SDN conference Cologne 2012 Better Health Services by Design | Using service design to innovate in healthcare Copyright, NHS Institute for innovation and Improvement

1. Better health
services by design
Using service design
to innovate healthcare
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

2. The National
Health Service
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

3. 1 million patients use
the NHS every 36 hours
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

4. 1 million patients use
the NHS every 36 hours
466 people a minute
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

5. One but many
1,431,996 NHS employees
£102 billion spend 2010/11
£35 billion in 1997
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

6. July 1948
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

7. The NHS now
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

8. Medical advances 1948 2008
Maternity hospital stay 13.5 days 1.9 days
Operations 5,514 49,500
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

9. • From re-active to Being an NHS patient is still
pro-active too often a frustrating
• Wider system experience. We ought to
innovation move towards becoming a
more patient-led NHS
Healthcare Commission, 2005
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

10. NHS productivity challenge
£126 billion needed by 2014
Actual funding likely to be frozen
in real terms at around £105 billion
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

11. £21 billion funding gap
We need to save £90
million a day
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

12. Innovation in the
NHS has become
business critical.
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

13. www.institute.nhs.uk | Assisting the NHS in transforming healthcare

14. What we do
We support the NHS to
transform healthcare for
patients and the public
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

15. Innovation now
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

16. The opportunity
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

17. www.institute.nhs.uk | Assisting the NHS in transforming healthcare

18. A proven and transferable
problem-solving methodology.
It’s not ‘design a car’ but
‘design for personal mobility’
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

19. Combined with
Lean thinking
Six Sigma
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

20. How we work
Co-creative: with not for
Learning from observation
Diverging & converging
Iterative by prototyping
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

21. What I hear I forget
What I see I remember
What I do I understand
Lao Tse
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

22. Role playing a new
portering service
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

23. Design to
Improve patient experience
Improve staff experience
Increase work productivity
Design out wasteful activities
Increase patient facing time
Inspire insights & innovative services ideas
Build internal capabilities inside the NHS
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

24. Experience based design
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

25. An design methodology
About using patient and staff
experience to gain insights and
identifying opportunities for
improvement
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

26. Equip people with the right skills
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

27. Improving MS services
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

28. Understanding patient needs
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

29. Opportunity areas
Onset of the condition | An increased focus on self-
management tools and self-referral
Post-diagnosis | A greater emphasis on learning and
counseling services for the family
Crisis situations | Fast access to specialist advice
Post-crisis situations | A good opportunity to
introduce future planning
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

30. The result
ENABLE | A joined-up community
service for people with long term
neurological conditions
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

31. www.institute.nhs.uk | Assisting the NHS in transforming healthcare

32. NHS Institute
Productive work
Early scoping
General Practice
Productive General Practice
Output from innovation cycle
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

33. Using a design & lean thinking
identify opportunities for
improvement in GP surgeries.
Releasing time to deliver better
services to patients
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

34. What we did
• Practice audit, collecting measures
• Observational visits to 11 GP practices
• Contextual interviews - patient & staff
shadowing and activity follows
• 2 national and 10 local collaborative
workshops
• Towards a nationwide programme that
helps GP surgeries improve themselves

35. Shadowing patients
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

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37. Experience shadows
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

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40. Patient representations
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

41. Mapping relationships
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

42. Staff routines
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

43. Opportunity framework
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

44. Specifically
• Access to health services
• Patient information
• Demand vs. capacity
• Wasteful admin processes & prescriptions
• Appointments
• Primary and Secondary care interaction
• Understanding the patient journey
• Embracing a service culture at reception

45. Impact
• Supporting doctors in their prescribing
decisions – as a result there were more
appropriate patient prescriptions
• Improved prescribing effectiveness
• The right referrals at the right time
• Increased joined-up care
• Decreased level of complaints
• Improved patient experience
• Improved work/life balance
• Reduced administration & duplication of work
• Increased levels of self care

46. Build capability
in GP practices
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

47. PGP programme
Improvement tools
27 case studies
E-learning
Coaching support
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

48. Capability building
www.institute.nhs.uk | Assisting the NHS in transforming healthcare

49. Thank you.
Julia Schaeper
julia.schaeper@institute.nhs.uk
www.institute.nhs.uk | Assisting the NHS in transforming healthcare