Older residents say digital healthcare must not be one size fits all
Members of Age UK advisory group share views on shift to digital
The Covid-19 pandemic continues to have a considerable effect on how older people in Camden access health and care services, with many face to face appointments replaced with a telephone or video call.
Our report ‘Life in Lockdown’ showed that remote care helped many, regardless of age group or background. However, some people reported negative experiences with remote health care, for example, patients with complex needs or with conditions where an in-person assessment is necessary, such as taking a Peak Flow test to check for asthma.
In October 2020, Healthwatch Camden spoke with 23 members of Age UK Camden’s Older Peoples Advisory Group (OPAG). Members of OPAG are 65 years and older. We asked them about their experience of using digital services to access health and social care.
Views on ‘shift to digital’
The need to self-isolate and socially distance had been a challenge for many of the older people we spoke to. Particularly those unable to afford digital equipment who, prior to Covid-19, had been using their local libraries. This has not been possible during ‘Lockdown’ as libraries are closed. This contributed to fears that ‘digital exclusion is widening’ for people who do not have access to technology.
OPAG members also said that digital access to healthcare is difficult for people with disabilities - especially people with sensory impairments, learning disabilities, or mobility issues; and for people whose first language isn't English.
OPAG members said that many who speak languages other than English are reliant on another family member to help them access services. With new Covid restrictions banning visitors from attending appointments and the rules around shielding, many people lost access to this support. This was similar to the experiences of those with dementia.
“I have not seen my family since lockdown, I am self-isolating, imagine the loneliness and despair.”
“…no one is here to help me, my family can’t visit me anymore, I worry about emergencies.”
For many other older people, accessing health and care services digitally has been a positive experience. They can get the right information and help without leaving the comfort of their home and order their repeat prescriptions online.
“I found recent online contact better than when visiting in person, I was amazed.”
“I had a consultation over the phone. It's actually better than before! Now I don't have to go and wait.”
Others made it very clear that health services delivered over the phone or online are not right for everyone. Some people feel excluded and intimidated by the need to perform tasks online when they are not confident using a device or the internet.
“Phone and online appointments should not replace face to face appointments as it does not work for everyone.”
“I can’t get an appointment; it takes ages to get through to the reception. Sometimes you are left hanging and the call cuts out.”
“I am really dissatisfied with GP appointments; I must wait 4/5 hours for a callback, sometimes even longer. Sometimes I must call back and remind them that I am waiting for a callback. I feel totally forgotten, neglected, and abandoned. I am shielding and isolating.”
Whilst many of Camden’s older residents rely on technology and the internet for information, there are a significant number of others who do not use these sources or find them difficult to use.
Risk of exacerbating inequalities
There is a risk that health and care services may expect people to access services digitally and thereby inadvertently contribute to inequalities in health. However, we are aware that local services are working hard to give people choices when they want to access health and care services.
These services must continue to make sure that people can access information about services in a variety of ways – for example, using local telephone information lines, community newspapers, radio, and television.
Choices should be available to people at the time of need and digital access must not be the only avenue available for people to access health and care services. Other options must be communicated clearly, and patients must be reassured that this form of care will be of as high quality, not second best.
Healthwatch Camden will continue to raise these issues with health & care services and policy makers.