
Listening to users
Thanks to digital urgent and emergency care colleagues in NHSX and NHS Digital for responding rapidly to my request to observe user research this week. It’s great to see how users are involved throughout design and development. This week in user research, I heard first hand from parents who recently took their children to an emergency department, from a 111 call handler, and from a service commissioner. I would love to hear how other people get their recommended dose of research.
Shared commitments
Di and I were together in several calls this week, including one with NHS Digital colleagues to review our shared top-level outcomes and deliverables for digital in urgent and emergency care. It’s important that we get these right, so that we have tangible, common commitments against which we can show progress, without being bound to specific solutions that might turn out to be the wrong ones as we learn more through service design and delivery.
System leadership
An inspiring talk from Sharon Watson, of the Northern School of Contemporary Dance, as part of an internal Leadership Development Programme in NHSX. The conversation with fellow participants about “system leadership” made me think we might be in danger of co-opting the language of systems but applying it only to the parts that professionals control. If we’re really thinking in systems, we need to engage with the external context. The real system respects no service boundaries.
The following day I found myself reflecting further on this when it became apparent that some work I thought we were going to collaborate on with another NHS team was getting going without our involvement. When I probed into the reasons, it became clear that we didn’t have a shared understanding of what the work was, or indeed who was on the team. I think we’re on the right track again now, but I’m glad I challenged when I did.
Making it visible
On Saturday morning, I opened up Sketch on my Macbook Air and tried to make a picture that will help me think and talk about the systems challenge in urgent and emergency care.

I shared the picture on Mastodon and Twitter, where as always, people jumped in with comments and questions that helped my refine my thinking. I will write that up further soon.
Making connections, maintaining connections
An introductory call with John, who leads on Shared Care Records in NHSX. John helped me make a connection to another piece of work, which someone had asked me about during the previous week’s digital convening.
Catch-ups with two of my previous team from NHS Digital. Always lovely to hear how they’re getting on, and even though I’ve moved jobs, there’s lots we can do together.
A really helpful call with Simon, our deputy CEO and Chief Clinical Information Officer.
Anoop put in a quick call to help me understand triage outcomes and dispositions, following on from a question I had raised in a show and tell. It’s great to have people on the team with deep service experience, who can still explain how things work in simple language.