As a product manager in the late 1990s, I had the good fortune to work in a multidisciplinary team with pioneers in two nascent roles.
The first was someone we would now call a data scientist, a biologist who – years before Google Analytics was a thing – married statistics learned studying fish populations with a hacker’s ability to take apart our server logs and give us back stories of how users moved in shoals through our website.
The second was a psychology and human computer interaction graduate who introduced me to the art and science of usability testing, along with a host of Jakob Nielsen memes.
As the infrastructure for this work grew more established, I became a regular visitor to darkened observation rooms. Safely unseen behind one-way mirrors, I cringed as users failed to get to grips with my clever ideas, before going back to the whiteboard and making things simpler for the next round of testing.
I learned the awesome power of users as slayers of bad ideas and vanity projects. I found then, as I have ever since, that there is something unexpected in every user research session.
Some of the work I’m most proud of from my 12 years in telecoms are the things we didn’t do – because users showed us they sucked. Every couple of years, another concept would pop up for a unified communications inbox bringing together emails, text messages and video calls in one. I knew from my time in research labs that this was a solution desperately seeking a problem. A problem which users had repeatedly shown us they didn’t have.
My last project at Orange was the hardest. I was tasked with creating user journeys for a putative joint venture under commercial secrecy. The lawyers forbade us from showing what we were working on to anyone outside the tight-knit, group-think-ridden project team. The project launched after I left the organisation, and pivoted a few times before it died. I vowed never to put a team in that position, of having to design solely by guessing without access to real users.
As a service designer, I came out from behind the mirror. I moderated user research of my own with homeowners about their heating controls. I sat side-by-side with a mental health nurse as service users told us how viscerally important internet access had been to them. And when social workers angrily showed me their battered old Nokia dumb-phones, I understood at once why rolling out digital services across health and care was likely to be a challenge.
Alongside all this, I had the privilege to hear the amazing Leisa Reichelt and other Government Digital Service colleagues teach the basics of user research to civil servants in the Service Owner Programme, and Digital Academy.
Here’s me crunching through the leaves on an autumn morning as head of design for the NHS website. That day I observed people with Parkinson’s using our prototypes and talking about the impact of poorly designed digital services on top of a disability:
“When a link’s too small or a button’s too fiddly, it’s doubly depressing because it reminds me of my condition.”
What I saw and heard that day made me more determined to support the team who were already pushing to improve accessibility across our digital estate, and make it central to the NHS Service Manual and NHS.UK Frontend.
I’m not a user researcher, but I am proud to have overseen the growth of the profession in my role at NHS Digital, and especially that we were able to train up a cohort of user-centred design (UCD) graduates, many of whom are helping to make the NHS more human today.
Earlier this year, I moved to a new role, in which I am the Senior Responsible Owner (SRO) for digital in urgent and emergency care.
This programme and its associated live services already had teams with a strong user-centred design culture. We also have patient voices embedded in our governance, which is not the same as user research, but equally essential.
I’m learning loads in my new role. I discovered early on that a multi-million pound budget is worthless as a lever to steer a programme when delivery teams are under-resourced. In this situation, we had better direct scarce delivery and leadership attention where it will make the biggest difference to patients and staff. If we don’t involve them, how will we know if we’re focused on the most important things?
Laura Wade-Gery’s review of transformation in the NHS puts leaders on notice that:
“Focused interventions will be needed to ensure that those in decision making positions are constantly aware of the day to day reality of the citizen experience, and make real the commitment to a patient and citizen centred approach.”
So here’s my one weird trick as an SRO to make sure I never lose touch with the user experience: I have committed to spend a minimum of 2 hours every 6 weeks observing primary user research.
That’s not an arbitrary figure plucked out of the air, but a recommendation from user-centred design leader Jared Spool, and adopted by the Government Digital Service as good practice for everyone on a multidisciplinary team.
Strangely, the more senior I have become, the less likely I am to be invited to individual research sessions. Maybe teams think I’m too busy, and that I should be looking at the aggregated findings, data dashboards, or highlight reports instead. That’s missing the point. What could be more important as you move up the organisational hierarchy than maintaining direct contact time with your service’s end users?
It’s no longer my job to design the service. I must avoid the risk of jumping to conclusions from just a handful of research sessions. And yet, listening to people in their own words as they engage with our products has given me powerful insights into why people make the choices they do about how and when to seek healthcare. There’s so much mythology in our sector, driven by well-intentioned staff and managers who only see a small part of the patient journey. Only users experience it all, from end to end.
What’s more, an SRO in the observation room can gain a great deal of assurance in a short amount of time about how a team is working – from the things it chooses to put into research, from who turns up to observe, and from the side conversations and sticky notes that go into analysis.
The move to mostly remote user research in the pandemic response has made it easier than ever to observe sessions from the comfort of my own desk.
Recently I watched an interview with a member of the public with access needs. I felt reflective pride as a recent leaver of NHS Digital’s UCD graduate programme confidently moderated a session over Microsoft Teams using a prototype built on the NHS.UK frontend.
Our user worked his way through the screens, voicing his thoughts as he went.
When he came to a piece of copy about how urgent the problem in the research scenario would be, he paused and asked the moderator a question.
Then he punched through the metaphorical one-way mirror and asked the same question of us – the well-paid, not-yet-elderly, not-yet-disabled observers.
Had we ever had the condition in question? Because if we had, we wouldn’t consider it “not urgent”.
Truth. Power. Spoken to.
That’s why I hope other SROs and senior leaders will join me in a 2 hours every 6 weeks commitment. What we learn from user research won’t always fit neatly into a slide deck and set of findings that can be acted upon in the next sprint. But the slow accumulation of clues will keep us focused on the needs of the people who we’re all here to serve.