Bridging the digital divide to support children and young people

Insight

Digital technology is now deeply embedded in everyday life. As digital tools continue to improve the way we manage our time and convenience across our daily lives, their use within healthcare has also expanded rapidly. Digital healthcare – defined as the use of software, hardware, and applications to support patients and improve health outcomes – has grown significantly in recent years (1).

Digital healthcare is now across a wide range of conditions and treatment pathways. A growing body of evidence now explores its use, benefits, and limitations, alongside concerns about potential risks. Among these is the possibility that digital healthcare may widen existing health inequalities, particularly for individuals who are unwilling or unable to access digital services – the digitally excluded.

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 (2). In the context of the cost-of-living crisis, 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).

While general guidance on digital inclusion exists, there remains a notable gap in guidance tailored specifically to children and young people (CYP). This fails to account for the distinct challenges they face when navigating an increasingly digital healthcare landscape.

On behalf of the NHS England East of England Children and Young People (CYP) Transformation Programme team, Health Innovation East completed a rapid evidence review to understand what is known about the drivers and impacts of digital exclusion for CYP health.

Conclusion of review

• Lack of research and policy guidance, especially taking account of the views of children and young people and their caregivers.
• Need to understand digital poverty, digital literacy and preference for digital vs. other ways of receiving healthcare.
• Local decision-making processes that consider who will benefit, who will be excluded, how to mitigate & how to implement equitably.
• Income inequality the most significant driver of digital exclusion, and one that exacerbates all other factors.

Intervention

Starting March 2025, Health Innovation East was commissioned by NHS England East of England to develop a practical framework to support digital inclusion for children and young people (CYP) across the planning, commissioning, and delivery of healthcare services.

The framework was informed by a comprehensive programme of work, including a previous review of published and grey literature undertaken in 2024, an updated review of grey literature, and interviews with ten key informants. This work was structured around four core workstreams: an evidence review, a grey literature review, stakeholder interviews, and the development of the framework itself.

A steering group, supported by NHS England East of England, was convened to guide the workstreams and provide expert advice from key stakeholders.

Impact

The resulting framework sets out clear, actionable recommendations to support commissioning, planning, and the delivery of healthcare services for children and young people (CYP). By translating evidence into practice, it enables professionals across the region to systematically address digital exclusion and embed inclusive digital approaches into 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 increases confidence, capability, and consistency among commissioners, service planners, and frontline clinicians.

Ultimately, this supports more equitable access to digital healthcare, reduces variation in practice, and improves the quality, safety, and effectiveness of digital interventions for CYP – ensuring that digital innovation enhances, rather than widens, health inequalities.