Some slides that Helen Bevan put together on using personas for friends on Twitter

1. NHS England and NHS Improvement
Using PERSONAS in redesign for
people who use services and/or
people who work in services

2. A growing interest globally in the concept of
“mass customisation” for health and care
Combining the personalisation and flexibility of individualised
services and taking it to a level of scale to cover a mass
population
People don’t want more
choice; they want what
they want, where, when
and how they want it
(Irma Jason)
Source of image: Syahibudil Ikhwan Abdul Kudus

3. In co-creating new service designs, we want to take a
view from both the balcony and the dancefloor
From the balcony:
• Identify the starting point and inequalities in the health of the
population
• See the big picture of the health and care system
• Identify the aspects that will make a difference to the majority of
people
From the dancefloor:
• Step into the shoes of individual people
• Understand the service from the
perspective of their lives
• Make sure that the service addresses
“what matters to me”
Personas are a powerful
methodology from Design
Science for getting the
view from the dancefloor
Balcony and dancefloor framework from Ronald Heifetz

4. 4 |
Why we need personas
A 19 year old university student will have very different needs from
a health and care system to an 80 year old retired person
• Often we are seeking to design or
enhance a service for a lot of different
people. How can we ensure that the
service design brings benefits for all
of them?
• We can do that by segmenting
people: thinking about different kinds
of people and their needs/wants and
making sure that the service design
addresses them:

5. “A practical alternative, widely used in
other industries, is to stratify the customer
population into groups that are sufficiently
homogenous to enable arranging a set of
commonly needed supports and services to
meet their expected needs.”
- Joanne Lynn
5
How? (more basically)
patient/service user segmentation
Source: Lynn J et al. (2007). Using population segmentation to provide better health
care for all: the “Bridges to Health” model. Milbank Q.
https://www.ncbi.nlm.nih.gov/pubmed/17517112
Source: IHI

6. We already segment based on patients’ clinical
characteristics; population health starts with
segmentation
1. More holistic segmentation delves into not only the
2-dimensional view of patients
(clinical/demographic), but rather multi-dimensional
view (who these patients are, not just what
problems they present with)
2. How do we get this more holistic view?
Psychograhics
6
We need holistic segmentation
(not just clinical)
Source: The IHI

7. Is about someone’s values, attitudes, personalities, and
lifestyles, and are the key to understanding their
priorities and motivations.
B. Walker. “Two cutting-edge ways to use psychographic
segmentation in healthcare.” Patientbond 2016.
7
Psychographics
Source: the IHI
Typically, we segment
people by
demographics. We also
want to segment
people by
psychographics and
other factors

8. 8
Personas come from holistic segmentation based
on multiple factors
Protected
characteristics
& inequalities
• Disability
• Gender identity
• Sexual orientation
• Literacy level
• Care for family member
• Health inequalities
Source: Helen Bevan

9. Independent
and committed
Worried and
committed
Traditional and
not worried
Vulnerable and
worried
Psychographic segmentation from the Swedish
Association of Local Authorities and Regions
@helenbevan #SirPeterCarr

10. Depending on the situation and the need - we make the
decicion together on what suits me and the situation best!
Segmenting by psychographic charactertistics
Independent
and committed
Worried and
committed
Traditional and
not worried
Vulnerable
and worried
Before During After
Make an
appointment
virtually
Consulting
Waiting
list
Called up
Self check
Reception
Your own
contact person
Waiting
room host
Reading a
journal
Video
meeting
Letter
Calls
Source:Swedish Association of Local Authorities and Regions

11. Creating personas
What do we want to achieve in developing personas?
• Stand in the shoes of the people that our service redesign is aimed at, to
make sure it is relatable and relevant
• Segmentation: create relevant attributes of some typical people
• Make the service design fit for the purpose of the people it is aimed at;
‘alive’ not just words on a page or another policy
Work with a
wide range of
participants

12. The most famous persona in the
world of improvement: Esther
Esther is not a real person, but her story has led to impressive
improvements in how people flow through the complex network
of providers and care settings in Sweden
Esther has inspired thousands of people to
improve the health and care system all over the
world

13. Esther is a persona
A persona is a characterisation
that helps focus problem
solving and design.
The best persona incorporate
real experience that identifies
key themes based on qualitative
user research, quantitative data
and discussion.
The result should be someone
people feel they can identify
with.
To learn more about Esther:
https://www.commonwealthfund.org/sites/default/fil
es/2018-09/1901_Gray_Esther_case_study_v3.pdf

14. Personas are archetypes, not stereotypes
• An archetype refers to a generic version of a person and is neutral
• A stereotype refers to the attributes that people think characterise a group
• A stereotype has little to do with the individual, and so mostly tries to
characterise them based on group affiliation or association, i.e., inferred
characteristics
• With a persona, you're describing relevant
attributes of some typical people, not
inferring attributes based on some group
affiliation or prejudice. Hence, a persona is
better described as an archetype

15. The problem with
stereotypes is not
that they are untrue,
but that they are
incomplete. They
make one story
become the only
story.
Chimamanda Ngozi
Adichie
“

16. Using personas in service redesign
• Personas are fictional characters based upon qualitative user research,
quantitative data, practical experience, knowledge and discussion
• Personas can help us to help us understand the needs, experiences,
behaviours and goals of people who will use our services
• Personas help us recognise that different people have different needs and
expectations and that there is no “one size fits all” The personas are not
meant to be representative but reflective, based on relevant attributes of
typical people
• Personas are not a final product; they should continue to evolve as more
people discuss them and the design process progresses

17. What to do next with personas
• The backgrounds, skills, priorities and goals of these personas have been created
as key points of reference for the design process
• We should utilise the personas to test the design as it evolves. We should stand in
the shoes of these personas and view it from their perspective: “What would
Deirdre from Dudley think about this proposal?” These are some example
questions to ask:
• Will the design make a difference for the majority of our NHS people?
• How will it help them achieve their goals and dreams?
• What might we need to add to the design to be impactful for more of these people?
• How will we make sure that the design reaches all of these people
• Will the design create unintended consequences ?
• We can use the personas at every stage to come, from design to implementation
planning
• Personas are most powerful when they are brought into the heart of the design
process and they are used in frequent conversation and discussion