Key messages

• digital healthcare should be inclusive by design rather than assuming universal access
• digital services must remain complementary to non-digital routes
• proactive identification of digitally excluded groups is essential
• partnerships with local authorities and voluntary organisations can support access
• support for devices, connectivity and digital skills is a core component of inclusion.

Policy implications

• NHS organisations should assess digital exclusion risks when implementing digital services
• offline access routes should be maintained and protected
• local partnerships are key to delivering practical digital inclusion support
• inclusion should be embedded in governance, commissioning and service assurance processes.

Gaps

• framework guidance is not accompanied by outcome evaluation
• limited evidence on how consistently the framework is implemented across the NHS
• need for monitoring of equity impacts over time.

Commentary
This framework provides a clear policy position on the use of technology in care, emphasising that digital transformation must not replace non-digital access routes. It recognises digital exclusion as a structural issue rather than an individual failing.

The focus on proactive identification of excluded groups is significant in terms of achieving care equity. Rather than relying on uptake data, the framework encourages services to understand who is missing and why.

The emphasis on partnership working reflects an understanding that digital inclusion cannot be delivered by the NHS alone. Local authorities, voluntary organisations and community groups play a central role in supporting access, skills and trust.

However, as a guidance document, the framework stops short of providing evidence on impact. Its contribution lies in setting expectations and principles. Ensuring these are translated into practice, and evaluated for their effect on inequalities, remains a key challenge for the NHS.