The associate director of design and user research at NHS Digital, Matt Edgar, looks at how user interface and design can help deliver better public services.
What are the priorities for NHS Digital in 2020-2021?
As the national information and technology partner to the health and care system, our priority will always be the patients, the public who rely on health and care services in England, and the NHS staff who provide those services. Much of what we do is invisible to them, such as making sure patient information is available when clinicians need it or protecting the NHS from constantly evolving cyber threats. Increasingly, people can also come into direct contact with our products and services, through the NHS App, the NHS.UK website, and 111 Online for getting urgent medical help. So this year our priority is to work with our commissioners - NHSX - and the people who run local services to support better health outcomes, to deliver better patient experiences, and to make best use of the public money that’s spent on technology for health and care. Our focus areas include screening services and work on bookings, referrals and appointments.
Are there any parts of government that have improved design and user research that you have taken inspiration from for the NHS?
We’re standing on the shoulders of giants thanks to the work on the UK Government Digital Service (GDS) who give us both inspiration and some really practical tools. By basing our NHS.UK Frontend design system on GOV.UK, but staying true to the trusted NHS identity, we’ve been able to deliver simple, accessible digital services much more rapidly than if we had to start from scratch. We also benefit from the thousands-strong community of user researchers and designers working in other government departments. Operating at NHS scale, we look to the big delivery departments, such as Home Office, DWP and HMRC, all of which have great design leaders always willing to share how they’re tackling tough problems at scale. Beyond that, the decentralised nature of the NHS means that we have lots to learn from teams working in local government, as well as design teams in the USA, Canada, and other public sectors around the world.
In the time you have been in your role at NHS Digital, what are some of your biggest achievements?
I’m proud of the teams that have transformed NHS.UK to a modern, accessible, mobile-first website. The visual style is clearer, and the information is simpler. We’ve released the code as open-source so other NHS organisations can use it too. This, in turn, gives us a good foundation to support end-to-end user journeys for patients finding out what might be wrong, deciding what to do about it, and interacting digitally with health and care services. Along the way, there are little changes that can have a big impact when working at a national scale – things like a letter being redesigned to reduce the number of confused users phoning up. And then there are the things we haven’t done because user research showed there was no need for them: stopping bad ideas sooner means we direct our attention to more valuable work.
You founded Stick People – a consultancy that helps organisations grow their service design and digital capabilities – can you tell us more about how you did this?
With associates Kathryn Grace and Sharon Dale, I started Stick People as a consultancy to help teams, organisations and communities grow their service design and digital capabilities. Our approach included coaching, training and co-designing, always with an element of skills transfer. This evolved from volunteering as hosts of the Global Service Jam and Global GovJam events in Leeds. Health and social care organisations were our clients from the start. For example, we worked with mHabitat and Leeds City Council to discover what help and support health and care practitioners in the city needed to make better use of digital tools and services. I remember social workers, who were quite digitally capable outside work, showing us the battered dumbphones they had to use in their jobs, and demanding to know what we were going to do about that! Seeing the potential for digital capability and user-centred service design in this sector eventually led to me taking up a full-time role as NHS Digital’s head of design.
What are some of the most common challenges that organisations have in applying user-centred design?
On our user-centred design team wall, we have a copy of the Design Ladder, developed by the Danish Design Centre. It shows how organisations move from having no design capability, through the early stages of using design to style their products and services, but without really changing how they work. The challenge for any organisation – and those in health and care are no different – is to move further up the ladder to make design an integrated part of its development process, and eventually a key strategic element in its operating model. That means everyone in the organisation from the front line to board level, having an awareness of the principles of user-centred design, and demonstrably using user insights to inform what they do, as well as how they do it.
Matt Edgar is associate director of design and user research at NHS Digital, where he leads a growing professional group of 150+ designers, user researchers, content specialists, product managers, and delivery managers. Prior to joining NHS Digital in 2017, he spent 5 years as a service designer, digital coach, and founder of service design and innovation consultancy Stick People. He developed the GDS Service Manager Programme and coached in the DWP Digital Academy. His service design clients included the Co-op, NHS organisations, and local government. Before that, he spent 12 years in product management and design leadership roles for mobile operator, Orange.