Measuring the digital divide among people with severe mental ill health using the essential digital skills framework.

AIMS: Amid the vast digitalisation of health and other services during the pandemic, people with no digital skills are at risk of digital exclusion. This risk might not abate by the end of the pandemic. This article seeks to understand whether people with severe mental ill health (SMI) have the necessary digital skills to adapt to these changes and avoid digital exclusion. METHODS: Two hundred and forty-nine adults with SMI across England completed a survey online or offline. They provided information on their digital skills based on the Essential Digital Skills (EDS) framework, sociodemographic information, and digital access. This is the first time that the EDS is benchmarked in people with SMI. RESULTS: 42.2% had no Foundation Skills, and 46.2% lacked skills for daily life (lacking Foundation or Life Skills). 23.0% of those working lacked skills for professional life (lacking Foundation or Work Skills). The most commonly missing skills were handling passwords and using the device settings (Foundation Skills) and online problem solving (Skills for Life). People were interested in learning more about approximately half of the skills they did not have. People were more likely to lack Foundation Skills if they were older, not in employment, had a psychosis-spectrum disorder, or had no Internet access at home. CONCLUSION: A significant portion of people with SMI lacked Foundation Skills in this objective and benchmarked survey. This points to a high risk for digital exclusion and the need for focused policy and tailored health sector support to ensure people retain access to key services and develop digital skills and confidence. To our knowledge, this is the first time this has been described using the EDS framework. Services, including the National Health Service (NHS), need to be aware of and mitigate the risks.

Occupational dermatoses during the COVID-19 pandemic: A multicentre audit in the U.K. and Ireland

Healthcare workers (HCWs) need to wear personal protective equipment (PPE) during the COVID-19 pandemic. Studies from China report high rates of irritant dermatitis in frontline HCWs (Pei S, Xue Y, Zhao S et al. Occupational skin conditions on the front line: a survey among 484 Chinese healthcare professionals caring for Covid-19 patients. J Eur Acad Dermatol Venereol 2020;Epub ahead of print). The British Society of Cutaneous Allergy conducted an audit of occupational dermatoses in HCWs. Eleven centres in the U.K. and Ireland organized occupational skin disease clinics to treat PPE-related dermatoses. A standardized proforma was completed, which included information about site, dermatological history, occupation, working environment, shift pattern, sick leave, PPE and handwashing practices. Diagnosis and treatment were advised during a virtual consultation. Each participating unit entered anonymized audit data into a spreadsheet. Data from 200 HCWs were collected in May and June 2020. Forty-three per cent (n = 86) worked in England;30.5% (n = 61) in Scotland, 13.5% (n = 27) in Ireland and 13.0% (n = 26) in Wales. Median age was 36 years. Ninety per cent (n = 180) were female;67.0% (n = 134) had nursing roles. The face was affected in 46.5% (n = 93) and hands in 46.0% (n = 92). In 94.0% of cases (n = 188) the clinical findings were felt to be occupational or partially occupational, with the most common diagnosis being irritant contact dermatitis: 59.0% of patients (n = 118). Seventeen per cent (n = 35) had required time off work (292.5 days in total;range 0.5-28). The mean number of hours of PPE wear per shift was 6.9 [median 7.5, interquartile range (IQR) 4-10]. Those who wore PPE for longer periods had more time off;each hour of wearing PPE during a shift increased the time off by 0.2 days [95% confidence interval (CI) 0.002-0.344;P = 0.048]. The mean number of handwashes with soap per day was 22.7 (median 20, IQR 10-30). Each handwash increased the expected number of days off by 0.03 (95% CI -0.013 to 0.069;P = 0.174). The mean number of uses of alcohol gel per day was 19.2 (median 10, IQR 5-30). There was an inverse association with use of alcohol gel and time off;each use of alcohol gel per day reduced the expected number of days off by 0.03 (95% CI 0.002-0.066;P = 0.04). These data indicate that the duration of wearing PPE, frequency of handwashing and use of alcohol gel have a significant effect on the time off work for HCWs.