To achieve this principle, we need to conduct observational, explorative user research on the users of the service to find out where they use the service and what the tasks and goals are.
ISO 9241-210 describes users not just as those who will use the product or service, but also people who may be directly or indirectly affected by its use. These groups need to be identified and their needs discovered. The standard says explicitly:
“Constructing systems based on an inappropriate or incomplete understanding of user needs is one of the major sources of systems failure.”
The standard refers to "human-centred design" instead of "user-centred design", emphasising that it also “addresses impacts on a number of stakeholders, not just those typically considered as users." This echoes service design thinking, which focuses attention on all the users, stakeholders and people involved in running the service, not just those who are the users or customers.
The first principle of the NHS Constitution, 'The NHS provides a comprehensive service, available to all', means we have to follow a human-centred design approach. It specifically highlights equity in the design of health services. We must “pay particular attention to groups or sections of society where improvements in health and life expectancy are not keeping pace with the rest of the population."
Equity can only be achieved by actively listening to those user groups who are most affected by our design decisions and ensuring they get the support they need.