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A single identity for health – how user research influences the design of the NHS login

By Rochelle Gold. 18 January 2019

A title image showing a picture of Rochelle Gold, lead user researcher for NHS login and Personal Health Records, with the title of her blog A single identity for health – how user research influences the design of the NHS login

It is such a straightforward concept that you would have thought we’d already have it: a single way to allow people to use one set of details to log into all their digital health services. We’ve been working over the past few years to develop this simple but powerful capability, which we call the NHS login, and it’s been a fascinating journey into the heart of our users’ experiences and expectations.

Do it once: User centred design of a single identity for health

At NHS Digital, human centred design, in line with our design principles, is a priority. This means that we design and develop services based on the needs of those using them and for this service we started with people with the greatest need for digital health and care services: people with long term conditions.

NHS Digital staff look at a wall display full of post-it notes when collaborating on the NHS login

Putting people at the heart of what we do

We conducted user research by interviewing people in their own homes about their current use of NHS services. How did they currently access them and how well did that work for them in their current situation?

We found they were using multiple services across multiple care settings and having to remember numerous user names and passwords. Many wanted control over and access to their health and care information, so that they could manage their conditions.

The most important thing for this group is getting access to the care they need, when they need it, but they also really care about the security of their health information – just as much as they care about their financial information. They rightly expect it to be kept completely safe.

Our research showed that people needed a single way to access their health services, records and apps. They talked about a single national login so they could use the same details to access services and medical records even if they moved to another GP practice or received hospital treatment elsewhere in the country.

They needed to feel that their health information was joined up and that they were in control of who could see it. In addition, security of health data and trust in the provider of the service were fundamental needs that had to be met.

Do we have this already?

We tested existing solutions to find out if they met user security, trust, usability and accessibility needs.

We found that existing solutions tested did not fit with what people expected when accessing NHS services in terms of brand and the information they were being asked to use to identify themselves – such as their bank details. Although the checks were there to make the data more secure, they made people feel concerned about what they were being asked to do. They questioned why their banking information was being requested if the site was about health. Some were reluctant to continue with the process.

Designing for trust

People really trust the NHS. When it comes to health data, research tells us that they trust it more than other government departments. In fact, when it comes to their own health data, people don’t seem to trust anyone else.

Using what we’d learnt in the discovery phase, we worked with a group of patients to co-design what this login could look like and what key features it needed.

The balance between security and convenience was crucial. The process had to feel secure and trustworthy, but not so lengthy that people would give up or so complicated that people would not use it at all.

Making, learning, iterating and being inclusive

We tested prototypes with a wide range of people, including those with long term conditions, access needs, carers, and people with English as a second language.

We tested the prototype under different conditions: in people’s homes, on their own devices, in user research labs, remotely and unmoderated, so we could see what happened when there wasn’t a researcher to refer to.

Over 1,000 people have participated in our research. We tested until we were sure that people could use it.

The big question – what would happen when people used the service on their own and in their own homes? What would happen when they were trying to access a service for real? To find out, we are testing it with a real service - the NHS App. The service is currently in private beta. We continue to research and iterate, always guided by our design principles and NHS Digital’s commitment to services based on user needs. NHS England is onboarding other services and suppliers soon.

A follow-up Digital Transformation blog will appear in a few weeks by Tero Väänänen, Principal Service Designer at NHS Digital. It will show how the information gained from our research influenced the service design and how this has enabled us to develop a login that makes access to digital health services easy for millions.

Last edited: 1 December 2021 12:19 pm