User research is key to understanding and championing the needs of those people who need to take a test to learn their COVID-19 status, and also those who work in test centres.  Our user-centred design approach helps the service to be accessible to anyone who uses it, regardless of background, circumstance or ability.

User research on the Test and Trace programme has looked very different to how it would on a traditional pre-pandemic programme.

We normally start with a partially understood problem and do a lot of discovery work to understand it better.

This might take place over a number of weeks, with us asking questions like: How does the problem manifest itself? Who are the users? What are they trying to do? What are their needs? How might we meet those needs more effectively and efficiently?

Following the initial exploration, we keep on researching, and testing ideas and prototypes developed by the designers we work closely with, as plans for a new service to best meet people’s needs develop from those insights.

The urgency and restrictions of the pandemic meant some user research methods were unavailable to us, and time was very constrained. No face-to-face research sessions. Not being able to wait for a six-week timescale for discovery research. New services and features going from concept to ‘live’ in days, needing us to run research alongside them.

The programme is big, complex and fast-moving, and there’s a lot of mental agility required to keep abreast of shifting priorities. The awful progress of the pandemic, and the difficult policy choices that resulted, made sudden context-changing a way of life for us.

We’ve been doing user research in an environment that’s been, at its most pressured, like walking into a hurricane.

NHS Digital has led a user research team with colleagues from different organisations all working together as one. We’ve formed a strong team spirit although most of us have yet to meet in real life. Hopefully we can fix that, safely, this summer. 

As the team has grown (it has always been huge in terms of talent) we’ve honed new ways to get effective user research done very rapidly without lowering our standards.

With much shortened delivery timescales, we’ve recruited people within 48 hours to take part in our research, using our ‘panel’ of willing participants, social media and partner organisations.

We’ve taken to doing hybrid research sessions where we cover the discovery and alpha stages in the same interviews. We will run intensive 3 or 4-day blocks of this research to listen to and observe as many people as we can manage.

We try to provide valuable insight in time to make an impact. There have been times when events and policies moved so fast that even these ways of working didn’t get us to the finish line in time for ‘live’ which can be disappointing for the team.

There are always at least half a dozen separate strands of research like this happening at once, shaping our understanding alongside our feedback surveys, analytics data from the service and insights from the 119 contact centre. We always share with researchers in the wider Test and Trace organisation, like the Customer Experience (CX) team.

We make great use of digital whiteboards for rapid capture and analysis of findings. We’ve stripped back our reporting of findings to focus on the most pressing issues, the most actionable insights, and made a priority of sharing with those that can make change happen.

We’re extremely grateful and humbled that huge numbers of people using the service have given their views on what works well and what needs improving.

Over 1.5 million people have given us feedback about booking or reporting a COVID-19 test.

Through this goodwill, we’ve recruited a group of thousands of people who volunteered to take part in further research with us, including people who are at a higher risk from the pandemic.

This has enabled us to carry out remote in-depth interviews and usability testing with over 1,000 people in the last year. These sessions typically last an hour, so that’s about 40 days worth of listening, understanding and feeling the impact COVID has on different lives.

We’ve also been able to bring the voices and experiences of people who have physical, cognitive or mental conditions into this vital programme. We always need to do more and want to see further changes result from the insight we gain. Delivering truly inclusive research, remotely and at extreme pace, is a challenge we are rising to.

It’s important to us that the testing service feels ok to use as well as technically working ok. 

A lot of people use this service when they are ill, anxious or stressed – a context very familiar to our NHS Digital team members from their previous work on things like the NHS website, and in urgent and emergency care settings.

We explore, “How might you get what you need in the least stressful way possible?” in a context where people need to know “Have I got a virus that could make me seriously ill, kill me or that I could pass on to a loved one?”

Some people also have low trust in government institutions or worry how their personal data will be used.

We recognise there is a wider picture and a balance to be struck.  We know for example that epidemiologists need to ask questions that help track the pandemic; we also know that there’s a point where people start thinking: “This is a very long process. Why are you asking me about all this? I just need to book a test quickly.”

We put that challenge back into the wider organisation: “Does the benefit from asking these questions outweigh potentially excluding some people or causing them anxiety?”

The insight we’ve generated led to us collating and widely sharing the ‘Top 10’ user issues. That approach helps the organisation articulate and assign a priority to the areas we need to address, for all who need the service.

As for everyone reading this, this period has been a personal challenge. Everyone in the team has been working at a high energy level for a long time, experiencing the pandemic in and out of work.  I am always aware of the pressure on our health and wellbeing.

Many of those we listen to in research share their stresses, fears and losses with us, and we feel that. I hope we’re doing enough to mitigate the impact on researchers and to support each other for the long term.

Everyone has been the best they can be, always stepping up and finding ways to be resilient, always adapting to new challenges. They are the most committed and talented group of people I’ve had the luck to work with.

I believe that the team’s work, along with sister teams on other COVID programmes, proves that putting people’s needs and experiences at the heart of everything we do, through user research, brings huge benefits, making it easier for people to do what they need to in this most stressful situation.

We can, and should, work this way even in the most urgent or pressured situation. Let’s not forget that lesson, in NHS Digital and across government.