The NHS has come a long way on its digital journey but still struggles to put user experience in healthcare at the centre of its transformation programmes.
Tracey Watson, our Client Principal, looks at the evidence for making user experience a primary driver of transformation success.
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Virtually every aspect of modern life has been, and will continue to be, radically reshaped by innovation and technology. Healthcare is no exception. However, the NHS still struggles to overcome barriers to new technology adoption.
Why is it that user experience (UX) isn’t a primary driver or measure for transformation success?
Evidence tells us employees that are happy with their digital tools are likely to be motivated to stay within an organisation, be more productive and efficient. This then leads to a better service provision and health outcomes. However, for a variety of reasons, when designing and delivering digital transformation, the human factors aren’t factored enough.
How many of us can point to a system deployment that has gone right technically but the end users are not on board? Merely deploying new technology without understanding need and its potential application is unlikely to achieve real transformation goals. Neglecting or insufficiently considering these elements is counter-productive and can lead to very costly optimisation programmes and workforce apathy.
The Wachter Review, commissioned by the Department for Health and Social Care back in 2016, was a seminal report reinforcing the criticality in taking a people-first approach. The review tells us “industry after industry has demonstrated that just installing computers without rethinking the way people work does not allow the system and its people to reach its potential; in fact, technology can sometimes get in the way.”
National NHS entities and UK Government departments have embraced user centricity. This journey was triggered by the Martha Lane Fox Review (2010) that examined how Government should interact with its citizens, followed by the introduction of the UK Government Digital Service (GDS) in 2011. This was groundbreaking at the time, changing the citizen’s experience of public sector services. Many of you will remember, before the advent of gov.uk and GDS, the laborious tasks associated with taxing your car. As a result of GDS, the user journey or process taken to tax a car was mapped, improved and simplified. They utilised what is commonly referred to as user-centred design, an iterative design process in which service designers focus on people and their needs using a variety of research and design techniques. This process allows you to gain a greater appreciation of how new systems or processes need to be designed or configured to improve experience, efficiency and productivity.
The Technology Code of Practice (TCoP) and the Digital Service Manual both reinforce the need to take a user-centric approach and are used across central UK Government departments and national NHS entities to assist technology design and build decisions. Behavioural insights, a discipline that combines psychology, cognitive and social science with empirically tested results to discover how humans actually make choices, has been embedded in health care policy teams.
So, what does all this mean for provider or Integrated Care Board (ICB) settings?
Digital has become synonymous with most transformation efforts; it’s the enabler that can provide the catalyst for change. All too often we hear about costly transformation programmes that do not deliver transformation. In many instances, this is because the people capital, or in other words, an organisation’s ability to invest the thought, time and energy needed to change their activities, is lacking.
Levels of digital maturity in England across the health and social care sector are mixed. Over the past decade, various national strategies have focused on secondary care and achieving core levels of digitisation. This has led to NHS England setting a target for 90% of NHS trusts to have an Electronic Patient Record (EPR) system in place by December 2023 and 95% by March 2025. Sourcing, designing and deploying an EPR is one of the most complex digital transformation processes a healthcare organisation can undertake. This surge in EPR demand provides an opportunity for ICBs and provider trusts embarking on their EPR journey, to invest the time and capacity to rethink how their service provision can be improved for service users and their workforce.
It also provides an opportunity for leaders to ensure UX becomes a primary driver of transformation success. This is a serious undertaking that cannot be tokenistic; it requires the workforce and service users to get involved and lead the design and delivery of new solutions. It also requires a personalised approach to learning a new system and processes.
In 2021/2022, NHS England commissioned a nationwide user-led survey, that measured and compared how well EPR systems supported frontline clinicians. Results from the survey revealed that improvements to learning, addressing digital and data literacy needs led to higher user satisfaction.
In addition to meeting EPR targets, ICBs have a statutory duty to consider how to reduce inequalities in access to and outcomes from health services. A number of interdependent factors contribute towards this problem and some groups face a higher risk of being digitally excluded; these groups also generally face a higher risk of health inequalities. Adopting a more personalised, inclusive approach to transformation will help ICBs and their localities address population health risks and needs.
The commercial sector and our national partners understand the criticality of good design and improved UX. They recognise that investing time and energy in understanding the needs of their workforce or service users will lead to a meaningful transformation. NHS delivery organisations are under tremendous pressure to stand up a service, respond to staff shortages, reduce waiting lists and health inequalities, whilst attempting to transform. Given these environmental factors, transformation activities can be rushed, corners cut to deliver on time and to budget. However, the risks associated with not taking a user-centric approach to transformation will become a problem for future endeavors and return on investment.
Get in touch
If you would like to discuss how a user-centred design approach could support your transformation project, contact Chloe Watson, Head of Design and Change, at chloe@ethicalhealthcare.org.uk.