I’ve worked 4 days over the last fortnight. The mix of childcare, sporadic work and other stuff going on, means I’m not sure I’ve got much chance of writing anything coherent this week.

I spent half my time in workshops.

I spent time talking about how to organise work.

I met 4 people we’re considering working with.

Prevention and risk

A core component of designing for health care is managing risk. The risks are literally life or death. Working in prevention we come up against how we can proportionally account for risk on a daily basis.

It seems as though the frameworks that measure risk in healthcare work well enough when people are already ill. But trying to predict risk before someone gets ill, the factors are too diverse to meaningfully apply the same kinds of risk measurement. A measure of risk needs to consider so many aspects (many of which are outside healthcare) that you are left with massive uncertainty.

So without any confidence in our risk calculations we take the worst case scenario and try to mitigate that. This makes the job of delivering services many, many times more complex.

We rarely consider the opposite risk – not delivering a service at all. We spend time and energy documenting potential risks of something new, but almost none measuring the harm of the current situation in comparison. The risks of action are weighted more heavily than the risks of inaction.

Types of service designer

3 of the 4 people I spoke to in the last couple of weeks were service designers.

I found myself describing the 2 different types of services designers we need:

  1. a systems thinking service designer – someone who understands systems and designs to reduce, remove or avoid complexity so users are better able to get the outcomes they need

  2. people‑focused designer – someone who thinks holistically about users, their communities and lived experiences, they consider emotional responses and personal contexts

This is a bit of a false split. Most designers consider both aspects in their work.

Coming from central government, I’ve mostly been the first type. The services I’ve worked on were often designed for professionals. User needs mattered, but the emotional aspects weren’t my primary focus.

In health, designing with the core aim of reducing health inequalities, the care with which we design around people and the experience they bring will have a huge impact.

The systems approach helps navigate healthcare complexity. But without designing for people’s circumstances and barriers, we risk designing services that work only for people already well‑served.

Credit to Irina Pencheva, who I stole the title for this week’s note from.