This week I’ve been worrying about how much time I spend thinking about alignment, continuing to shape a discovery into health assessments and getting closer to the Personalised Prevention Platform team.
Alignment
If you were designing a system that was prone to duplication, it would look like public health in England. As far as I understand it, we have at least five policy organisations and more than 1,000 organisations responsible for delivery.
Everyone within NHS England is railing against waste. There are maps, slide decks, catalogues and many meetings aimed at getting alignment.
The downsides of duplication and misalignment are clear. But in this ecosystem it’s probably unavoidable, and has cost too.
Taken to the extreme, it’s risk‑averse and biases against action. I can’t help wondering – would we be doing a better job if we spent less time aligning and more time building?
I’m aiming for us to be pragmatic with a sprinkling of denial. Speak to people while we push on with delivery. Accept the risk. Hope that if we’re ahead of other people they’ll have to align to us. Map only what’s relevant. Align as we go.
Health assessment discovery
When Irina Pencheva and I first scoped the exploration into health assessments, it had two aims:
- Establish the impact of making more health assessments digital (we already have the NHS health check online)
- Investigate if we can do this through health assessment components (for example, if two or more assessments need a blood pressure check, can it be the same code, design, protocols etc.)
Risk calculation
Before the discovery kicked‑off, Irina and I spent time thinking about gaps in what was happening against what needed to happen to meet our vision for personalised prevention.
The biggest gap was independent risk calculation.
Risk calculation is a necessary part of a health assessment. But to create a system that is able to consume multiple data sources (health assessments, screenings, home testing) we need to calculate risk independently of health assessments.
It’s a risky assumption that we can create a way to calculate risk for anyone.
Irina (ruthless pragmatist and always one step ahead of me) was confident that calculating risk could be included in the health assessment discovery scope.
In the kick‑off for the discovery, I tried to emphasise my concerns about the breadth of aims. Nobody seemed in the least worried.
Two weeks in, the discovery team is getting into the weeds of the problem space. I’ve been having fun conversations with Anisha Kanabar – service designer on the team, about some of the details:
- what are health assessments – do they include screening?
- is a risk calculation a component of a health assessment or stands alone – can you have an assessment without a risk calculation? Can you have a risk calculation without an assessment?
- use cases for personalised prevention platform and health assessments – would we notify a user to say a new services is available based on their risk? Would we prompt people with increased blood pressure to check it more often?
Including risk calculations in discovery was right. I’m looking forward to seeing what the team recommend.
Working with Personalised Prevention Platform
The Personalised Prevention Platform (PPP) team have just started an alpha phase and I’m filling the service designer gap in the team.
I had a chat with Simon Wilson – the PPP Product Manager (PPPPM) this week about how busy I was and what support I could give to the team. I found myself saying ‘nobody is asking me to do the work I’m doing’. Which is sort of true and also not at all.
I joined them as a team member on Wednesday and then didn’t have the capacity to participate in much of the time they set aside to work as a team. We’ll see how it goes, but I already feel like I’m letting the team down.
The time I have spent with the team has been valuable. Getting into the detail of the problems is reassuring and is helping me to refine our strategy.
Next week
I’m going to:
- prioritise time with PPP
- attend ‘big room planning’ which aims to help teams across ‘Products and Platforms’ (the parent of the bit I work in – Digital Prevention Services), align
- plan the session Sarah Fisher and I are running for Services Week