Building a design team from scratch in a large and complex organisation

Simon Dixon
Jun 18, 2019 · 6 min read
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Two and a bit years ago, when I started my current senior leadership role as Head of Digital Strategy and Design at Public Health England, the organisation did not have a human-centred design function.

Today we have a brilliant design team of more than 20 people, covering service design, user research, visual design, content design, and interaction design.

Also, we bring in more traditional health skills such as evaluation and behavioural insights into the design process. We are growing design capability, methods and approaches in the organisation. We try to ensure that the delivery of any project, product or service we are involved with is human-centered.

It has been built pretty much from scratch and I have had quite a few people asking me how we did it. So thought it was a good topic for my first blog!

What do I mean by design?

TL:DR — Design is more than how things look!

I usually find it helpful to define what I mean by design, given I used the word a lot.. By design I do not mean how things look, I am referring to well-established processes for solving challenging, systemic problems. Good design is about having a approach which makes people the focus of what it does. I have always believed that a creative mindset and design thinking/doing can improve any of the work an organisation does and the services they offer. If we design things to solve real problems for people, where they are, then we will end up with a more consistent, inclusive and effective experiences. Even though I have worked primarily in digital teams, I have always believed in making things better not just digital. In health especially, we need to remember that people are complex human beings in a whole variety of circumstances and not simply a collection of user needs.

As a wider point, I believe design has a huge role to play in health. Health is not a transaction. It is a complex web of interactions, institutions, relationships and services. I think the real benefit of digital in particular will come from designing sets of services and interactions based on a holistic understanding of the how and why people seek to improve their health. Some of the biggest challenges in healthcare systems arise not from lack of good intentions, but from how complicated it can be to aligning the interests of different or siloed organisations and people.

Design plays a uniquely important role in health as it helps us to account for the needs of multiple system stakeholders, cultural contexts, it brings focus to existing challenges, and inspires solutions grounded people’s context and what they actually need. It helps us ask the right questions — as a designer I seem to spend my life asking ‘why’…

How we built and embedded a design team from scratch in a large national organisation

It has not been easy building a design team but I have summarised some key points into a number of steps.

Step 1: Money!

It seems most things start with the money. So the first thing I did was create a compelling narrative and case for why investing in an internal design team would provide efficiency and value for money. I was fortunate to work with an excellent finance team who understood what we were trying to achieve and were supportive of the approach. There are lots of great publications now about the value of design (such as this one from McKinsey). However, simply trying to sell the benefits of design in a vacuum is not likely to go down well, especially given the current financial situation in government. So I identified how an internal design team could provide a specific efficiency saving for the organisation — in this case replacing spend on external agencies with an in house team. Looking at the amount of work gave me an idea of the initial team to pitch for and making the point that these skills are common across projects (and can be used to support the design of internal services) really helped.

Step 2: Recruit the right person first

This is one of the most important things — you need to make sure that the first person you bring into the team, especially if they are going to lead it on a day to day basis, is the right person, has credibility and experience. My first hire was (and still is) one of the most talented design leaders I have ever met and without her we would not have achieved what we have achieved.

Step 3: Start doing valuable stuff as quickly as possible

Our team functions as an internal service, designed to change behaviour here so all teams and individuals are aware of, on-board with and feel able to design and deliver effective, people friendly services. The important thing was to show the value of design and demonstrate publicly how we work as designers. This does not have to be a big project, starting small and iterating quickly is usually better.

We started by using our own methods to rapidly ‘service design’ the design team. Aside from leading by example simply being good practice, there were a number of benefits of doing it this way:

  1. It helped us build good relationships with people across the organisation and built our understanding of their needs and behaviours.
  2. It gave us an example to refer to immediately and gave the team an opportunity to practice working together.
  3. It lends us credibility. We can’t exactly tell people to be person centered if they feel we have no empathy for them or understanding of their needs.

After this, we started a couple of discovery phases ourselves and provided consultancy support to already existing projects. Also we looked at a couple of internal services we had control over, how we do procurement for digital work and how we approve digital work, and used a service design approach to make this a better experience for people who used them.

Step 4: Build culture before scale

Have a common mission and proposition for the team helps and we developed this as a team. However, culture really comes down to people and their interactions. In general, I think we need to build more empathy at work for other people, their views and the perspectives they have. However, this is even more important in a design team. We focus on how we work together and how we interacted with people across the organisation and grew steadily over 18 months rather than brought everyone in at once.

Also, no matter how hard it is you need to hold onto core values. It is so easy to forget your user centered principles when there is a new policy directive or idea from a stakeholder. At times like this it is important to embrace the challenge of assessing the ‘new’ through the eyes of the users, rather than just implementing. It can lead to some uncomfortable conversations but as a design team our role is to query the status quo, think differently and validate everything through the experience of the user.

Step 6: Encourage others to use design methods

Support people to adopt the key approaches to design as a means of helping them with their work. We developed training materials, help people to use design methods and have regular learning events. If I could do anything, it would be to teach empathic research methods and how to prototype to everyone in the organisation.

Not everyone needs to know how to do Agile but i’ve never worked anywhere where the basics of the design method would not improve people’s work. Ultimately whatever your role is, a large part of it is to solve a problem for someone else; for which empathy and understanding is key.

Step 7: Find friends across the organisation who already work in this way

Chances are there will be people across your organisation who have a similar mindset, use approaches such as design research or prototyping or who are really keen to learn. Find them! Bring them together into communities so you can all share and learn from each other. Design approaches should not be owned solely by designers.

Step 8: Build resilience!

Introducing a new discipline into a new organisation is not easy! We cannot expect to turn up with user centered design and expect people to simply adopt it. It is a relatively new discipline and other methods have been around longer. Having a team to rely on helps but you need a level of resilience.

We are still on a journey…

So that is our journey so far, we are still a relatively new team and we have a way to go embedding and scaling across the organisation. We are starting to introduce design methods into our strategic work and starting to get the organisation to think all the services we deliver.

Hopefully this inspires you to start to introduce design into your organisation so you can start using these methods to deliver creative and human centered solutions to the complex and interesting challenges you face.

Simon Dixon

Written by

Senior leader and doer of design and digital stuff in health and government. Currently Head of Design at NHSX

Simon Dixon

Written by

Senior leader and doer of design and digital stuff in health and government. Currently Head of Design at NHSX

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