There was an announcement this week about using AI in the NHS app to ‘give patients direct access to trusted health information’. The article had quote from Wes Streeting ‘If you get annoyed at Deliveroo not getting your dinner to you in less than an hour, how will you feel being told to wait a year for a knee operation?’
The quote stuck with me.
Technology continues to make things in life more ‘frictionless’.
Friction is often seen as a bad thing, especially when designing services. But whether friction is good or bad depends.
30 years ago, if an average person wanted to gamble, they’d need to leave their home, travel to a shop and buy a scratch‑card (in cash), do some scratching. Now you can use apps to automatically buy crypto, on repeat.
30 years ago, spreading misinformation meant bullshitting in a pub. Now there’s TikTok.
The removal of friction doesn’t just make things faster it changes behaviour and outcomes.
As Wes Streeting points out, ordering food is now frictionless and people’s expectations have adjusted accordingly.
Ordering pizza and getting a knee operation are not obvious equivalents in my mind. Maybe ordering pizza and getting weight management support are a closer comparison. If you can order takeaway in a few taps, should getting support to lose weight be as simple?
There’s a lot of friction in the way of people’s access to support.
Finding support to stay healthy means navigating unclear eligibility criteria, inconsistent referral processes and lengthy waiting lists.
Only highly motivated people or those with good support navigate this system. People who need help most often miss out.
A lot of our work will be to remove the friction that wears away at motivation. But making healthy choices is difficult for most people. Finding time to exercise or cook healthy meals requires effort, planning, often money, and other trade‑offs in people’s lives.
This article in The Guardian – Britain in 2025: sick man of Europe battling untreated illness crisis, has a powerful example of the impact removing real‑world friction has:
In Fleetwood, eight miles north of Blackpool, NHS bosses spotted that a large number of children were failing to turn up to mental health appointments. They realised it was because families could not afford the two‑hour round trip on public transport. Since moving the service to Fleetwood, the child and adolescent mental health services waiting list has fallen to almost zero. A&E attendances for children in mental health crisis have decreased by 59%.
Removing friction around accessing support won’t be enough to make a significant difference to people’s lives.
Last week I wrote about how one of our services is considering connecting users to a digital service as default, instead of, as we had originally assumed giving people the option of connecting to local services and digital services.
For many people, digital services have less friction. They require less organisation and capacity than booking and travelling to an in‑person service.
But not all friction is bad. There may be some people, for whom the friction is worth the cost. If in‑person services connect people to personal support that is more enduring and helps people to make a more significant difference in their life.
A successful version of how we help people access support will give options that are relevant and available to them, in a way that lets them make a choice about what will help them the most.