We’re the ones that are hard to reach, not them— Digital Inclusion in Health
For those of you who have followed our progress on the NHS Widening Digital Participation programme, you will know that we have been working with the most excluded groups in England to see how and when digital might be able to improve their health/wellbeing / isolation.
We’ve had some amazing stories along the way; like when some of the homeless community in Hastings started to take their medication at the right time of day (after years of taking it incorrectly) because they were shown trusted information on NHS.UK. Or when Breast Cancer Screening attendances rose by 13% in Stoke (against a national decline of 4% year on year) by simply using Facebook as a way to interact with people.
I’ve been blogging throughout that time on how my/our terminology is changing because of this learning and this blog is no different. Today I’m writing about 2 things;
- A digital metaphor
2. What does ‘hard to reach’ mean?
A Digital Metaphor
Good Things Foundation (where I work) wants to see a world where everyone benefits from digital. This is a very noble thing as there are a lot of benefits for being digitally active, able and equal. (We also know there are some potential dangers — that’s for a further post). This means that we — or more importantly the wonderful people in our centres — try to explain to non-users of digital what it is and how it can help.
Very often figurative language can help people to understand and makes sure that the word digital doesn’t become, itself, a barrier.
So here’s my clumsy metaphor for finding information in a digital world for non-users.
Historically health information has been passed to people in packs or in books.
“Mr X you have XXXXXXXXX condition and here is all of the information that you will ever need”
Thud. A big pack of leaflets, books and letters are dropped onto the desk. Consequently, during the span of his condition, Mr X will need to go through a lot of information that isn’t useful to him in order to find the bit that is. He will need information then and there and it will be difficult to find it.
Now for the metaphor…..
Remember the Wonkavator — from the proper Willy Wonka with Gene Wilder?
“It looks like an elevator to me”.- Grandpa Joe
“Yes but elevators only go up. The Wonkavator can go sideways, and slantways, and longways, and backways… and squareways, and frontways and any other ways you can think of. It can take you to any room in the factory just by pressing one of these buttons.” — Willy Wonka
Charlie just needs to know where he wants to go, push a button, and *ZING the Wonkavator takes him there.
Digital can do the same for health information. If our old friend Mr X knows what buttons to press then *ZING — he can be taken to the precise bit of information that he needs for this exact moment. This information is trusted, timely and suits his personal needs right now.
I sometimes worry that public services still look at digital like Grandpa Joe would. They don’t see it as a Wonkavator that can help people when they need it. Yes, it’s very important that Mr X sees a health professional but digital can support in between, even reduce his need to see a health professional if he can get the answers he needs.
What does ‘hard to reach’ mean?
We all know about hard to reach communities. Those communities that can benefit the most from services but don’t use them, or don’t use the right one.
How arrogant we are!
Through my programme of work I’ve been toying with the phrase ‘take health to people, not people to health.’ We know that currently you may get an appointment with a health professional in 4 weeks at 3pm on a Wednesday and you (as a person) are supposed to be able to bend your life around that. This is difficult for every user of health services and even more so for those with complex lives and needs. But Mr X has his condition for the rest of the 27 days, 23 hours and 53 minutes of this 4 weeks (outside of his appointment) and may need help/support/information at any time during this period .
I was still working on my phrasing (as it’s a little clumsy) when someone said to me;
‘THEY aren’t hard to reach — it’s US who are hard to reach”
And there it is. One little flip and it all makes sense.
Hard-to-reachness is nothing to do with the communities and people who are struggling, and everything to do with the inflexibility of the services we (society as a whole) offer. The people we are trying to help aren’t hard to reach… they are sitting there on our streets, they are in our jobcentres, and A&E departments but we don’t reach them and that is on us.
Anyway these are just two things I’ve been thinking about recently.
If you want to know more about the Widening Digital Participation programme or our work at Good Things Foundation then please get in touch pete@goodthingsfoundation.org @pics_in_clouds
