Offline and isolated - the impact of digital exclusion on access to healthcare for people seeking asylum in England (2023)

This report provides essential insights about the intersecting obstacles that people seeking asylum face when accessing healthcare digitally. It explores the impacts of digital exclusion on both wellbeing and access to healthcare for people seeking asylum in England, and sets out solutions for how to address this.

The British Red Cross identified a lack of evidence about how digital exclusion may impact access to and experience of healthcare for people seeking asylum in England. Between March and November 2022, researchers conducted a qualitative research study to explore the issue. Five peer researchers with lived experience of seeking asylum conducted interviews with 30 people currently seeking asylum in England.

The Covid-19 pandemic has accelerated the digitalisation of healthcare in England. While digital healthcare and platforms have made healthcare more accessible for some, these services are out of reach for digitally excluded people.

People experience digital exclusion when they cannot use and benefit from the internet or digital devices in their everyday life. Digital exclusion can occur for various reasons, such as the affordability of the internet and devices, low literacy, low digital skills and confidence, and inaccessibility of digital services. Digital exclusion is more likely to affect some sections of the population than others – such as people whose first language is not English, older people, those on a low income and people with disabilities.

For example, in 2018, 1 per cent of 25 to 34-year-olds in the UK had never used the internet or had not used it in the last three months, compared with 25 per cent of 65 to 74-year-olds.

People seeking asylum are particularly at risk of digital and healthcare exclusion, as many face multiple and intersecting barriers to digital access, such as language barriers and low income.

These obstacles compound existing barriers to accessing healthcare, and impact the experience of healthcare received. In some cases, unable to access or navigate digital healthcare services, participants avoided seeking help altogether or saw A&E as their only option. This inability to access primary care in a timely way undoubtedly places additional pressure on already stretched emergency care services. Participants also spoke about the impact of digital exclusion on their mental health and wellbeing, often causing isolation and loneliness.

Participants’ suggestions to improve digital and healthcare access

In the interviews, peer researchers asked the participants for suggestions on improving digital and healthcare access for people seeking asylum. Their responses included:

• Provide free Wi-Fi in accommodation and credit for mobile data and devices. This would help enable access to medical video calls and applications like the NHS app.
• Provide digital literacy training. Some suggested setting up training centres or sessions where people seeking asylum can access support to navigate the online environment.
• Improve the accessibility of online healthcare. This could involve simplifying registration and online booking processes, and offering different language options and voice assistant systems.
• Improve access to healthcare in general, including in-person access. These suggestions included providing health assessments soon after arrival in the UK and free transportation to appointments.
• Listen to people seeking asylum. Suggestions included offering opportunities to give feedback on healthcare or the support they receive as part of the asylum-seeking process.