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It takes a village to design a service

Tero Väänänen, Head of Design at NHS Digital, talks about how important it is to design your organisation before you start designing services.

The demand for service designers has grown rapidly in recent years, while the understanding of what service design is, has not. For many organisations, service design is simply ‘user experience’ with a new name.

Service design, and user-centred design, are mutually supportive ways of working to approach problems, to achieve the best possible outcomes.

For effective service design, organisations must understand the conditions required and be prepared to make changes.

Service design as a culture

Service design brings together all the different parts that are required to design, build and deliver the service: It involves understanding the user needs of all the users, including the public and the staff operating the service. It also requires an understanding of the backend servers, data flows and infrastructures that make up the visible part of the service possible, and then the supporting processes, like all the policies, training of staff, budgets and business cases.

The problem is that a single person cannot design a service on their own and hiring a service designer to design the service will likely fail if the organisation itself is not well set up to design services.

Hiring a service designer, or even a whole service design team, without understanding what delivering an end-to-end service will entail, is a risk. Money and time are wasted, and the service designer will either leave or burn out as they don’t feel like they can add real value.

Service design thinking is something that the whole organisation must adopt. It’s not that everyone is a service designer, but to deliver the service outcome, everyone must acknowledge and accept they are part of the solution to solve the problem.

Therefore, organisations should focus on educating all the people within the organisation, regardless of their role, about service design thinking; what does it mean to their role? How can they contribute to the organisational goal of designing and delivering services?

At NHS Digital we are making changes to the way we work to address these challenges. As the health and care system is so vast and fragmented, this is not always easy.

For example, for most public facing services we don’t own whole services, but only parts of them. Therefore, we are taking steps to work better with our commissioners, policy makers and stakeholders to bridge the ownership gap and work together to solve whole problems and be part of delivering whole services. This will give our teams better understanding of the context they operate in, which service outcomes they are working towards and thus which metrics should they measure.

We are also educating our people about user-centred service design thinking, and how to advocate for it. A couple of years ago we launched our own internal training course. This year, we have reviewed the needs of our teams and developed the course further. The more people who understand the role they play in user-centred service design, the better. It is everyone’s responsibility, whether it’s in your job title, or not.

Break down silos

An important part of service design is identifying organisational barriers and opportunities for more efficient communication and collaboration.

While discrete, focused teams dedicated to a specific problem can be very effective, problems arise when a group of teams do not have a collective vision to solve a larger problem area together.

If teams have conflicting or misaligned targets, collaboration can be seen as a threat to meeting those targets. Overcoming these challenges and being able to break down silos which prevent collaboration are major parts of the service design culture.

This is important on a team level as well; too often we see teams brought together, but not actually working together. Tasks are distributed to the subject matter experts within the team, but they may not work together to solve the problems.

Don’t let teams work in mini-siloes within the team, Service design problems are as much about technical architecture, and business analysis, as technical architecture or business analysis are about service design – they must be solved together as a team.

Many service standards, like the international standard for “Human-centred design for interactive systems” BS EN ISO 9241-210, and our own NHS service standard, include the principle “The design team includes multidisciplinary skills and perspectives”.

Bring diversity to your team

Alongside professional skills, it’s also important to look at the diversity of the design team. You cannot design truly inclusive services, if your design team is not diverse to make sure you don’t inadvertently make decisions that risk excluding people. 

In his book “Rebel ideas”, Matthew Syed talks about cognitive diversity as well as demographic diversity and explains how individuals simply cannot solve complex problems on their own, nor can a homogenous team with people from similar backgrounds and beliefs cover the whole problem space.

This means we should look at how we recruit staff to the organisation. Do we encourage diversity in our recruitment, by making sure we advertise the jobs in places which invite more diverse applicants, does the wording in our job adverts exclude certain people, and do we cater for diversity in our interviews themselves?

For example, at NHS Digital we aim to make sure applicants are aware that it is ok to bring their children to the interview, if they cannot get childcare, and we are exploring whether we can send interview questions out beforehand so people have time to read and digest them without having to rush under pressure.

Of course, we also have to make our organisations more inclusive and equitable so that people from diverse backgrounds want to stay with us.

Matthew Syed also warns us about moulding the initially diverse people to fit into the organisation’s own mould and thus suffocating the diversity – instead, we should actively encourage our people to be themselves, have their voice heard in meetings and celebrate the diversity we have.

Without the right breadth of skills, diversity, and the experiences in your team, you will not be able to design the whole service.

The 3 key pillars of clarity, control, and competence

In his excellent book on leadership “Turn the ship around!”, L. David Marquet describes that teams and people need 3 components to be able to succeed; clarity, control, and competence.

Clarity - on the goals and purpose of the mandate, so that the teams understand what they have been asked to solve. Understanding the background, policy decisions, any immovable elements are all important aspects. Having the mandate to find the right problem to solve and then the freedom to solve it the right way. But importantly, providing clarity does not mean describing the solution the team should go and build.

Control - Teams should be empowered to have the freedom and authority to have full control of how they are going to work to solve the problem. They should also be given the time and space to work and bring people around the problem to solve it and to deliver the service. Self-managing teams are the core of agile processes, and this is key in service design as well. Service design is as much about how we deliver, as it is about what we deliver.

Competence - The teams should have the competencies to solve the problem. Teams should be multidisciplinary, skilled and have demographic and cognitive diversity to design inclusive solutions. The teams should also have all the necessary training, or access to further expertise.

These pillars are true for any team, but especially true for teams tackling complex service design problems. What is interesting is how L. David Marquet makes clear that lack of clarity for a team can make the individuals look and feel incompetent. If people lack the vision and direction, or if the direction is constantly and frequently changing, the team will look and feel like they don’t know what they are doing.

So, next time, before you hire service designers, make sure you have the environment for service design to succeed. It really takes a village to design a service.

Interested in working at NHS Digital? Search our latest job opportunities.


Last edited: 23 December 2021 10:48 am