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Battle of Ideas debate intro

Last Sunday (November 1st), I was on a panel for a debate at the Battle of Ideas festival. The following is my intro, which I didn’t quite follow to the letter, but used as a basis for many of my points.


I’m really excited about having this debate. I feel that issues around design don’t get debated enough in this sort of way, and it’s reassuring to see so many people in the audience here today.

I’m going to try and keep my intro brief. I have four key points that i’d like to make.

Point 1
More designers entering the healthcare arena is a good thing.

Point 2
…But they need to know their limitations.

Point 3
There is a danger that we give Patient Experience too much of a focus at the detriment of the overall performance of the NHS

Point 4
Designers need to focus on what they are good at and be careful of becoming stooges for tit-for-tat government policy

Let’s explore those points in more detail…

More designers entering the healthcare arena is a good thing
It’s been historically quite difficult to get good designers to be interested in designing for healthcare. I know I have struggled in the past, trying to recruit fellow designers in the agency that I worked to invest more than a few months working on some really interesting challenges. For so long, most would rather work on big brands doing cool new things. Work that might look really beautiful in their portfolio, that might win awards and win respect amongst their peers. Healthcare is certainly not beautiful in the traditional view.

I think it’s good that this new wave of designers have evolved their toolkit with user-centred, research-driven and collaborative practices. I strongly believe that design in this way is good design and can create better products and services. Products and services that are more efficient, more effective, safer and fit into the way people actually currently or will behave.

I hope that the influx of designers can help to nudge out some of the management consultants who have stationed themselves firmly into the NHS on long contracts, changing the service through bean counting and old school approaches to process re-engineering where people are actors in a system, cogs in a machine…

I think it’s great that designers are wanting to get involved in changing the world for the better. That is after all, why many wanted to become designers in the first place.

…But, my second point is about self-awareness

Designers need to know their limitations (and hidden powers)
Many of the challenges in healthcare are incredibly complex. There are a great number of roles, environments, and thousands of other variables that are hard to even understand, let alone influence.

I think a lot of designers can be quite naive, thinking that they can change the world with ideas. They are great at taking a complex problem and coming up with a simple solution, made tangible so it can be better understood and bought into. There is a rise in more ethically, seemingly more altruistic attempts at changing the world – whether it’s tackling the wicked problems of obesity and wellness, sustainability, or economics. I don’t doubt that designers can have a great influence on tackling challenges in these areas, but so many young designers are being flattered in their education or excited in the press, giving them the belief that it’s easier and more fun than we all know it really is.

I think above all, and especially in the healthcare space, most designers don’t have the patience to see their ideas through to completion. During the initial research and concepting, they are intellectually stimulated and challenged the greatest. This is what designers love, understanding a problem and coming up with ideas from the practical to the wacky. It’s infectious if you are a businessman or maybe a healthcare professional to be around designers at this sort of stage. But after this stage, there is a split in whether a designer will push through or move on. Some love getting into the detail design, getting around the barriers that are put in place by manufacturing, usability, or politics. Some just want to go to the next problem and do the early stages again. Unfortunately, I see more of the latter these days than the former. Less designers having the patience and the drive to follow through their ideas and realise the impact of the decisions they make.

This is incredibly important when it comes to policy, and designers shaping it through their work.

and so to one of the main points to all this, a point that has gotten ever more relevant in the past 2 months after we had started to pull together this debate…

There is a danger that we give Patient Experience too much of a focus at the detriment of the overall performance of the NHS
For some reason there’s a lot of ‘customer experience’ thinking and rhetoric around public services. Because of the internet, and the increasing power of consumers, politicians have decided that the government and all the public sector departments need to start treating citizens as customers. Is that really right? Is it even fair?

Now, I am big into making products and services better for the people that interact with them, improving the experience of their use. But I really can’t buy into the naive ideal that as consumers of public services, we should be treated like a paying customer. I know we pay, but as someone pointed out yesterday in the debate around the welfare state, public services and our investment of taxes into them is all about spreading risk around and trying to be fair to everyone.

A common theme at the moment is that of choice. Patient choice being a big policy agenda item. Citizens, like customers, should be able to pick the service they want and can decide where they might go for treatment. Flexibility is a good thing, but is choice in this way? Is it fair? or does it play to those that understand how to ‘game the system’ for their own benefits to the detriment of the less informed public. Do we really need trip advisors or eBay style comments for health services when those commenting have no idea of the complexities involved in the care being given. Very little is done about informing people of their basic rights – just have a look at the NHS constitution and try to get your head around that. When people just want to get better and are intimidated by even visiting a GP, I think that the whole choice agenda is incredibly premature.

So, in the past months, ‘patient experience’ is getting a lot of profile. As part of World Class Commissioning targets or just in the politician point scoring press. New targets will be set for healthcare professionals around this, meaning that if they deliver poor patient experience, they will get less funding. Now, let me tell you something that I believe to be true. Targets work. They have proven to be effective in healthcare. At reducing 18 month waits to 18 weeks or less. Targets work well, but only for delivering against the nature of the target itself. If that target is around the wrong area, or if the peripheral effects of delivering against that target are not fully understood – disaster can happen.

Maybe in the future, surgeons could start spending more time chewing the fat with patients to boost their ‘patient experience’ points at the detriment of doing more or better surgeries. Now obviously, that’s an extreme perspective. But this much is true. Targets in the NHS change behaviour, and we can’t easily anticipate how healthcare professionals will change their behaviour around the periphery of patient experience to line their pockets or keep themselves in a job.

Should designers really be using their powers to help policy makers score points of each other at the detriment to the care that the public receive.

..and so to my last summarising point…

Designers need to focus on what they are good at and be careful of becoming stooges for tit-for-tat government policy
They need to get back to the detail design and stay interested past the initial romance of the concepting.

They need to focus on delivering efficient, effective and safe products and services that fit the way people currently behave or will behave in the future.

For me, I believe that we just need to shift our focus in design, focus on the healthcare professionals that have to use appalling software or archaic physical instruments and monitors. These are the people that really need help. Help them and we help everyone.


Ego vs. Empathy presentation at Sense

So there I was after a couple of days of some of the leading lights in User Experience presenting to and training my fellow User Experience peers at UX London. I had signed up to do a presentation/discussion in the evening of Tuesday 16th June around a subject that I am constantly thinking about – the balance of ego and empathy: what makes the best design?

I was quite scared (shitting it) because I was fudging together the presentation in-between loads of work and I knew it would be contentious to a User Experience audience.

I have uploaded a version of the slide deck here, but it doesn’t really represent the experience that those there had. Just imagine these points, with lots of swearing, some cheesy animations, better fonts, a drunk but passionate Jason.

Given the responses i got from people, I feel much better about the whole experience and like always, it was worth doing. I aim to evolve this with some more concrete examples, maybe some in-depth research (well, maybe not).