From research to service delivery, the work of the NHS is underpinned by a strong evidence-based culture. Digital transformation, however, is one area of the NHS where this passion for evidence and data is often not translated into its approach.
Throughout Public Digital's work helping organisations to make digital transformation possible, we've seen that gathering and using evidence is a crucial part of designing effective digital services. The best approach to digital service design is to seek out information about your users, observe how they interact with your existing services and apply that knowledge to make their services genuinely user-centred. It means designing services based on what your users need, not what the organisation needs. There is much more to it than buying new technology.
Leaders also need a fundamental understanding of the value user research skills brings, as a crucial part of successful digital transformation.
Principal Consultant
Within the NHS, users are not just patients, but also the clinicians and staff that work within your trust. All of these individuals have needs which the trust must meet in order to ensure healthy patients and happy staff. We all have assumptions about what those needs are. User research is a powerful way of setting yourself up to discover and validate those needs.
As a leader in the NHS, you are unlikely to be directly involved in user research, but you will be instrumental in introducing user research to your trust by recruiting the right skills and creating the right conditions for success. Leaders also need a fundamental understanding of the value user research skills brings, as a crucial part of successful digital transformation.
What is user research?
User research is the methodical study of your service's users. It applies some of the principles of ethnographic and social research to build a deeper understanding of individuals and their behaviour.
While its goal is often the same – to identify user needs in order to improve a service – user research differs from other forms of research you may practise, such as patient engagement, in that it does not ask what patients want from services. Instead, it focuses on observing users, and asking them open questions that don't assume any knowledge or understanding.
One example of user research is usability testing. This involves observing people trying to complete a task or find information using your service, for example booking an appointment or finding out who they need to speak to to get support. In usability testing, you ask people to think out loud as they go in order to understand their thought process and what is motivating their behaviour.
You will only be able to implement the right solution if you first understand the 'why' behind the trends you've identified.
Principal Consultant
User research is important because it reveals the unmet needs that people can't, or won't express about their experience of a service. Using this method enables us to gather the most powerful insights.
For instance, since the pandemic we have seen a significant increase in the use of video consultations across the NHS. We have also seen very different levels of uptake across different services. In areas of low take-up, there could be a range of reasons why staff are not using video consultations. They may feel uncomfortable, or lack the correct skills, or it may be due to material factors like poor equipment or low-quality video connection. It's only through user research that you can really get to the bottom of the 'why'.
The reason behind the low-uptake will determine the appropriate solution for tackling the problem. That's why user research is so important: You will only be able to implement the right solution if you first understand the 'why' behind the trends you've identified.
How to bring user research into your trust
While the best person to conduct user research is a user researcher, leaders can model behaviours that send signals to the rest of the organisation, and drive small, simple changes to start incorporating user-centred ways of thinking and user-centred research into the practices of your trust.
Here are seven steps to take:
Always ask "what is the user need?"
Your teams need to be able to articulate the problem they're solving and who they are solving it for. That means maintaining a consistent focus on the user need.
Look at the data you've already got
Make use of the data gathered from any complaints, satisfaction surveys, or web analytics relating to your users' experience of your trust. Develop a picture of your trust users' digital experience, identify the problems and prioritise those which you can solve most quickly and/or easily.
Be creative and experiment
Where you are already doing research, think about where you could try a different approach. Surveys are often the most obvious method, but what else could you try instead? For example:
- user research interviews (when you run generative interviews with users and potential users of a service to build a broad understanding of their needs)
- contextual enquiry (when you go to where your users are and observe their behaviours in the context in which they are or would be using the service)
- usability testing (useful for testing prototypes, designs and existing services and products to see how your users interact with them)
- monitoring website analytics (useful for understanding how people are currently engaging with your organisation and services online, for example, what are people searching for? Where do they get stuck?).
Go to where the action is
Simple observation is a powerful tool in user research. Stand up from your desk and go and sit in a public area. Note down five things that you observe users doing successfully or unsuccessfully. Consider what you have learnt, and what you can do about it. Across the course of our programme, we met a Chief Executive who listens into calls on the IT Help Desk. How can you get closer to what's happening on the ground?
Share your findings widely
Your ultimate goal is not to complete the research but to land the messages about what your users need, so make user research recordings, publish your findings on the internet, and keep talking about what your research has taught you.
Hire an expert in user research design
Rather than assigning your existing staff with the task of designing user research, recruiting this skillset into your trust will help you to see the best results. Having an expert in their midst is likely to give your staff the momentum they need to get involved.
Find people with empathy and curiosity to do your research
Staff in your trust with these qualities are likely to have an aptitude for the work of user research and to easily recognise its value. When recruitment is a challenge, there is a lot you can do to upskill people in this way of working.
We can help
The Digital Boards development programme aims to build board understanding of the digital agenda and increase board confidence in harnessing the opportunities of digital.
Bespoke board development sessions
Through bespoke developments sessions, briefings and events, the Digital Boards programme can help you and your trust think through how you can create and develop the conditions for digital transformation in your trust.
User research workshop
In our workshop for board leaders on user research, we talk about the important of user research and how to introduce a user-centred mindset into your trust. We focus on usability testing as an example because it is such an insightful tool and it is especially focused on the power of observation. It's a great introduction to the world of user research. Join our next session on 23 February 2023.
Get in touch, we would love to work with you.
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