Oli Lovell asked me what it would look like to create the optimal experience for users looking after their health. It’s one of those questions that feels both easy and hard. I spend a lot of time thinking about the user experience for prevention services – I feel like I should be able to answer easily – but I haven’t spent much time actually thinking about the perfect experience, because I spend all my time looking at problems.
But it’s actually quite an easy thing to answer. Don’t make users have to think. Show them what they need. Help them move through any journey – coping with the infinite complexity of health and associated factors – show them only the most useful things without limiting their options.
Easy to say. Hard to do. The user experience as a whole is no one’s responsibility.
Can we give a connected experience for a whole pathway – the way GOV.UK treats ’learn to drive’ as a single thing a person does, not 17 separate transactions.
I started mapping the process a person goes through – from first contact about cervical cancer screening, just after they turn 24 and a half, through to treatment if it’s needed. But with all of these things it’s an abstraction. The map is not the territory. I keep a list of things I’m not including, to be transparent about how surface my representation is – people with learning difficulties, language barriers, those experiencing homelessness, survivors of sexual violence. The list gets long quickly.
From that mapping, a theme emerged. Things that are connected for a user – a letter, an appointment, a result, a follow‑up – are owned by different organisations or held in their own system with no simple way to talk to, or rely on each other. For example, the system that triggers an invite to cervical screening has no knowledge of when a user books an appointment. The NHS has to design with the assumption of worst case scenario because it can’t verify that another part of the system has done its job. Independent, loosely connected entities. Each system stores its own data because there’s no trust. If you can’t trust the record someone else holds, you keep your own – there are as many versions of the truth as there are organisations involved. The last fallback is always the GP, everyone sends a letter to the GP.
The fix doesn’t start with tech or design standards. It starts with relationships between things that are connected for the user across organisations.
The NHS app might be the best way to help the NHS think differently about how it helps users understand services. Not because the app solves the problem, but because it could force connections. To connect a journey in the app, you have to connect the organisations behind it. Can the NHS app own the experience. By being the place where the user’s journey is whole, even when the system isn’t.