Mapping your services helps you understand what you currently provide. But doing this alone risks a narrow, organisation-centric view. You could end up re-creating the same services on top of modern technologies.

The best protection against this is to look at your organisation from the outside-in, grounding your digital strategy in the real experiences of patients, clinicians and carers.

It's essential that those leading strategy development spend time understanding the needs of your users. This is even more true now as more patients are changing the ways they interact with the health service, for example by accessing virtual consultations or requesting their own data.

It isn't a new concept for the NHS: all trusts have established ways of bringing patient and service user views to the board. And trust leaders are now committing to get closer to the digital experience of their users, too.



  • Reach beyond the usual voices. Good user research can't be done by listening to expert patients or clinical informaticians alone. Don't underestimate the importance of user research skills.
  • Check your bias. It can be tempting to assume you know what patients or clinicians need, particularly if you have been one. However, this can be a dangerous assumption: those involved in developing digital strategies are atypical.
  • What people say they want is not always what they need. It is better to observe how they work, understand their lives and listen to their frustrations.
  • Think about all your users. Thinking about your mainstream users vs those with more specific and unique needs can be a good way to test your digital strategy. This short guide from IDEO can support your thinking.



  • Use existing data: like friends and family test results (especially write-in answers), complaints and staff survey responses.
  • Go to the 'gemba': spend time shadowing, visit wards and try to use IT systems yourself.
  • Interviews: a small number of user interviews and focus groups will often give you insights you won't get from surveying thousands.
  • Diversity and inclusion: Ensure you are speaking to all parts of the communities you serve. As an employer make sure you build diverse and inclusive teams by reviewing recruitment practices, connecting with new networks and seeking new ideas. The NHS's Widening Digital Participation programme can provide more advice.
  • Go deep in one or two areas: you won't be able to do detailed research across all areas of your trust, but it is helpful to explore a couple of domains in more detail.


Further reading

It does not necessarily have to be expensive to undertake user research, advice on how to do so can be found in books and blog posts. To get a broader view of your services and policy challenges there are a range of techniques you can use like journey mapping.

During the development of our digital strategy I kept walking in the shoes of a newly qualified staff nurse on a Monday morning: would the strategy be meaningful to them? Will it mean they have access to equipment, health and wellbeing support, and the right training? If they have an innovative idea, how will they let people know, and are they in the position to have this discussion? This is how I made it feel real.

Gill Green    Director of Nursing and Governance, Greater Manchester Mental Health NHS Foundation Trust