NHS should ‘prescribe FitBits’ to prevent inequality in health tech


The NHS should prescribe fitness trackers and other personal health technology to people who would be unable to purchase these tools themselves, a think tank has said.

The Social Market Foundation (SMF) report, National Health Servers: delivering digital health for all, found access to improved health outcomes, such as FitBits and smart scales, should not be limited by a person’s ability to pay for innovative technology.

The report examined the patient’s journey through the NHS, from prevention and diagnosis, primary and secondary care through to management of long-term conditions.

It found there are “huge opportunities” to keep patients out of the NHS using digital technologies, but that access to technology needs to be equal.

Kathryn Petrie, senior economist and author of the report, said: “Technology has the potential to deliver better healthcare, but it is vitally important that those benefits are available to all, and not just the people with the means to take full advantage.

“There is a risk that unequal access to health technology will further exacerbate the existing health inequalities in the UK.”

The recently published Topol Review also noted that technology had the potential to worsen health inequality if not used correctly. The SMF report warned technology may influence the ability of the NHS to provide universal care if it encourages inequality.

“If personal technologies, such as wearables or smart home devices become a primary delivery channel for improving health outcomes, there is a significant risk that only those who can afford the latest devices are able to benefit,” it said.

“This raises the question of how technology may influence the ability of the NHS to continue to offer a universal service accessible to all, if those from the most affluent backgrounds have better access to cutting edge health technology.”

The NHS is currently piloting schemes that allow Clinical Commissioning Groups to offer fitness trackers to some individuals. The SMF is calling on the NHS to consider the programme more widely, even though it’s too early to know if the intervention is good value for money.

In 2017 NHS England (NHSE), Public Health England and Diabetes UK launched a diabetes and obesity prevention pilot project for 5,000 people offering wearables, apps and other gadgets to manage their condition, which feeds into its Diabetes Prevention Programme.

NHSE also runs the Widening Digital Participation Programme, in conjunction with Good Things Foundation, which has seen twenty digital inclusion pathfinders set up across the country to improve people’s digital skills.

But in order to close the inequality gap further, the report also calls on the NHS to prescribe digital skills classes to those who struggle to keep up with how quickly technology changes, particularly for those whose health would improve with access to technology.

Those with lowest household incomes are also those likely to have the least digital skills yet the most comorbidities, according to the report, but digital skills could help improve the health of one in three people over 60 and make them feel less alone.

Other policy recommendations made in the report include; initiating an honest debate on electronic patient records and how information is used in the wider healthcare setting, including explaining the value of patients sharing their personal data and making the opt-out system more straightforward; establishing clear priorities for digital services; pursuing integration as a priority project; and enshrining the right to digital services in the NHS Constitution.

NHS England was contacted for comment but did not respond.

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