I’ve been working at NHS England (NHSE) for 5 months. It’s been intense and I’ve learnt a lot.
I joined at the beginning of October 2024 as service design lead for Personalised Prevention Services, which sits within Digital Prevention Services.
In my first months I was drowning in complexity.
I’ve worked in the public sector since 2013, but the other organisations (Government Digital Service, Cabinet Office, Department for Business Energy & Industrial Strategy, and Department for Education) don’t come close to the mix of bodies, boards, trusts, and services that make up the NHS (not to mention the Department of Health and Social Care, outsourced services or the tech that it all runs on).
Then there’s the domain. Through my career I’ve enjoyed seeing the back-end of government. It’s been fun to learn how product safety or teacher training works.
The learning curve for health is basically a wall.
Personalised Prevention Services
When I joined, it was hard to judge what was in flux and what was normal. I realise now that I didn’t appreciate how new Personalised Prevention Services was.
We had 2 teams within Personalised Prevention Services. The Digital NHS Health Check (DHC) moving towards a private beta launch, and a discovery (mostly) called ‘Personalised Prevention Platform’ which had started just before I joined.
DHC is a digital version of the NHS health check. It’s for people aged 40 to 74. It measures height, weight, blood pressure, cholesterol, glucose, and lifestyle and helps identify risk factors for cardiovascular disease, diabetes, and other health issues.
The Personalised Prevention Platform was a loosely scoped discovery. It was hard to say what it was really about.
I wasn’t clear how DHC and Personalised Prevention Platform were linked, or what our program was aiming to achieve. I was looking for someone to tell me. I felt lost. I didn’t feel I could offer either of those teams much support or direction.
Emily Houghton – Deputy director and lead for Personalised Prevention Services was supportive and encouraged me to speak to teams across Digital Prevention Services. But without clarity on what I was doing I found it hard to ask for people’s time. Theoretically it’s OK to ask to learn about what people are working on, but I didn’t know where to start or what I could usefully offer anyone in return.
I read a lot.
I met people on an almost daily basis who were also working on something ‘personalised’.
I worried about what ‘personalisation‘ meant and why it mattered.
I mapped things.
I felt anxious about my lack of contribution.
Eventually I understood that personalised prevention was a space for us to define.
Once we (Georgina Watts – strategy lead, and Irina Pencheva – head of product) found the time to work together and define what our program was, I began to feel better.
I spent a few days on some slides that defined how I saw our strategy and created an example journey using the NHS prototype kit.
It felt good to have something to share, iterate and work on together. With Georgina, Irina and people across Personal Prevention Service we evolved and refined our aims.
Personalised prevention vision
Our vision was simple — make it easy for people to check their health, understand their risks, and find the right services to stay well. Put like that, it’s hard to argue with. The detail involves using digital health assessments to help people understand their health risks and connect them to the most appropriate services. For example, someone with asthma is eligible for a yearly flu vaccine, but if they also smoke heavily and haven’t had their lungs checked recently, addressing that should take priority.
Provocatyping
Irina called the example journey the ‘provocatype’. Making it clear that the journey was not a prototype, had not been tested, wasn’t possible given how we operate currently, but showed our vision.
We shared the provocatype and the slides with more and more people. I was expecting push back. The positivity of the response surprised me. We were on the right path.
It gave us the confidence to better guide the Personalised Prevention Platform discovery. With a clear vision, we could define the areas it should and shouldn’t focus on.
It also meant we could think about other capabilities we needed.
We planned a discovery into the possibilities of component based health checks. Exploring if its possible to standardise and reuse the individual parts of a health assessment (for example, a check of blood pressure or some lifestyle questions). It started two-weeks ago.
Now
That’s sort of where we are now. A lot of other things have happened in that time, but I think that’s the important stuff.
The Personalised Prevention Platform has just started its alpha phase. I’m going to be working more closely with the team.
The Health Assessment discovery is growing from our original vision. I’m proud of the work done to get that off the ground.
The highlight of this week was speaking to a team of researchers looking at health assessments for people with learning difficulties. Aside from being incredibly important, it brings home the complexity of use-cases we can support.
People
I wanted to join NHSE because of the people I knew working there.
The mission is important, it means more to me than I anticipated to work for the NHS. I’m proud to put my NHS lanyard on. But the thing for me was the great people I already knew who were there.
Since joining I’ve met and get to work with more incredible people and this is the happiest I’ve been in my career in a while.
I can’t think about my time at NHSE and not mention Vicky Teinaki.
Like every other designer in the public sector, I knew her by reputation. She joined NHSE shortly after me and worked on the Personalised Prevention Platform. I was lucky to get to know her better and see her work up close. She was incredible.
Working with her reminded me that being a designer in the public sector is a privilege. You get to spend your days trying to make the world better. She embodied that completely.
I was and still am devastated by her death. My heart goes out to everyone who knew her.
I’m grateful for the support I got from everyone at NHSE.
Next
I’m planning to write shorter post about what I’ve done each week going forward. If you’ve read this far, I appreciate you ;-)