As health systems increasingly adopt digital channels, there is a risk that digital transformation can widen existing health inequalities. People experiencing barriers related to connectivity, affordability, digital skills or confidence may be less able to access and benefit from digital health services. For health systems, a key challenge is identifying where these overlapping risks are greatest so that action and resources can be better targeted.
NHS England developed the Digital Exclusion Risk Atlas (DERA) to turn this challenge into actionable intelligence. DERA is a free, interactive mapping and analytical tool that brings together multiple national datasets to identify areas across England where the risk of digital exclusion may be higher. Its composite approach considers four dimensions of digital exclusion:
– Digital access and capability
– Affordability & economic pressure
– Ability & skills
– Agency, motivation & trust
providing a more comprehensive picture than any single indicator. Users can explore patterns at neighbourhood level and aggregate insights across health geographies, supporting health and care leaders, commissioners, analysts and digital teams to combine national evidence with local intelligence and community engagement.
DERA provides England with a consistent, evidence-based approach to understanding geographic variation in digital exclusion risk and supporting more informed planning, prioritisation and partnership working. It enables organisations to move beyond assumptions about who may be digitally excluded and towards a more systematic assessment of where barriers may exist and what may be driving them. While developed for England, its underlying approach offers transferable learning for health systems internationally seeking to ensure that digital transformation improves access to healthcare without inadvertently deepening inequalities.