By Nicola Gill. 27 August 2019
By Nicola Gill. 27 August 2019
In partnership with Good Things Foundation, we have been researching, developing and testing new ways to support the most excluded in society to access and use digital health services and tools as part of the Widening Digital Participation Programme.
Our goal over the past couple of years was to try out and test models for digital inclusion and then create ‘How to’ guides and resources that digital health commissioners, designers and service delivery teams could use to ensure they are delivering inclusive services. Essentially, we wanted to share the things that were working.
However, not all our projects have worked and rather than shy away from our failures, we’ve used those experiences to learn from and feed into future projects. We have made learning from our failures as important as learning from our successes (if not more) and it has really worked for us. Through adopting an agile ‘fail fast, learn and move on’ approach to our service design, we have been able to create models that better meet user needs and are more effective. Fostering an open and safe environment, where we can admit ‘this is not working’ quickly, has allowed us to move on and get to the things that do work faster - saving a lot of time and frustration.
In retrospective discussions on our projects that didn’t work despite changes and iterations, we realised that we could save other people and lot of time and money if instead of publishing the usual how to guide – we actually published a ‘What not to do’ guide. We won’t really call it that, but at the end of the year, we will be putting together a lessons learned / things that don’t work if you’re developing digital inclusion projects guide. It will include advice like people are not motivated to do digital things but they are motivated to improve their health. Talk first about outcomes and leave the digital part until later. The language we use is really important. People are put off by technical digital terms so we need to keep it simple and don’t assume people understand words like digital or app or download – which we did!
Embracing failure has also led us to work more closely with people in the places they go to every day – whether that’s a physical space like a community centre or virtual place like a Facebook community group. Asking people to come to us on our terms does not work. If we want to connect with and reach people, we need to learn more about their day-to-day lives (helped by actually talking to them) and design the intervention to fit with that.
We have made learning from our failures as important as learning from our successes
We also learnt to focus on using everyday digital tools that people already use. For example, our digital inclusion pathfinder in West Yorkshire, supporting people with hearing and sensory impairments, showed us that people are mostly using the pre -loaded accessibility software on their phones to help them to better communicate with their health practitioners and with using digital health tools. Expensive apps and hardware are costly and not necessarily as convenient and useful as the things we use every day.
Across the NHS, even amongst the most agile of teams, it’s fair to say that we tend to focus more on our successes with little or no mention of our failures and the incredibly useful insights and learnings that they bring. In many areas of our work we have learned valuable lessons from what didn’t work and yet we don’t talk about or share that vital information with each other.
As well as benefiting our work on WDP, we want to use our experience to create a more open and celebrated culture of ‘successful failure’ across the NHS so that we can all save time and money and develop better digital services that people want to use.
There's more information about successful failure and the principles of agile delivery at the GOV.UK website.