Digital services are a strategic priority for the NHS, as outlined in the Ten-Year Plan’s ‘shift’ – from analogue to digital. Leaning into digital encompasses the expanding the safe use of AI, enhancing NHS apps and improving digital access to patient data. However, there is no guarantee that everyone will be able to take advantage of the improvements these initiatives offer. Whilst shifting from analogue to digital presents opportunity, it also runs the risk of digital exclusion and therefore the widening of health inequalities.
Being digitally included means people having the access, skills and capabilities needed to engage with the technologies or digital services that help them take part in society, including in their healthcare (1). With services and treatment pathways more and more online, digital inclusion is increasingly a basic need (2).
Digital health interventions are seen as efficient ways to get promising health and care solutions to young people in a personalised way (3). Yet, digital equity among children and young people in the UK is mixed.
45 per cent of households with children fall below the Minimum Digital Living Standard, and 14 per cent of young people do not have adequate access to digital devices suitable for learning (2). In the context of the cost-of-living, affordability presents a further barrier, with nine per cent of households struggling to pay for mobile phone contracts and eight per cent unable to afford broadband access (2).
Health Innovation East completed a rapid evidence review looking at digital exclusion among Children and Young People. The evidence review identified that there remains limited research into the challenges and barriers that CYP face when accessing healthcare in a digital world, especially if they are digitally excluded. Notably, there was a lack of research and policy guidance taking account of the views of children and young people and their caregivers.
Whilst NHS England has published a framework to support action on digital inclusion for all, guidance for general practitioners states that specific protocols should be developed for children and young people under 18 years old. However, there is currently no national guidance on how such protocols should be designed or implemented.
Following the completion of the evidence review and discussions with regional Integrated Care Boards, Health Innovation East was commissioned by NHS England East of England to
The framework we developed sets out clear, actionable recommendations to support commissioning, planning and the delivery of healthcare services for CYP. By supporting professionals across the region to translate evidence into practice in a systematic way our framework helps tackle digital exclusion and ensure inclusive approaches to digital interventions across routine care.
The framework strengthens decision-making by providing improved, consistent information and guidance for those offering digital interventions to CYP. Through evidence-based practice recommendations, practical templates, illustrative fictitious case studies and clinician flowcharts, it is intended that the framework will increase confidence, capability and consistency among commissioners, service planners and frontline clinicians.
Ultimately, these outcomes will support more equitable access to digital healthcare, reduce variation in practice and improve the quality, safety, and effectiveness of digital interventions for CYP – ensuring that digital innovation enhances, rather than widens, health inequalities.
References
(1) Mistry, P. Jabbal, J. Thorstensen-Woll, C. (2025). Supporting digital inclusion in health care. [Online]. kingsfund.org.uk. Available at: https://www.kingsfund.org.uk/insight-and-analysis/projects/digital-equity [Accessed 6 May 2026].
(2) Good Things Foundation. (2024). Digital inclusion: What the main UK datasets tell us. [Online]. goodthingsfoundation.org. Last Updated: 18 September 2024. Available at: https://www.goodthingsfoundation.org/policy-and-research/research-and-evidence/research-2024/digital [Accessed 6 May 2026].
(3) G.J. Melendez-Torres, Rabeea’h Waseem Aslam, Joelle Kirby, Sean Harrison, Sophie Robinson, Tom Arthur, Claire Tatton, Joht Singh Chandan, Ruth Garside, Jo Thompson Coon, Samuel Vine, Rhiannon Evans Rhiannon Evans. Digital Inclusion for Young People Inclusion of underserved young people in digital public health interventions: Systematic review and equity synthesis of effectiveness, moderation, and implementation evidence. PROSPERO 2024 Available from https://www.crd.york.ac.uk/PROSPERO/view/CRD42025641364
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