This week we stopped to question whether we were moving in the right direction. It’s early days, but we felt like we’d made a false start. I’m torn between wanting to move forwards and the need to make sure we’re creating solid foundations.
We tried to move fast – find somewhere we could add value quickly, learn what it takes to make changes in the NHS app. Unsurprisingly, there’s not much we can do that has value, progresses the strategies of both Digital Prevention Services and the NHS app, and isn’t incredibly complex.
Scrimshaw
With new people joining a couple of weeks ago, it felt like a good time to reassess. What’s our purpose? What foundational work do we need to do to reduce the risk of going in the wrong direction?
Even with a small team, communicating clearly about our purpose matters. We’re now five people. I can’t assume everyone is on the same page.
I started by framing the purpose of our team to be the intersection between the goals of the Digital Prevention Services – helping people stay healthy, and the NHS app’s goal of being the primary way user’s access the NHS.
R‑Type
For me, there’s one riskiest assumption. ‘Prevention’ or ‘reduce your risk of getting ill’, or whatever we end up calling it makes sense to users as a single concept. We need an informed view of this to shape almost everything else. The last thing I want is to ship our org structure if it doesn’t match how users think.
We started by exploring whether to put screening and vaccines on a single page. I built a prototype to explore what this might look like – the data needed, how you might organise it. But screening and vaccines are just two things that reduce risk. There are many others, for example taking medicine.
A chronological view feels inside‑out. Organised by when things happen rather than what they mean to someone. This probably changes depending on who’s looking. Parents might think differently about their child’s record than their own. Most people will only care about the most critical thing – what have they missed? What needs action now?
That matters most for people who are least likely to chase up. People who move frequently, have lower health literacy, or have had poor continuity of care. The people we most need to reach.
Dowager
When we look across the ideas we’re exploring, they fall into two groups. What we’re referring to as transactional services – one‑off things like screenings and vaccinations – where theoretically the app can help people know what they’re due and act on it. And ongoing support – behaviour change, managing long‑term risk – where the relationship between the user and their health is sustained over time. Different problems. The transactional stuff is hard, really hard, but people are working on it. Ongoing health management might never be part of the app, or if it is, it’s a long road to get there.
Blackfriars
The prototype I built is useful to talk around, to explore what data needs to be available and what will be hard about this, but it’s leaping to a solution. I’ll be more comfortable starting with basic user needs and mental models. How do people think about reducing their risk of illness? What do they need to know, and when?
None of these ideas are small. Making any of them real will need commitment from across the NHS. I keep reminding myself we’re not going backwards – we’re just building more structure before we move.