From GPs to the DWP – the public sector must ensure digital is not the only answer

Digital transformation can bring great benefits, but the needs of the millions of people that still need non-digital means of interacting with government must not be overlooked, argues PublicTechnology editor Sam Trendall

I don’t mind admitting that, despite almost a decade as an IT journalist, I am naturally something of a technology sceptic.

Over the years I have sat in innumerable conference halls and meeting rooms and watched as technology vendors have shown off their latest wowbox with a demonstration of how its awesome power could transform the way businesses and the public sector operate. Such fanstastical visions of the future have, invariably, appeared in stark contrast to the hotchpotch of ageing PCs and faltering software which seemed to power the day-to-day business of most organisations in both the public and private sector, whose services I either used or helped to provide.

I remember one particularly grandiose keynote in which the audience was treated to an exhibition of how stalks of corn, cans of fizzy drink, and donkeys – yep, donkeys – could all, thanks to a certain company’s technology, become connected devices in the brave new world of the internet of everything. 

And all I could think was: “Sounds great. But is there anything you can do about the Kafkaesque search function on my publication’s website, and the fact that my company laptop slows to a crawl every few hours?”

At another conference about five years ago, I saw a demonstration that included a scenario in which doctors used technology to consult their patients remotely. Which prompted my typical internal three-word response: it’ll never work.

My position on this matter had not changed much as of earlier this week, when NHS England announced that it is getting ready to launch a £45m framework for online GP services. 

The news prompted me to have a rethink.

And, initially at least, I had the same reservations I had half a decade ago. 

Without wishing to go into detail – which PublicTechnology readers will no doubt be extremely relieved to hear – I thought back to numerous interactions I’ve had with doctors that, shall we say, required the two of us to be in the same room. There are many duties a doctor needs to perform that simply cannot be carried out via videoconference.

But it did not take me long to realise that the rollout of remote consultations could be very beneficial for some people. Perhaps those who have limited mobility, work irregular hours, live in remote areas, or have young children. 

What is more, increasing the ease with which patients can make appointments and consult with a professional surely makes it more likely that people will act on nagging concerns about their physical or mental health, and have them addressed by a clinician. 

There are almost five million UK adults that have never been online. The government must ensure they are not left behind

In these cases, and no doubt many others besides, online consultations could be a very worthwhile option.

But the key word there is ‘option’. 

For doctors and the patients they serve, there is a clear and unavoidable need to maintain a physical space in which examinations can take place, and treatment can be administered. GP appointments are not going 100% digital anytime soon – nor should they.

Credit where it’s due
One public-sector service that is handled almost entirely online – with 99% of transactions conducted digitally, according to the government – is the process for making or updating a claim for Universal Credit. 

Given that only one in every 100 claims is made over the phone, the volume of criticism the government has faced for initially failing to provide a free helpline might seem excessive. 

But, then again, given that 1.4 million claims for Universal Credit have been made in the last year, about 14,000 people have already been subjected to those call charges – which are as high as 55p a minute. A further 15,000 people are, on average, filing new claims each week. That is 30 people every day, who likely have little spare cash to begin with, having to fork out potentially exorbitant telephone rates – just to claim the benefits to which they are entitled. 

Percentage of disabled adults in the UK who have never accessed the internet  Source: ONS

Approximate number of people who have used the Universal Credit helpline in the last year

Estimated amount being provided to CCGs and GPs to acquire online consultation services

Cost per minute of calling the Universal Credit helpline from some mobiles

Government needs to ensure it serves the needs of this 1% as fully as it does the other 99%.

So, the decision by the Department for Work and Pensions to move all its helplines to freephone numbers is welcome news.

And this recognition of the requirement for non-digital means of interacting with government is something that ought to be replicated elsewhere. 

There are still millions of people who lack the means or the confidence to use digital platforms. Figures from the Office for National Statistics reveal that, as of April this year, 9% of adults in the UK have never used the internet. This figure rises to 22% for disabled adults, and well over half of people aged 75 and over.

In total, there are almost five million adults in this country who have never been online. As it continues on its journey towards digital services, the government must ensure those people – many of whom are among society’s most vulnerable – are not left behind.

Digital transformation projects across the length and breadth of the public sector have already delivered demonstrable cost savings and, many would argue, service improvements too. And, for most of us, digital has become the default option for engaging with the public sector. 

But, for all of us, the government must make sure it is never the only option.



Sam Trendall

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