Co-design for digital health inclusion

A sneak peak into how we have developed our co-design approach

We have been using co-design in the Widening Digital Participation programme here at Good Things Foundation for a little over 2 years. My, personal, definition of that is:

Co-design is the method of involving users (people), stakeholders (decision makers) and practitioners (front line staff) in the process of design. Whether you are designing digital products, patient pathways or both, it is important that everyone affected has the opportunity to input into the process.

— Dr Pete Nuckley, (not a real doctor, mistakenly given the title in an educational journal article and would very much like to keep it)

This is quite a difficult blog to write for 2 reasons;

1. Articulating how you go about ‘co-designing’ is rather difficult as it isn’t an overly formulaic discipline (at least not for me)
2. Twitter and other platforms are awash with very clever people with very clever opinions on these sorts of things and I’m probably going to upset some of those very clever people as it won’t be how they would do it….. and I really really want those people to like me :-)

Nevertheless, we have developed a guide on how we have been doing co-design — hopefully a good starting point for anyone who wants to give it a go.

Some Principles — online version

I quite like principles. Some people don’t like them because they don’t give clear instructions. I think that they are important because they give flexibility to find your own way but can be a guide of what you can aim for. Our principles have been through a number of changes as we have learnt more about engaging people, finding out their needs and testing things quickly.

Good Things Foundation Co-Design Principles in Health

Maybe we can boil this down even further to “talk to people before you do something”. If that’s the only thing that changes for local commissioning bodies then that’s a great start.

Structure of our Co-design

Co-design will never (and should never) happen as cleanly as this. However, the model that we’ve put together may help to guide you if you have some problems to solve in your area.

Model for Co-Design

How can you tell if you are doing it right?

I’m not claiming that we are doing it right. But…. I think we are doing it less wrong than some others. You will know if you are heading in the right direction because you will;

1. Learn something that you had never thought of before
2. Start to use people’s stories as examples in meetings when decisions are being made that you know won’t work
3. Have cried. This isn’t a joke. When you spend time with people and start to understand their lives you will get upset… and angry. But this will help you to make things better

If we don’t spend time understanding the lives of the people that we serve then we will continue to design a world in our image. In my case that will be the image of a 35 year old-white-heterosexual-overweight-man (literally the dullest HR tick box in the world). And the world is already designed for me — that is the reason it’s in such a mess. My dear friend Tim Brazier once told me;

“Twitter was designed by 12 men. Twitter was not designed to deal with people using it to harass people — not because they decided not to, but because none of the 12 men designing it had ever been harassed — so it never even came up in conversation, let alone made it to the point of making a decision about it.”

— Tim Brazier (probably read it in some book so it should be attributed to someone else)

I think just 1 woman in that room would’ve said “hold up lads, are we missing something here”. In a world where those who make the decisions overwhelmingly look like me, we have to design WITH not FOR those who are impacted.

It stands to reason that involving those people who will be /use something will make it a better thing.

Working with the deaf community in West Yorkshire to see understand the barriers they face when accessing services

I think that co-design shouldn’t be the sole domain of people with job titles such as Service Designer (of which I’m one) or User Researcher etc etc. It should be the norm for any person in any project — particularly in the health arena. In an ideal world we won’t be reliant on those people armed with post-its and fancy pens. I hope there will be a time when the term co-design won’t even be needed as it is just part and parcel of how things are done.

If you want to know more about the Widening Digital Participation programme and the things it has achieved through this co-design process then contact pete@goodthingsfoundation.org