"Don't Leave Non-Internet Users Behind", Brighton Health Chiefs Told

Some of the most vulnerable people in Brighton and Hove could be missing out on basic healthcare as doctors increasingly make use of new technology, city health chiefs were told.

People who are old, frail or poor and some people with disabilities may be unable to book appointments online or by phone – and may be unable to have virtual consultations.

One councillor said that she knew a woman who did not have a computer or smartphone – just a landline – and who had been found dead, having been unable to access medical help.

Other councillors spoke about patients struggling because – since the start of the coronavirus outbreak – they had not been able to turn up at their doctor’s surgery as they usually did.

The issue was raised at a “virtual” meeting of Brighton and Hove City Council’s Health Overview and Scrutiny Committee on Wednesday (14 October).

They were told that – at the start of the lockdown – virtual appointments were introduced and telephone appointments expanded to limit the risk of infection for patients as well as staff.

Labour councillor Amanda Evans, who chairs the committee, said that a woman she had known for more than 20 years had been found dead in her Queen’s Park flat.

Councillor Evans said that the woman had tried to access medical help but failed because she had no access to a computer and smartphone, just a landline.

She described the woman as vulnerable but not elderly – and likely to have been a victim of Covid-19.

Councillor Evans said:

“She was vulnerable and she was unable to access help and she died alone in her flat and had to be found by a friend breaking in.

“That is very upsetting to those who knew her. It’s another story of the lack of access to primary care, or to help ultimately, because she was not capable one way or another of accessing that help.”

Her fellow Labour councillor, Amanda Grimshaw, who represents Moulsecoomb and Bevendean, said that she was concerned about a person she is supporting who has problems with digital access and who finds it difficult to talk on the phone.

The person moved from supported housing to their own home just before the lockdown. Councillor Grimshaw said that she helped her to fill in digital forms to register with a doctor.

She said:

“In the past she would have had support from housing or presented at the surgery and asked for help.

“Eventually, it was done but they were unable to access the doctor as it was too much of a struggle because they could not just turn up.”

Another Labour councillor, Gill Williams, said that digital communication has proved essential but there were a significant number of people in the city who did not have access to a smartphone, computer, internet access or digital literacy.

She said:

“Our presumption that most people do have access to digital communication has left an awful lot of people behind.

“It’s left an awful lot of people more isolated than they were.”

Councillor Williams, who represents East Brighton, said that she had been inundated by people asking for help getting in touch with medical professionals after leaving messages on answerphones.

She asked what steps were taken to ensure that people were not left on hold for hours – or leaving messages but had no one responding to them.

Brighton and Hove Clinical Commissioning Group (CCG) managing director Lola Banjoko told the committee that the changes had been a rapid response because in normal times such changes would have been introduced over several years after consultation.

She said:

“We moved into this so rapidly – the switch to digital. If we didn’t have covid, this is not something we would have done in this timeframe.

“It would have taken us a longer period of time to switch through this. Covid just made us move in a way we would not have done.”

Dr Banjoko said that she was sorry to hear the stories shared by councillors and added that lessons were being learned.

She accepted that for some people, digital was not the best way forward but said that, as health services found new ways of working, face-to-face appointments would be available for those who could not access services via digital platforms or, when it was essential, a medical professional would see patients in person for diagnosis.

She said that but to maintain infection control, patient “throughput” was lower.

Medics who might previously have been able to see ten patients were limited to five to allow for cleaning and ventilation between consultations.

When it came to the CCG’s response to covid-19, Dr Banjoko said that medics had learnt that they were better prepared for a short-term local event rather than a sustained global incident.