NHS - Preventative Care 2030
About the project Title: NHSi Type of Work: User Research, Workshop Facilitation, Co-design, Service Design Duration: 6 weeks - Group Work NHSi is the result of a 6 week live project with NHS Ayrshire & Arran. This project looked at the future of the NHS in 2030 and in particular the future of Preventative and Holistic Care. We focused on blended healthcare, a future pathway for NHS Scotland, find ways to use digital technology within healthcare without loosing human connection. The final outcome of this project was a speculative service design focusing on preventative health; it was modelled like a local authority roll out in Ayrshire with residents receiving a wearable health tracker and a prevention plan. Alongside the prevention, holistic healthcare hubs were set up in local areas to support people with everything health related and beyond healthcare i.e. environmental, economic, social factors. Due to COVID-19 this project and all workshops/co-design sessions were run online using Miro and Zoom.
The Challenge
Developing Preventative and Holistic Care in the NHS system, has not been a priority and working to develop a futures based service within this aspect of healthcare needed a new focus with both organisational and health based changes. We had to unpick a range of meanings, culture beliefs and understanding around Preventative and Holistic Care.
Our focus was on blended, digital and human approaches to a futures based healthcare system. Due to COVID-19 a lot of NHS Scotland Services have been blended and services like NHS Inform have been rolled out and used throughout the pandemic.
Some of the information for this project is confidential, but this should show the overall processes and outcomes.
The Process
In order to dig deep into changes that could be made and find design opportunities in the system we started off the project with a large research phase.
User Research
We ran a series of user and stakeholder interviews with NHS Ayrshire and Arran, NHS 24, South Ayrshire Social Services, the charity Centrestage in Kilmarnock and The National Institute of Integrative Medicine. From our user research and desk based research we determined personas within the system, user journeys, eco-system maps and found pain points that existed and could potentially be redesigned.
Futures Research
This project was a speculative futures proposition and therefore needed to be positioned within Scotland in 2030, using various futures thinking methods such as STEEPLE Cards, futures research and future world development we created a future scenario to position our designs and our conversations.
Co-Design & Feedback
Once we had gathered a range of insights and initial concepts, we created 6 co-design sessions that helped us understand how users might navigate our concepts. We ran our workshops in 2 stages, the second building on what had been chosen in the first session.
Session 1
In the workshops participants were asked to choose values for our future world, based on the available value cards - for example "An inclusive society" "Full democracy" or "Free Healthcare" to name a few.
Participants were also asked to give feedback on the persona cards and think about how each person might move through a healthcare scenario. They were also given a care scenario card and asked to think about service touchpoints for users. i.e. What would the Care Coach do to help a patient who had broken their arm.
Session 2
In this session participants were then taken through a service design blueprint and asked specific questions and choices for touchpoints. They were also asked about their views on the ethics.
Some of our ethics card questions were more challenging; we asked participants to choose whether people in our future health world should "Be prevented from being ill, without knowing what they were being prevented for" or whether a digital device "could alert their other community members to friends, neighbours, even strangers poor health"
Mapping the service & development
We mapped the end-to-end vision and a detailed service blueprint, which allowed us to:
- Understand how the users would move through the service
- Develop touchpoints at crucial parts in the service
- Identify the roles and activities that would be critical to offer the service
- Make sure technology in the service was matched with human connection
Developing a truly preventative system
"The National Illness Service"
From our insights, feedback sessions and co-designed we developed a preventative health service that focused on not just what is happening now in terms of a person's health but what could be going on. We realised from our research and user feedback that preventative care has already failed at the point someone reaches the NHS. We wanted to create a futures based service that looked at preventing you before you become unwell. One of the provocations we produced in our co-design was "Should someone know if they are unwell" the response to this was really interesting, our stakeholders and users felt that unless it was something life-threatening it could be a possibility that people didn't need to know.
From that we developed the NHSi wearable device that tracked your data based on the Diabetes Monitoring system already widely used in the NHS.
The Outcome
NHSi is a pilot scheme in Ayrshire, focusing on truly preventative technology and medicine paired with holistic local services.
The NHSi Device
Our futures research and thinking led us to the conclusion that data and wearable technology will increase in the general population over the next 10 years, so our service used this insight to create our tracker. Like a Fitbit device or apple watch, it tracks your data continuously, but the difference is it joins up the dots in your health, those everyday symptoms like headaches, colds, skin rashes etc. that may not seem connected. The tracker learns about you, learns about your health and predicts if you are going to become unwell, it then sends you preventative medication weekly. People do not know what they are taking (like most medication that people take each day in the UK) and they do not know what they are being prevented from.
NHSi Service
It was important alongside the device to create a service that could humanise the experience and help people beyond their healthcare problems. We created local healthcare hubs, that offered additional community based services and holistic services - these hubs were co-designed with our participants to offer a range of options like community based therapy, sleep support, financial support and community growing.
NHSi Pilot Launch
We developed a range of artefacts to launch the NHSi project:
- Revamped but consistent branding using the NHS Scotland secondary colours
- Local and online advertising - thought provoking adverts to make people question their preventative health
- NHSi information emails, brochures and letters
A glimpse behind the scenes at our team process
Project Process Journal