Digitalised primary care in the UK: a qualitative study of the experiences of minoritised ethnic communities.

Abstract

Barriers to accessing and using primary care services among minoritised ethnic communities have been extensively evidenced in the UK. However, the impact of the rapid digitalisation of these services on these communities remains under-researched. To explore the impact of digitalisation on access to and use of primary care services among minoritised ethnic communities. Underpinned by a critical realist intersectional approach, and employing qualitative research methods, this study explores minoritised ethnic individuals' experiences of digital primary care in the UK. In total, 100 minoritised ethnic adults who identify as Black African, Black Caribbean, Bangladeshi, Indian, Pakistani, Chinese, and of mixed or multiple ethnic heritage in four sites in the UK were purposively recruited and interviewed. Interviews were thematically analysed to increase understanding of how individuals' ethnicity intersects with other characteristics (for example, language, age, gender, socioeconomic status) to identify constraints and enablements to accessing health care. Minoritised ethnic individuals' access to digital primary care is impeded by factors such as digital precarity (for example, inadequate devices, internet connectivity, and digital literacy skills), a lack of language support, and staff shortcomings in responding to ethnically diverse populations. Intergenerational support and bespoke offerings by general practices in some areas enable some individuals to overcome some of the constraints. The rapid digitalisation of primary care services is replicating and potentially exacerbating barriers to using these services among minoritised ethnic communities, a finding that merits urgent attention by practitioners and policymakers.