Reducing Digital Exclusion for People with Complex and Multiple Needs

Digital technology is transforming adult social care, creating new opportunities for independence, communication and personalised support. However, people with complex and multiple needs remain at the greatest risk of being excluded if digital systems are not designed and delivered inclusively. Learning disabilities, autism, acquired brain injury, mental health conditions, dementia, sensory impairments, physical disabilities and multiple long-term conditions can all create barriers to accessing digital services when appropriate adjustments are not made.

Reducing digital exclusion is therefore both a social value commitment and a quality imperative. It helps tackle health inequalities, promotes independence and ensures people can participate fully in decisions about their care. This article forms part of the Social Value Knowledge Hub and complements guidance on Health Inequalities, Prevention & Early Intervention, Person-Centred Care and Digital Inclusion, Access & Reducing Exclusion.

Commissioners increasingly expect providers to demonstrate that digital innovation reduces inequalities rather than widening them, particularly for people with the most complex support needs.

Understanding Digital Exclusion in Adult Social Care

Digital exclusion is rarely caused by a single factor. Instead, it usually reflects the interaction between personal circumstances, technology design and the way services are delivered.

People may experience digital exclusion because of:

• learning disabilities or cognitive impairment
• autism and sensory differences
• mental health conditions
• visual or hearing impairments
• physical disabilities affecting technology use
• limited digital confidence
• poverty or lack of suitable equipment
• language and literacy barriers.

Understanding these factors allows providers to plan personalised support rather than applying standardised digital solutions.

Why Commissioners Are Increasingly Focused on Digital Inclusion

Commissioners recognise that more health and social care services are becoming digitally enabled. Appointment systems, care planning, remote monitoring and communication increasingly rely on technology.

Providers therefore need to demonstrate:

• how digital barriers are identified
• how reasonable adjustments are provided
• how non-digital alternatives remain available
• how inclusion is monitored over time
• how digital systems improve rather than restrict access.

Failure to address digital exclusion may undermine equality objectives and reduce opportunities for genuine person-centred care.

Identifying People at Risk of Digital Exclusion

Digital inclusion should begin during assessment and continue throughout care planning and review.

Assessment should explore:

• confidence using digital technology
• communication preferences
• access to devices and connectivity
• need for assistive technology
• support from family or advocates
• previous experiences with digital services
• changing health or cognitive needs
• personal goals relating to technology.

Digital confidence should never be assumed simply because someone owns a smartphone or tablet.

Embedding Digital Inclusion into Everyday Practice

Leading providers integrate digital inclusion into daily support rather than treating it as a specialist project.

Practical approaches include:

• supported digital learning sessions
• easy-read digital information
• accessible communication formats
• assistive technology where appropriate
• step-by-step support for online services
• maintaining non-digital communication options.

This flexible approach enables people to build confidence while respecting personal choice.

Operational Example 1: Supporting Someone with a Learning Disability

A supported living provider identifies that an individual wishes to access their digital care plan but struggles with written information.

The provider:

• creates an easy-read version
• adds photographs and symbols
• provides regular supported practice
• reviews understanding during keyworker sessions
• updates communication methods following feedback.

The individual becomes more involved in reviewing their support and making informed decisions.

Operational Example 2: Supporting Digital Access for Someone with Autism

An autistic person experiences significant anxiety when using a complex online appointment system.

The provider responds by:

• simplifying access arrangements
• providing visual guidance
• agreeing predictable communication routines
• offering alternative booking routes
• reviewing confidence over time.

Digital access improves because the system adapts to the individual rather than expecting the individual to adapt to the system.

Operational Example 3: Reducing Digital Barriers for Someone with Multiple Needs

A person living with physical disability, anxiety and visual impairment finds it increasingly difficult to access online healthcare information.

The provider works alongside healthcare professionals to:

• introduce accessible software
• arrange larger text and screen-reader compatibility
• provide assisted access during appointments
• retain paper information where preferred
• review digital support at each care review.

This approach improves participation while maintaining independence and choice.

The Critical Role of the Workforce

Staff are central to reducing digital exclusion. Technology alone cannot overcome barriers unless staff recognise when support is required and understand how to respond appropriately.

Training should include:

• recognising digital exclusion
• person-centred digital support
• accessible communication
• reasonable adjustments
• assistive technology awareness
• maintaining choice and independence.

Supervision should reinforce that digital inclusion is everyone's responsibility rather than the sole responsibility of IT teams.

Maintaining Choice Through Non-Digital Alternatives

True inclusion means offering choice rather than forcing digital engagement.

Providers should ensure people can still access services through:

• telephone contact
• face-to-face appointments
• printed information
• easy-read documents
• family or advocate support
• other accessible communication methods.

Digital innovation should increase options rather than remove them.

Governance and Organisational Assurance

Senior leaders should receive assurance that digital inclusion remains embedded across the organisation.

Useful governance measures include:

• numbers of people receiving digital support
• accessibility audit findings
• complaints relating to digital barriers
• staff training completion
• feedback from people using services
• quality improvement actions arising from digital inclusion reviews.

Regular monitoring demonstrates organisational commitment to reducing inequalities.

Common Mistakes Providers Should Avoid

• assuming everyone wants digital services
• equating device ownership with digital confidence
• removing non-digital communication routes
• failing to review digital support as needs change
• designing systems without involving people using services
• treating digital inclusion purely as a technology project.

These mistakes can unintentionally increase exclusion despite good intentions.

How to Evidence Digital Inclusion

Strong evidence may include:

• individual communication and digital access assessments
• records of reasonable adjustments
• easy-read and accessible resources
• staff competency records
• digital inclusion audits
• feedback from people using services
• examples of improved outcomes following digital support
• quality improvement plans linked to digital inclusion.

Commissioners increasingly value evidence that demonstrates continuous learning rather than isolated examples of good practice.

Conclusion

Reducing digital exclusion for people with complex and multiple needs is fundamental to delivering equitable, person-centred adult social care. Providers that identify barriers early, tailor support to individual circumstances, maintain genuine choice and monitor inclusion through robust governance demonstrate mature leadership and meaningful social value.

As digital transformation accelerates across health and social care, organisations that embed inclusive practice into everyday service delivery will be better positioned to reduce health inequalities, improve participation and evidence high-quality care that works for everyone.

---