Service design at NHS Digital

By Tero Väänänen. 26 April 2018

Service designers work behind a sign that reads NHS Digital Service Design Day

At NHS Digital, service design is still a very young discipline, but I believe that here more than anywhere else, service design can really make an impact, and now is the time to do so.

Service design is a practice of designing the end-to-end service from the user’s point of view – from the very beginning of how users become aware the service exists, to the very end of them leaving it. But what makes service design different from just thinking about the user journey, is also the need to design the service from front to back. From all the individual touch points the users interact with the service at the front, to the back-end supporting processes, and the underlying policies and standards.

Service design is often described using the analogy of a theatre:

  • The front stage is where the actors are and where the audience can see them. For us in health setting, these are our service touchpoints for the users – websites, mobile apps, telephone calls, or face-to-face meetings with a health professional.
  • The backstage is the lighting, sound, costumes and make-up. For us, these are the back-end systems, servers, databases, and processes. Anything that makes the frontstage happen.
  • The supporting processes are the ticket sales, running the theatre as a business, insurance policies, health and safety and so on. For us, these are our policies, standards and procedures to run the service, the third parties we connect to, and our strategic plans we need to align with.

Making an impact

Service designers work across the whole end-to-end user journey, not just the digital bits. This is especially important when addressing topics like mental health and social care, where the services themselves can be delivered in many different ways, by diverse networks of people and organisations. And this is where working alongside user researchers, technical architects and business analysts to discover the landscapes and map them out in service blueprints can really help to understand where we have gaps, where can we improve, and where can digital make a real difference.

By focusing on designing the whole service, and not just individual touchpoints, we can also ensure services connect with each other seamlessly, providing a coherent experience. We can identify improvements in the service, which will have a positive impact elsewhere. For example, how might we redesign the letters sent to patients earlier in their journey to be easier to read and understand and therefore allowing us to design a simpler experience online. Only understanding the whole service, we can identify the touchpoints which are the most cost-effective or have the most impact.

The underlying premise is that, by allowing the public to self-manage their health using digital tools, or allowing health professional to focus on patient care, rather than filling in paperwork, we can make significant savings to the NHS.

Moving forward

With the growing service design community and some well-established service designers within our programmes, it felt like the right time to pull everyone together and tackle some of the challenges we faced as service designers at NHS Digital.

Recently, we had our inaugural Service Design Day at NHS Digital. It was great to get all the everyone together, meet each other and talk about the challenges we all face as service designers.

The main themes emerging from that were:

  • We have to talk more about service design within NHS Digital and the value it brings to programmes
  • We need to be clearer about the role of the service designer
  • We need to learn how to clarify the journey from insights, into decision making, and further to delivery
  • We need to design sustainable services, which the NHS can afford to run
  • We need to make it real – prototype more real services, not just digital user interfaces
  • We need to understand how we work with policy makers

We are growing the service design community and are planning our next Service Design Day, where we we’ll continue with the earlier themes. This time, I will also invite some service designers from the wider NHS family, so we can start to learn from, but also support those service designers whose help we need to design the end-to-end experiences. After all, the challenge all of our service designers at NHS Digital are facing, is that we often own only a very small slice of the end-to-end service people experience. We simply can’t do this on our own.