Digital Literacy in the NHS

Written by Susan Kennedy, Digital Literacy Lead, Health Education England and Building a Digital Ready Workforce.

It’s easy to look around us and see a world transformed. We book our holidays, order our takeaways and our taxis online, increasingly using mobile devices. Also increasingly in use are smart voice recognition and voice activated products for our homes.

Digital is integrated into our lives to the extent that we now appear digitally addicted and lack a healthy balance between digital and ‘real’ life. But who is ‘we’ and how true is this picture? We know that to talk of a digital ‘we’ excludes huge numbers of the UK population who, according to the Office of National Statistics (ONS), have never used the internet (around 5.3 million Britons). Even those that have, lack basic digital skills (10 million adults according to the ONS). A recent study of IT professionals emphasised the problem and the impact on business and productivity.

In the study, almost six in ten of those surveyed globally believed the root cause of IT issues in the boardroom was the fact that employees are not ‘digitally savvy’ enough to use the technology available to them. Meanwhile, 40 per cent said it was because employees didn’t believe it was their job to fix technology problems – a figure that rose for 45 per cent for the UK. In terms of both citizenship, full participation as individuals in a digital society, and as workers in a digital economy, all of us need those digital capabilities that will enable us to thrive, work, learn and to live and participate fully.

The health and care workforce, the largest workforce in the UK, presents a similar picture to the workforce as a whole and our work focuses on how to improve the digital literacy of that workforce. As part of NHS Health Education England’s (HEE) Technology Enhanced Learning (TEL) Programme and the National Information Board’s (NIB) Building a Digital Ready Workforce (BDRW) Programme, our digital literacy work is focused on developing a digital capabilities framework that both existing and newly commissioned educational and training resources can be linked to.

In common with most digital literacy frameworks, the HEE framework sees digital literacy as plural and describes that plurality by way of different domains or categories. Similarly, in common with most other frameworks, the focus is not simply on the technical but includes a range of dimensions, mapping to knowledge, skills and behaviours across social, cultural, ethical dimensions.

Rather than a simple competency framework, HEE aims to describe digital literacies that bring real benefit to users/learners in terms of confidence, competence and capabilities and, most importantly, wellbeing. Describing and aligning to HEE’s definition of digital literacy, the framework is intended as a developmental and supportive tool that empowers and enables. It is intended that those accessing the tool are provided with guidance toward extending their digital capabilities to be able to live, learn, work, participate and thrive in our complex, ever-changing digital world.

Digital literacy is not a simple binary of either being digital literate or illiterate. Nor can it be a straightforward linear sequence of ‘achieved’ competencies or even capabilities. Digital literacy is about immersion, about contextual learning and development, and, as Doug Belshaw states, is ‘a condition, not a threshold’ . The pace of change is such that being digitally literate is inevitably a work in progress and as much about an attitude that embraces change, a willingness to learn and an enthusiasm for the exploration of the individual, community and societal benefits that digital offers. It’s also about access and where digital access is limited, intermittent or non-existent, it becomes difficult for health and care staff to prioritise improving their digital capabilities, especially given other competing priorities, as Helen Beetham points out.

Digital capabilities must necessarily be dynamic and will be impacted not only by continuous innovation but also cultural, political, economic and social contexts. Any static set of competencies that aims to assess digital capabilities, whilst appealing perhaps in terms of recruitment and/or driving education and training, is probably doomed to failure. But by outlining generic capabilities that support individual motivation and development and, crucially, that promote positive attitudes towards change, technology and innovation, both competence and confidence can result.

As part of the work on a capabilities framework, we are looking at the development of a of tool or interface with it that people can use to ‘diagnose’ their own current state of digital literacy. This is a step towards identifying ways to address either specific skills gaps and/or looking at who we might want to be digitally, what we might want or need to be able to do or be. The NHS and care sector are already seeing new roles emerging that utilise and depend on digital. Horizon scanning within and beyond HEE suggests that digital capabilities, some identified, others certainly yet to emerge, will drive the creation of more new roles that will help deliver better health and care outcomes.

At a recent workshop, a healthcare professional said to me: “I’m scared that all this digital is taking the human out of care.” Digital isn’t about less care, less compassion. It’s about supporting staff in the provision of better care by improving efficiency, reducing wasted time and by allowing more real and meaningful face to face time with individuals. We need to provide more and more case studies that boost health and care staff’s confidence in the power of digital to support their values, their expertise and their mission.


  • A mobile working solution for community nurses resulted in a 60% reduction in time spent on paperwork and an increase of 29% in time spent actually with patients.
  • A telehealth hub across 210 care homes saw a 35% reduction in hospital admissions and 59% reduction in hospital bed days.

The role of digitally competent and confident staff in health and care cannot be underestimated. This is why this is such exciting work. The opportunity to improve the quality of care is one being seized on daily within our health and care landscape. However, there are too many who feel reluctant to engage, or who lack confidence and training or who are simply unsure of what digital capabilities they have or may want/need.

Establishing a clear definition of what digital literacy is, which digital capabilities enable that digital literacy and why this matters to each and every person working in health and care is a significant part of our work this year.

If you want to find out more about what we are doing with this project and other areas of work the TEL Programme is involved in follow us on Twitter – @HEE_TEL and visit our website.


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