Understanding and tackling digital inequity within the older adult community

Danyal Mahmood is a third-year medical student (Medicine in Community Apprentices) at Imperial College School of Medicine, London.

Adnan Saad is a GP principal at Sheepcot Medical Centre, Watford; Associate Professor at St George’s University, Grenada; and Clinical Tutor at Imperial College School of Medicine, London.

With the COVID-19 pandemic there has been a shift to digital technology that has necessitated both GPs and their patients to adapt rapidly. This has been beneficial to GPs by potentially providing shorter remote consultations, which are efficient and convenient; and beneficial to the patient by avoiding having to wait in congested waiting rooms filled with unwell patients for an appointment that may be over-running late in clinic, and also avoiding the need to take dedicated time off from work, making them a very useful service provision in general practice for the foreseeable future.1

However, with this shift to digital technology, there is a patient demographic that will overwhelmingly struggle to adapt at such a fast rate due to their low usage rates and lack of technological literacy: the older adult community.2

A possible way forward would be to explore how to provide more patient-centred care in the older adult population by tackling digital barriers in accessing healthcare services.

There is a large disparity in IT skills between the older adult demographic and the rest of the population. This, in turn, has resulted in fewer older adult patients attending appointments due to difficulties such as the online form-filling process. According to the Office for National Statistics, 49.9% of females compared to 59.4% of males in the ≥75 years age group were classified as internet users in 2020, defined as using internet in the last 3 months.3

At present, one in five adults in the UK are providing care,4 with the number of unpaid carers aged >65 years nearly doubling to 4 million over the COVID-19 pandemic.5 This group not only run the risk of potentially mitigating digital exclusion but may also not understand how to access digital healthcare tools themselves, let alone explain it to those they provide care too.

In primary care it may be felt that older adult patients have a lack of support from their GP in conducting digital health tasks, and as patients there is a lack of awareness as to where to receive IT support, especially when there is an increased reliance on using IT systems for health questionnaires, online registrations, cohort group messages, and up-to-date key practice and health notifications, all pointing to an increased need for digital literacy.

Age UK, as part of their post-pandemic response, host digital inclusion face-to-face classes for those aged >65 years. These include offering computer and tablet training as well as accessing internet through the deployment of trained volunteers. Private home visits are also offered for flexibility and convenience, enabling personalised care. Participants of the course are directed to Age UK’s staying safe online and information guides on their website, also available to the public.6 Tablets are offered to participants and Wi-Fi is provided as part of attendance to the programme. Age UK volunteers can also come in to educate GP practice staff instead of patients on how to approach and inform patients, as well as signposting them to digital support.

Hence, a GP may wish to:
• explore digital awareness with older adults towards the end of a consultation;
• sign-post patients directly or via a social prescriber for digital support; and
• add additional language options to a practice’s website to tackle further online accessibility.

Hopefully, such measures can transition into being a clinical practice standard for GP surgeries nationally, preventing the ageing population of the future from struggling with the healthcare innovations of tomorrow.

1. Taggar J, Saha R, Hopwood-Carr P, et al. Clinical placements in general practice: concepts and considerations of implementing remote virtual placements in the COVID world. Educ Prim Care 2021; 32(4): 237–244.
2. Arcury TA, Sandberg JC, Melius KP, et al. Older adult internet use and eHealth literacy. J Appl Gerontol 2020; 39(2): 141–150.
3. Office for National Statistics. Internet users, UK: 2020. 2021. (accessed 24 Feb 2023).
4. Carers UK. Key facts and figures about caring. (accessed 24 Feb 2023).
5. Age UK. New Age UK research finds the numbers of UK over age 65s caring unpaid nearly double during the pandemic to more than 4 million. 2021. (accessed 24 Feb 2023).
6. Age UK. Staying safe online. (accessed 24 Feb 2023).

Featured photo by freestocks on Unsplash.

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