss of hearing, having a learning disability, having lived experience of a mental health condition, having autism, or a long-term condition. People from Indian, Vietnamese, Chinese, Asian British , Black British , Black Caribbean, Black African, Mixed Black African & White, Mixed Black Caribbean & White, White – European, White – Irish, White Polish and Gypsy, Roma, Traveler communities. |
| Togetherness Community Centre bring together people from across the local community to boost wellbeing, reduce loneliness and foster a stronger and happier community by creating joyful cultural and intergenerational experiences. | Ran a yoga session along with a digital and health presentation and a board games session. They followed up with six 1:1 interviews. | 45 people aged 55-85+. People identified as having a condition or disability, being blind or partially sighted, being deaf or having partial loss of hearing, having a learning disability or having lived experience of a mental health condition. People from Indian, Black British, Black Caribbean, Black African, Black Nigerian, Turkish, Mixed Black Caribbean & White and White – Irish communities |
Richmond
Four organisations in Richmond were awarded funding for the Digital and Health fund and delivered 19 activities.
| Organisation | Activities | Who they spoke to (e.g. ethnicities, age, gender etc.) |
| Elleray Community Association runs a social centre for over 60s to prevent loneliness and isolation. | Ran their ‘here Comes Summer Party’ which included bingo, lunch and theatre entertainment and chats about digital technology. | 25 people aged 65+. People identified as having a condition or disability, being blind or partially sighted, being deaf or having partial loss of hearing, having a learning disability, having lived experience of a mental health condition, having autism, or a long-term condition. People from Black Ghanaian, Jewish, White – British, Northern Irish, Welsh, Scottish, White – Irish and White – Italian communities. |
| Hampton & Hampton Hill Voluntary Care is a neighbourhood group that supports socially isolated people | Ran 3 digital Drop-In sessions. | 40 people aged 65-85+. People identified as having a condition or disability, being blind or partially sighted, being deaf or having partial loss of hearing. People from Black British, White – British, Northern Irish, Welsh, Scottish, White – Irish and White – European communities |
| Richmond AID is an organisation providing support services for people with disabilities. | Ran a number of activities including their RAID Art Club, an accessible Walk, Coffee Mornings, Connect to Tech Sessions, and a Neurodiverse Support Group | 48 people aged 25-85+. People identified as having a condition or disability, being blind or partially sighted, being deaf or having partial loss of hearing, having a learning disability, having lived experience of a mental health condition, having autism, or a long term condition. People from Black British, White – European, White – British, Northern Irish, Welsh, Scottish and Asian British communities |
| Ukrainian Social Club is an organisation that supports Ukrainian refugees to adjust to life in the UK. | Ran three group discussions and a questionnaire in community chat. | 17 aged 18-74. People identified as having a condition or disability, having lived experience of a mental health condition, or a long term condition. People from White European communities. |
Sutton
Four organisations in Sutton were awarded funding for the Digital and Health fund and delivered nine activities.
| Organisation | Activities | Who they spoke to (e.g. ethnicities, age, gender etc.) |
| Sutton Old People’s Welfare Committee – a charity tackling loneliness in older adults | Ran a VE Day Celebration – for members, volunteers and the family of members. They had 1:1 conversations. | 32 people over 65. People identified as having a condition or disability, being blind or partially sighted, being deaf or having partial loss of hearing, having a learning disability, having lived experience of a mental health condition, or a long-term condition. People from White – European and White – British, Northern Irish, Welsh, Scottish communities. |
| St Mary’s Jacobite Syrian Orthodox Church – an organisation with reach into Sri Lankan,Tamilian and Malayalee communities. | Two gatherings to discuss, share views and create awareness on NHS digital services. They also conducted an online survey. | 17 people 55+. People identified as having a condition or disability. People from Indian or Asian British communities. |
| Malayalee Association Sutton Surrey (MASS) - a community group for Malayalee families from Kerala in India. | Ran a group event and feedback collected through in person and online | 10 people aged 35-65. People identified as having a condition or disability, or a long term condition. People from Indian and Asian British communities. |
| Wallington SDA Hub – supports families and young people | Delivered five information sessions for food bank attendees | 40 people aged 21 – 84. People identified as having a condition or disability, having a learning disability, having lived experience of a mental health condition, or a long term condition. People from Bangladeshi, Chinese, Indian, Nepali, Pakistani, Sri Lankan Sinhalese, White – British, White – English Arab, Sri Lankan Tamil, Sri Lankan other, Vietnamese, Black or Black British, Black – Angolan Black – Caribbean, Black – Congolese, Black – Ghanaian, and Black – Nigerian communities. |
Wandsworth
Five organisations in Wandsworth were awarded funding for the Digital and Health fund and delivered 17 activities.
| Organisation | Activities | Who they spoke to (e.g. ethnicities, age, gender etc.) |
| Generate Opportunities – supporting people with learning disabilities and autism in Wandsworth and surrounding areas. | They used their ‘Voices Forum’ to hold conversations with their members. | 26 people aged 18-54. People identified as having a condition or disability, being blind or partially sighted, having a learning disability, having lived experience of a mental health condition, having autism, or a long-term condition. People from Black British, Black Caribbean, Black African, Black Nigerian, White – British, Northern Irish, Welsh, Scottish and White – North American communities. |
| Living Truth CIC - offers wellbeing support services and training programmes. | Ran a focus group with attendees. | 14 people from aged under 16 – 84. People identified as having a condition or disability, having a learning disability, having lived experience of a mental health condition, having autism, or a long term condition. People from Pakistani, Vietnamese, Fillipino, Asian British, Black British, Black Caribbean, Black African, Black Somali, Yemeni, Afghan, Mixed Asian & White and White – Eastern European communities. |
| Share Community - supports adults with learning disabilities and autism to leave happier, healthier and more independent lives. | Had 1:1 conversations with people about digital technology. | 16 people aged 18-64. People identified as having a condition or disability, being blind or partially sighted, being deaf or having partial loss of hearing, having a learning disability, having lived experience of a mental health condition, having autism, or a long-term condition. People from Mixed Black Caribbean & White, White – British, Northern Irish, Welsh, Scottish, Black British, Asian British communities. |
| Happy Homes – supports Asian families, with a focus on women and children by promoting health and wellbeing. | Ran a coffee morning with art activities whilst having 1:1 conversations. | 100 people from children under 16 – 74. People identified as having a condition or disability, having lived experience of a mental health condition or a long term condition. People from Pakistani, Sri Lankan Tamil, Asian British, Indian and Bangladeshi communities. |
| Power2Connect – working for digital equality and reducing the digital divide in Wandsworth. | Engaged with residents facing digital exclusion. | 23 people aged 25-85+. People identified as having a condition or disability, being blind or partially sighted, being deaf or having partial loss of hearing. People from Bangladeshi, Black British, Black Ghanaian, Mixed Black African & White, White – Irish, White – British, Northern Irish, Welsh, Scottish, White Turkish Cypriot, Black Somali, Latin/South/Central American communities. |
Challenges and Barriers to digital
This section brings together what we heard from people and communities across Croydon, Kingston, Merton, Sutton, Richmond and Wandsworth. It reflects common experiences shared by many and shows were views differed.
Benefits and using digital
Digital tools can save time and can be easy to use. People liked being able to access their notes more easily and complete administrative tasks fast, such as ordering repeat prescriptions. Sending photos to their GP for simple issues like wounds or cuts, was seen as helpful and viewing test results online improved communication following diagnostics tests. Those managing long-term conditions also found digital tools helpful, for example, people with diabetes using the Libre app valued being able to track their blood sugar and health needs during appointments. One person said that remote monitoring following their health condition was particularly useful.
“The app makes everything smoother and quicker”
For regular users of services, the NHS app offers convenience and independence. Managing long-term conditions through the app makes people feel more in control. Being able to review medical records and have direct communication with their GP surgery makes communication with easier. People found having their information kept in one place was also useful. For people who struggle to get to the GP or hospital, being able to get help using technology is important.
“I prefer using the NHS website and GP app.”
Efficiency of being able to share data across the NHS. Peoplelike the idea of different clinicians being able to view their medical records, meaning they do not have to repeat their story at every appointment. One person described how she struggled when moving to London from Wales because she felt no one knew her medical history of a heart condition. Joining up medical records digitally across the country would be of huge benefit. Some people caveated that this is fine as long as it is contained within the NHS and private data is not shared further.
“Less paper-based because all information is at your fingertips.”
Better access to information to support self-care. People described the benefits of looking up their own condition or symptoms before accessing help from care professionals, particularly to help people to manage their long-term conditions. It helps speed up access for information and guidance to manage health conditions.
“I use the on-line diagnosis with my phone and found it quite useful.”
What people feel might get in the way of going digital
Worries that digital technology may replace face-to-face contact with health professionals. People feel that some digital tools can feel impersonal, and people worry that they will lose human contact during their care. People were concerned that they wouldn’t be able to express their concern properly over a digital consultation and communication wouldn’t be as effective. This shift seemed more frightening for people who may need mental health support, and some said could be cutting an outlet for their social wellbeing.
“I fear being misunderstood or overlooked when services are delivered remotely or through apps.”
There is still limited knowledge of what the NHS App can do. While many people know about the NHS App but often don’t take advantage of all elements of it. Some of this confusion comes from different GP surgeries using different apps which can make it harder for people to know which one to use and what each one does.
“If I understood the benefits, I’d be more inclined to use it.”
Others were aware of the app but did not know where to go for help with it. They would like more support in their community, or a simple guide on how to use the app.
“Clear instructions would make a big difference.”
People who do not speak English as a first language do not feel able to use digital tools unless they are fluent in English. The app was highlighted as a particular issue as it is only available in English. People spoke about the importance of information and support being available in different languages to enable more people to use technology in healthcare. This barrier was highlighted by people from Turkish, Ukrainian and Global Majority communities as well as refugees and asylum seekers.
The Turkish Youth and Community Association said “About 98% of our people need extended training to be able to access devices. These people are confronted with many kinds of barriers like language”.
The NHS App isn’t accessible for everyone with additional access needs such as visual impairments, low literacy or where English isn’t a first language. Tick boxes and drop-down menus are not accessible for people with visual impairments, even with individuals switching on accessible formats on their phones. People with a visual impairment expressed an interest in using the app if the accessibility was improved. Other communication issues that act as barriers to using digital applications include age, literacy levels and communication difficulties, impacting those with learning difficulties.
“People who cannot express themselves would find it hard to communicate with the app.”
The cost of devices and internet access is a real barrier to using technology. It was highlighted many households still do not have Wi-Fi at home due to rising costs. It was suggested that there needs to be more provision in place for people to be able to access technology and the internet with the increased use of digital tools.
“We need community places with internet and computers where people can go.”
Lack of digital confidence and support creates barriers to use. Many people feel they lack the skills needed to use digital tools. Even if someone has a smartphone they don’t feel able to download or navigate the apps, or they are worried about getting it wrong. Complex login processes can also increase exclusion. This lack of confidence has left them feeling excluded from services and are often embarrassed to ask for help. People feel they need repeated support because information doesn’t stick when they aren’t using it regularly.
“I got stuck at the beginning. I didn’t understand the security steps. I just stopped trying.”
People have concerns about potential leaks of private data and stressed the importance of user consent for data sharing. This worry was more prevalent among Global Majority communities, some of whom do not trust the NHS to handle their information safely.
“Data should be highly secured and safe, with only herself and her doctors being able to access it. Data sharing should only be done with her consent and only if it is absolutely necessary.”
Some people dislike in technology in general and worry about the negative impacts in the future as it’s use increases.
“These online things steal people’s jobs.”
Concern that digital solutions can have technical issues. People complained about issues with online systems including the NHS App. Worries around technology not working whilst someone was receiving treatment and the physical impacts of this caused concern. There were also concerns about the possibility of a cyber-attack on the NHS, like the recent attacks on big companies.
“Concerned that if the internet goes down then it would be a big problem as there is no back up option like keeping records by hand like there used to be.”
Ambient Artificial Intelligence (AI): Hopes, fears, and the need for a human eye
People have mixed feelings about Artificial Intelligence, balancing hope for efficiency with scepticism and fear. Some people liked the idea of AI being able to type up their appointment notes for them to review at later date. This was seen as particularly helpful for people with learning disabilities or those who process information differently. There were other hopes that AI could simplify diagnosis and in turn reduce waiting times for appointments.
However, not all participants could see the benefits of using AI, some felt it will only lead to further mistakes which could have costly impacts on people’s care. Korean communities expressed worries about the ability of AI technologies to understand their accents and with the increased reliance on technology, they worried about the possibilities of misdiagnosis or being given the wrong prescription.
“I am against artificial intelligence because it is not a living being – it cannot understand emotions or accents.”
Emotional and cultural concerns amplify mistrust around AI. Fears of surveillance, loss of human jobs, and data misuse were common. People worried that we didn’t know enough about these systems and what the impacts of using them further down the line could be. They worried about AI having access to personal medical data and having recordings of their voice.
“We have watched I, Robot. Technology is dangerous.”
“We need to know it’s safe and that humans are still in charge.”
People want AI to support, not replace, human care. They shared concerns about its ability to consider the bigger picture, recognise emotional cues and avoid errors. People are worried that AI could miss subtle signs such as discomfort, which is especially important for people who have a mental health need or those with a language barrier.
“I am against artificial intelligence because it is not a living being and it cannot perform a comprehensive analysis taking into account all indicators of the disease, the person’s psychological, emotional and physical condition, and their life history.”
People suggested a combined approach of clinical staff and AI tools. For example, they could see the benefits of using AI for diagnosis then follow up with human care.
“We need hybrid GP /AI initial diagnostics followed by human specialist consultant care.”
To build trust, people suggested involving communities in designing AI tools and innovative technology. People recommended co-designing approaches that actively include the voices of those with lived experience of exclusion, a point emphasised by individuals with learning disabilities or autism.
Specific Communities
This section shares the experiences and views of specific communities regarding digital services and health.
Older adults
Lack of compatible devices, and a lack of digital skills, can leave older people faced with being digitally excluded. Some people rely on family members or carers to help them use the NHS App and others would like to be able to pass on the responsibility of using technology to the person that is supporting them.
“I don’t have a smartphone, so I can’t use the NHS App.”
Some older people are uninterested in learning how to use technology better. Others called for more and continuous support to help them get to grips with new technology which would help them access services would put them more at ease. The calls were for this support to be provided in trusted community spaces that are familiar.
“There are not enough resources to teach us how to use it”
People with disabilities
People with visual impairments or dexterity issues encountered app designs that were inaccessible or incompatible with assistive technologies. Some people with visual impairments prefer traditional means of calling the GP and having face to face appointments but others did say they’d used AI technology which made accessing services quicker and easier.
To make digital tools easier to use, people requested voice navigation, and simplified interfaces tailored to their needs.
People with learning disabilities
Language, communication and usability challenges make digital tools feel inaccessible or intimidating. For people with learning disabilities, they said they can sometimes struggle to navigate websites, often finding it hard to remember passwords or understand messages from the GP. This can make people feel frustrated or worried about getting things wrong. The NHS App was highlighted as particularly inaccessible as it doesn’t have information in easy read.
One person said “The NHS App should have easy-read information and videos to help people like us” which shows that clearer, visual guidance on the app could make such a difference.
Others spoke about wider trust issues with technology, saying that they are unsure how reliable health information is or whether the information or website they have is even real. People felt that digital healthcare tools would be more inclusive and effective if those with lived experience were directly involved in designing and testing them. This would really help making sure that simpler language, video support and easy to understand options are included from the start.
“I don’t trust some of these websites. It’s hard to know what’s real.”
Refugees and Asylum Seekers
As well as language being a barrier to accessing digital tools, Ukrainian refugees said they feel more comfortable seeking support through refugee support organisations who are culturally competent, rather than formal NHS routes. They trust these organisations. They suggested training session and outreach ran through these existing networks.
“If someone at the Ukrainian Social Club says there is help with health apps, I would go. I wouldn’t go to a big NHS office”.
Suggestions for improvements and ways to support usage
Provide digital support to boost confidence. People want more help using technology NHS digital health hubs were suggested, in accessible community venues to help give people support and digital confidence. People also wanted a hotline specifically for troubleshooting NHS tech issues.
“I want to use the app, but I don’t know where to begin. I need someone to sit with me and show me.”
Digital tools to compliment, not replace in person care. People like the idea of a blended approach of both technology and face to face support. They highlighted that digital only care doesn’t suit everyone, and it is important to offer solutions for all.
Signpost through trusted community networks. Local community leaders are a tool for educating and upskilling people in how to use digital tools to access health and care. Having sessions in a familiar environment, in people’s first language, would help build trust and encourage more people to use them.
“I don’t trust a random website, but if someone at my mosque or local centre says, ‘This is helpful,’ then I will try it.”
Simplify and diversify resources available. Create clear, multilingual, and accessible materials. Keep tools user-friendly and free of jargon, using everyday language and visual aids.
“Even a short video in Ukrainian would be helpful. I understand better when I see something, not just read.”
Codesign alongside people with lived experience. Develop and test new technologies with communities, not just for them. People with learning disabilities and neurodivergence said lived experience should guide both new developments and updates to existing apps and resources.
Next steps and recommendations
This insight will:
- Shape our providers’ digital strategies, transformation programmes and investments.
- Inform a business case for ambient voice technology across South West London in our four acute hospitals.
- Be discussed at relevant digital meetings and networks.
The insight from this report is informing local and regional health strategies, with findings shared across public health teams and key planning meetings across South West London.
Appendices
Appendix A: Existing insight on digital services
Insight on digital services, support and technology
Engagement on the 10 Year Health Plan with 80 community leaders and voluntary sector partners in South West London found strong support for digital innovation in the NHS but emphasised the importance of preserving human connection that underpins good care. There was enthusiasm for improvements such as a single point of digital access, better integration of services and the ability for digital tools to empower self-care. There were concerns about accessibility, digital exclusion and trust. Many residents lack access to smartphones, data or digital literacy. There is mistrust around data security and the effectiveness of existing NHS technology. Participants called for joined-up systems that communicate across health, care, community services and for inclusive design that supports carers and diverse users. Borough-specific feedback reinforced the need for cultural competence, language support, accessible communication to ensure digital health advances rather than widens inequalities. (NHS South West London (2025)South West London Listening Event 10 Year Health Plan – Insight Report)
115 community groups across South West London engaged 10,000 residents in over 350 activities revealing widespread digital exclusion and low awareness of NHS digital tools. Many residents particularly older adults, non-English speakers, and those with limited digital skills were unaware of the NHS App’s full functionality beyond COVID-19 records. Barriers included complex sign-in processes, poor navigation, inaccessible text sizes, lack of appropriate devices or internet access. Language and communication challenges further compounded these issues with residents struggling to understand app content, urgent care booking systems and inconsistent translations. Mistrust around data privacy also deterred usage. Many felt left behind as services moved online with some avoiding the app entirely due to frustrations with registration and access. (NHS South West London (2025)Insights from communities winter 2024/25)
Co‑design with those most affected by digital exclusion including older adults, socio-economically disadvantaged groups and people with limited English is essential for trustworthy, usable digital services. The five core enablers for inclusive design are genuine long-term meaningful engagement, addressing power imbalances to ensure people’s perspectives are heard and considered, building staff capacity for community collaboration and engagement, overcoming systemic barriers like time and funding and to prioritise accessibility and trust. (The King’s Fund (2025) Designing inclusive and trusted digital health service with people and communities)
A summary of over 300 community engagement reports across South West London reinforces digital inclusion as a cross-cutting theme. While many residents use NHS and council websites and rely on smartphones, significant issues remain including fragmented digital systems, poor interoperability, and a lack of support for users with low digital confidence. Although digital tools have aided access to appointments and care for some, uptake remains inconsistent, especially among older adults, disabled people and people whose English is a second language. Community voices stressed an urgent need for clear, accessible information, better system integration to improve continuity of care and proactive measures to prevent digital exclusion (NHS South West London (2024) Insight from local people and communities in South West London updated in 2024 – Summary Report)
Engagement on the Joint Forward Plan found strong support for the digital ambition, with 93% of respondents concerned about digital exclusion and 79% strongly agreeing with the vision. Many people valued digital tools for tasks like booking appointments and managing prescriptions, especially those with long-term conditions, concerns were raised about usability, fragmented systems, and digital exclusion among older people, disabled individuals, and ethnic minority communities. Participants stressed the importance of retaining face-to-face care and improving digital accessibility through training, support, and better system integration. Data security and trust in how the NHS handles personal information also emerged as key issues highlighting the need for an inclusive digital strategy that balances innovation with equitable access and human-centred care. (NHS South West London (2023) Joint Forward Plan – Our Engagement with people and communities April to May 2023)
Healthwatch Kingston reveals barriers to digital engagement and service access among 137 Kingston residents emphasising the need for face-to-face outreach and accessible information. Poverty is a significant factor as well as barriers including lack of trust, digital skills, language difficulties, physical disabilities and personal preferences to avoid digital channels. Many participants stressed the importance of face-to-face contact, accessible formats and outreach in familiar community settings to ensure their voices are heard. Feedback methods must be tailored to diverse needs, such as offering phone lines, translated materials, and clear, concise questions. (Healthwatch Kingston (2024) Including Digitally Excluded Communities: Engagement Report July to October 2023)
Qualitative interviews across Croydon, Merton, Wandsworth, Sutton, Kingston and Richmond revealed overall acceptance of virtual wards, with patients valuing being monitored at home via devices (e.g. oximeters, tablets), phone outreach, and centralised oversight. (Health Innovation Network South London (2022) Evaluation of Virtual Ward Models in South West London). In Croydon, Merton and Wandsworth barriers included reluctance to adopt tech, uncertainty about reliability, and varied digital literacy, often mitigated by personalised telephone or visit support. (Healthwatch (2025) Virtual Wards Qualitative evaluation of non-users’ views on virtual wards in Croydon, Merton, and Wandsworth)
NHS South West London engaged over 150 people through focus groups and a survey to understand public awareness and attitudes around patient data sharing for risk stratification. 23 out of 27 focus group participants were unaware their data was being shared or that they were automatically opted in with only 36% of survey respondents understanding the types of data collected. Despite this, many participants expressed interest in the potential benefits of data sharing for preventative care and called for clear, accessible information in formats and languages that reflect the local population. Concerns around trust and opt-out behaviours, particularly within Black and Ethnic Minority communities where fear of data misuse could lead to higher opt-out rates and unintended health disparities. Participants emphasised the need for targeted, culturally sensitive communications to address these gaps and ensure people understand the benefits of participation in data sharing. (NHS South West London (2023), Engagement on section 251 unpublished