Repost: In 2014 @richardhod asked me “What’s service design?” This is what I wrote then. Seven years later, the practice has evolved, and taken a huge role in many endeavors, yet I think these definitions and principles remain:
Service design is playing an increasingly important part of that way that our public services, consumer products and society are developed – and developing.
For some it is best defined as a specific methodology or approach, yet for others it is merely a recognition of the capacity design thinking has to have an impact on the world. It could even be argued that it is the formalisation of the tendency many designers have to want to improve and make a positive contribution to the world around them – whether they are paid to or not.
I would like to propose that it’s simpler than that – it is a collection of principles. This is what I believe these to be.
Principles of service design
It must be
Innovative and not afraid to make deep system-wide changes
Open, participatory and giving everyone a chance to contribute their experience, opinions and insight
User-focused and based on actual needs and circumstances
Aiming to deliver a benficial, tangible and ideally measurable, change or effect.
Throughly researched and managed both before, during and after the project
A process which adds value during and hopefully beyond the lifecycle of the project
The insistence that anyone can overcome or transcend
physical limitations such as disability or illness when for any reason it is
just not possible for them to do so.
The assumption that if one person can, anyone can,
regardless of circumstances resources or any priviledge.
The belief that expressing vulnerability is to be avoided, and that asking for help or support makes us weak rather than pragmatic – or just human.
The assumption that limitations in one area mean that we
have no competence or potential in others, and that we do not deserve support
for those limitations
That any differences in capacity and ability are not ‘normal’, they make us lesser by default, and we are helpless, or a drain on resources
It takes all of us working together to dismantle these assumptions, bias and prejudices. We need:
To meet people where they are, to listen and to work out
what CAN be changed or improved, and to accept fully and help mitigate what
cannot
To understand people’s circumstances, and the barriers and
challenges they experience, especially practical ones that are often
overlooked.
To help everybody recognise their vulnerabilities, and to also assert their needs and to take action to keep safe.
To be more human ourselves, to be open about our vulnerabilities, and what we need help and support with too.
To assume competence, and give people the opportunity to try and fail if they want to.
To give people more time to learn, and more support.
To normalise differences, to recognise the contributions
that people make and the right they have to make hem, however small.
To listen, listen, and listen more. Give people a voice. Give people the chance to discuss.
We are all creative, and in our own different ways, yet for those of us who put our heart and soul into the work we do to earn a living, certain risks go along with the rewards. Or do they?
Why are there so many good articles about how to deal with burnout, but not so many that take a good hard look at how it can creep up on us?
Is it really right that burnout and related mental health issues are seen as the inevitable price that we pay for genius, and for doing great, inspired work?
Why is it accepted that creative people ‘think different’ but not understood that we might need to evolve how we relate to our works and ourselves?
We owe it to ourselves and to others to take a systemic view, and to examine the expectations and assumptions that might be getting in the way.
Female doctor visiting patient in hospital room. Male patient lying in hospital bed with his friends and doctor.
The autistic spectrum is not, as is commonly understood, a line of severity but a cluster of impairments. Should the health issues that autistic people are prone to be considered alongside of, or as part of the spectrum? If so, why hasn’t this been spotted before now?
During the recent Autism Awareness month, there was much talk of the need for better awareness and support for mental health but very little discussion of physical health and how that might relate to wellbeing and capacity.
We now need to seriously consider whether some of the impairments and limitations we are used to accepting as part of autism have underlying causes that can be addressed.
“Do we really understand what autistic people need to ensure their health and well-being?” and “Why are patterns of comorbidity a specific concern?” and highlights the importance of framing the problem and enabling patient reported outcomes and citizen research in autistic health.
Not only is she my namesake, she is also my second cousin once removed, so I have known about her for a long time: my cousin and I began her Wikipedia page.
Lucy’s research has been important to me for many reasons. Her work on folates and other nutritional issues lead me to investigate the root cause of health issues that have been running through my branch of the family for generations.
I have great admiration for mainstream medicine, but until I found the right diagnoses for myself, my health conditions were generally treated as if they were psychiatric in origin or purely a response to stress. While stress plays a huge role, the mind body divide is proving to be much less definite than previously assumed.
Indicators such as cognitive function and social resilience are very rarely measured in general medicine yet such symptoms can be just as indicative of underlying health issues as ‘hard’ measurements like blood pressure or heart rate – if not more so.
Our mental health is much more closely linked to our physical health: and symptoms of both should be considered together.
Lucy saw health in context, looking not just at what she saw in the microscope, but at social, cultural and economic factors that affect us, affect what we eat, and what our bodies might need to function fully. I’m looking not just at individual health and wellbeing, but at what our healthcare systems ans services need to flourish.
The NHS is world leading in many aspects of medicine, but autoimmune conditions and complex health disorders are still relatively poorly understood, and under-diagnosed. Late diagnosis is all too common. Across many other fields of medicine there is a lack of general understanding of generalised or sub-acute symptoms, and of a joined-up approach.
When health symptoms are found to have been wrongly ascribed, there is very little opportunity for most doctors and consultants to pass this information back into the system fully, because it just doesn’t fit in the right boxes yet.
Co-morbidities cost the NHS an estimated £4.3 bn annually, and yet funding for new initiatives is limited. Strengthening observational healthcare would be a very good place to start. Preventative care could be improved without having to spend hundreds of thousands of pounds upfront on research programs for individual conditions. That would come later.
The way that healthcare services are being delivered is evolving, we now have the opportunity to involve patients, doctors and nurses in building better ‘patient pathways’ and involving communities too.
Not everyone is able to research their own health and advocate for themselves in the ways that I have. I believe that everyone should be encouraged and supported to participate more in their health and in their well being, and to report Patient-reported outcomes. It’s what Nesta have named ‘People powered Health’, and I am all for it.
This is why I have founded Globefox Health, to help people better identify, track and report what they are experiencing, and to give them the support that they need.
We have a initial focus on supporting people with Ehlers Danlos Syndrome, and Hypermobility, partly as these conditions are so complex, but also as they can cause cognitive issues that can make using existing health services very difficult, or even impossible to use.
We are not diagnosing, but applying design and key insights to people’s data, to create dashboards, summaries that will help doctors and the people who look after us spend less time gathering this information and more time interpreting it.
I hope that the information that we gather will not only help people access the care and help they need but also help ensure this new generation of Healthcare will leave no condition or individual behind.
So happy Birthday, Lucy Wills, It’s an honour to be walking in your footsteps!
