The NHS increasingly tells us that the future of healthcare is digital. Book appointments online. Order prescriptions through an app. Complete forms on a website. Receive notifications by text message.
For some people these changes have improved access.
For many deaf and disabled people, they have done the opposite.
Across Enfield, deaf and disabled residents are finding themselves locked out of essential healthcare because services that were once accessible through human interaction are now accessible primarily through technology.
For many disabled people, the barriers do not stop with disability itself. Disabled people are also far more likely to experience digital poverty. Many cannot afford the latest smartphones, reliable broadband or enough mobile data to use increasingly digital services. Others rely on shared devices or have had little opportunity to develop digital skills. Disability and poverty often combine to create multiple barriers, making digital healthcare even less accessible.
The result is that many people now depend on family members, neighbours, carers or community organisations simply to do things they once did independently.
One Enfield resident told EDIE that they now rely on a relative just to book a GP appointment because the online system is inaccessible. Something that was once a private and independent task has become dependent on someone else’s time and support.
For many disabled people, digital exclusion is not an inconvenience. It is a loss of independence, dignity and privacy.
The Equality Act 2010 was designed to prevent exactly this kind of exclusion.
Many people with visual impairments cannot easily navigate websites, apps or online forms. Some people with hearing impairments struggle with telephone systems and automated communications. Many people with learning disabilities need support to understand and complete complex digital processes. Others live with cognitive impairments, neurological conditions or mental health conditions that make digital systems difficult or impossible to use.
For these residents, the problem is not a reluctance to embrace technology. The problem is that technology has become a barrier to healthcare.
When a patient cannot book an appointment, request medication, obtain test results or communicate with a healthcare professional because the only practical route is digital, the issue is no longer about convenience. It is about access to healthcare itself.
The NHS Already Knows
What makes this situation particularly concerning is that NHS England itself acknowledges that digital exclusion is a significant health inequality. It has published an Inclusive Digital Healthcare Framework which states that digital healthcare should complement—not replace—non-digital routes into healthcare. It has developed a Digital Exclusion Risk Atlas that identifies the communities most at risk of being excluded from digital healthcare. It has recognised that disabled people are among those most likely to face barriers.
In other words, the NHS already knows.
It knows who is most at risk. It knows where exclusion exists. It knows the consequences.
This changes the conversation completely. The issue is no longer whether there is enough evidence. The evidence already exists. The issue is why services continue to be designed in ways that produce the very exclusion the NHS has already identified.
Digital exclusion is not simply a technology problem. It is a systems problem. The system is becoming increasingly efficient for those who can use digital services while becoming increasingly difficult to navigate for those who cannot.
A Question of Equality
Some argue that everyone should use the same digital systems. But that is not what the Equality Act 2010 requires.
The law places a proactive duty on service providers to make reasonable adjustments where disabled people are placed at a substantial disadvantage. Public bodies should anticipate barriers rather than waiting for people to complain after discrimination has already occurred. The NHS is also subject to the Public Sector Equality Duty, which requires public bodies to eliminate discrimination, advance equality of opportunity and remove disadvantages experienced by disabled people.
When organisations know that disabled people are unable to access essential healthcare because of digital barriers, yet fail to provide effective alternatives, they risk placing themselves in breach of these duties.
The existence of the NHS Digital Exclusion Risk Atlas makes this particularly significant. Once exclusion has been identified, mapped and measured, it becomes increasingly difficult to argue that unequal outcomes were unforeseen. Knowledge brings responsibility.
A Better Way Forward
This is not an argument against digital technology. Digital services can be life-changing for many people.
But technology should expand access, not replace it.
Sometimes the most important accessibility tool is another human being. A receptionist who understands someone’s communication needs. A member of staff who can help complete a process. A face-to-face conversation instead of an online form.
Human interaction is not old-fashioned. For many disabled people it is the reasonable adjustment that makes access to healthcare possible.
There are practical ways forward.
Every GP practice has a Patient Participation Group where patients can help shape local services. Digital exclusion should be a standing item for discussion. Disabled people, carers and community organisations must have a stronger voice in designing services, not simply responding to them after decisions have already been made.
The people experiencing these barriers every day are experts in what needs to change. If we are serious about tackling health inequalities, they should be partners in redesigning the system.
The NHS has already identified digital exclusion as a health inequality. It has mapped where it exists. It has recognised who is most affected. The question is no longer whether the system knows. The question is whether it is prepared to act on what it already knows.
If services continue to become inaccessible despite this knowledge, the issue is no longer one of awareness.
It becomes one of accountability.
Empowering Disability in Enfield (EDIE) is a lived experience working group supported by LocalMotion Enfield. We are working with disabled residents to understand the barriers people face and to help create fairer, more accessible public services designed with disabled people, not simply for them.
This article was first published in the print edition of the Enfield Dispatch in August 2026
Photo by Kai Campbell of KaiImages