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

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


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

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


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

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

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




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




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


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




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




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




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




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




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

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

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

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

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

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




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




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

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

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




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

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Better Health Services by Design

  • 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
  • 36. www.institute.nhs.uk | Assisting the NHS in transforming healthcare
  • 37. Experience shadows www.institute.nhs.uk | Assisting the NHS in transforming healthcare
  • 38. www.institute.nhs.uk | Assisting the NHS in transforming healthcare
  • 39. www.institute.nhs.uk | Assisting the NHS in transforming healthcare
  • 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