22 October 2024
By Deborah Rozansky, SCIE Director of Policy, Research and Information
Yesterday marked the launch of the public consultation for the NHS 10-Year Plan. The opportunity to design a future health service made me think about critical learning from my recent design degree.
The “extreme” or “super” user is a key concept in the practice of human-centred design. The objective is to understand the experiences of outliers – the people in the tail of a bell curve – and to design solutions that work for them, but also for all.
People who draw on social care and support could be considered super users. These may be people of working age with life-long conditions and disabilities, or they may be older people with complex conditions requiring a mix of health and care interventions.
A deep understanding of their experiences and expectations ought to be at the heart of the government’s consultation for the NHS 10-Year Plan. Designing to address how they describe the system’s shortcomings will generate fresh insights and ideas for making improvements for all.
The consultation has three focus areas: community services, digital-first services and prevention. Within the consultation is a clear proposal for neighbourhood health centres, and care workers are expected to play a role in this expansion of primary care. Digital-first proposals include expanding shared care records and building on the existing NHS mobile app for what the Secretary of State is calling the new “patient passport”. In terms of prevention, the consultation mentions scaling digital innovation that supports people to manage their own conditions at home.
This all sounds very whizzy and exciting, but the headlines still concentrate on hospitals, GPs and patients. Thinking about our super users in social care, the solutions are less straightforward than the proposed plan of action.
For example, will the move towards neighbourhood health centres lead to culture change in primary care – i.e. from a transactional service-led model of care, to an enabling relationship that supports personalisation and continuity of care?
Will the expanded NHS app and shared care records offer people who draw on care the opportunity for two-way communication? Will care records represent the full picture of a person’s needs by including information from social care providers, the majority of whom are not part of the public sector?
And will digital innovations work for people who often face exclusion from the digital world because of age, disability or health condition, such as learning disabilities or dementia? Are we blinded by the excitement of technology and forgetting that the essence of care is relational? And how can we be confident that data about people’s personal lives is secure and not used to limit access to care?
At SCIE, we will be submitting a formal response to the government’s consultation. Our starting point will build a case for change through the experiences of super users in social care. As we noted recently, the Darzi Review lays bare the critical and long-standing issues facing both the NHS and the social care system, from service fragmentation and underfunding to inefficiencies and an ageing population.
Most importantly, the government’s NHS consultation continues to strengthen the case for acting on social care reform sooner rather than later.