Happy birthday! We are now 1 year old as a team and what a year it has been. Back then, we were just starting out on our NHS.UK alpha journey and now we’re a fully-fledged programme. We’re working on a beta, a transactional service and a set of standards, with teams in both Leeds and London.
Our first year has been quite the adventure, and when you are in the thick of it all it is easy to lose sight of what’s been accomplished. Things haven’t always moved as fast or as smoothly as we’d have liked but we’ve taken these challenges and turned them into opportunities.
For NHS.UK alpha, the initial team of DH, NHS England and NHS Digital folk were charged with incubating a new type of project. We pledged to do three things: put users first, learn by doing and be open.
And recently, as joint team leads, one of our proudest moments was hearing the new chair of NHS Digital refer to our work as a catalyst for change, acknowledging that as well as the digital products we’ve created, what we’ve actually built is a culture.
As the two of us say farewell to the team we wanted to write this open letter to you as a reminder of some of the things we’ve learned, and as a big wide-armed hug and thank you for the experience.
We’re returning to our roles at the Department of Health to help start-up and incubate more digital projects in health and care. The start-up phase of NHS.UK is well and truly complete but we’ll be cheering you on as you continue the journey through beta and beyond.
Putting users first
As a team we have an unflappable belief when it comes to starting with the needs of the user, and by user we mean patients, service users, carers, clinicians, frontline staff and back office staff. Everything we design needs to work for all its users and we’re not naive to the complexities of health and care, or the immense financial pressures that face the NHS and social care services.
By putting the user first, we look at the end to end experiences of people going through health or care journeys. And that’s where we can add the most value. None of us joined this team to design a portal or an app. What we really care about is helping improve actual services and connecting people to the care they need.
Our approach has been challenged on numerous occasions and we’ve responded. You will continue to face challenges like these as the project gathers speed and profile, but stay stubborn in your beliefs. Continue showing people what we mean, bringing the critics even closer to the users, through lab sessions or playbacks. Make it impossible to refute.
Learn by doing
In the past year, we’ve spoken to more than 400 service users and healthcare professionals to produce hundreds of user needs. That’s led to 7 prototypes and 10 pages of content all being tested with users and iterated. Each of these steps has got us closer to meeting those needs.
And in the past 8 weeks, we’ve had more than 20,000 visits to beta.nhs.uk, mostly from users of the current NHS Choices website. We’ve had more than 400 pieces of feedback, increasing each week as we add more conditions and symptoms pages. Feedback is good, whether it’s positive or not. It’s how we learn.
Through trial and error we’ve also learned a lot about the way we work best.
We actually started out as 2 teams – Alice as strategy lead and Nayeema as delivery lead – but at about 10 weeks in we brought everyone together to work as one team and have continued to evolve.
By bringing all the disciplines together we’ve built mutual respect for people’s ideas and experience, and NHS.UK really is a team sport. Everyone sketches, everyone realises their typing skills aren’t so great when transcribing user research sessions, but everyone gets involved. We should be really proud of that.
When we started we took the decision to be as open as we could about what we were doing. We didn’t all find this easy, all of the time. Even now, it poses us with challenges as sharing things in small bites can jar in a world where people expect the big reveal.
We’d like to thank those early team members who pushed us to be open by default – it was the right thing to do (Hello Dom Baggott, Hello Paul Furley).
There’s no fanfare in publishing a page on warts on beta.nhs.uk, but releasing little and often is the best way to learn fast and produce the experiences users really need.
Over the course of the year, we’ve blogged about what we’re doing, held weekly – now fortnightly – show and tell sessions, open to all. We’ve had umpteen visits from industry, partner organisations and other bits of government, all of whom are keen to see what we’re up to and share their work. Our work is all the better for it.
What we’ve learned
It’s hard and it isn’t going to get easier. To get the best results, you are going to have to keep on tackling the gnarliest of problems. But the way that we’ve worked, in picking off the smallest thing that makes a difference, means that you’ll get there faster. We’ll still help where we can 😉
When we first started with our jeans and post-it notes, some called us a carbon copy of the Government Digital Service and said that we didn’t understand health. We’ve learned a lot from GDS and have received a lot of support from them too, but we started as a vision piece, a blank page as we’ve often called it. We wrote our own story.
And there are many benefits to having fresh eyes on a problem. People who have joined the team are passionate about improving the experiences around health. Many have received excellent care for themselves or their loved ones but can see the potential of joined up services and the opportunities digital health can bring.
As a team you’ve reached out and built networks within health and care, and this broader engagement will be crucial to the success of this project.
Personally, we’ve needed to call upon resilience we didn’t know we had, and it has been very special to work with a group of people who we’ve always been able to rely on. Whether that involves pulling together major presentations or workshops at short notice to stepping out of your comfort zone and running pop-up user testing.
There’s genuine excitement from people wanting to join the team and that’s thanks to the ethos and determination that shines through what you do and the way you talk about your work. It’s a culture that we’re confident will continue as the team grows under the stewardship of Rachel Murphy as Delivery Director and Juliet Bauer as NHS England’s Director of Digital Experience.
This past year has been the most challenging, emotionally exhausting, rewarding, and proudest year of our professional careers. Thanks for the ride.
Love Alice and Nayeema