The NHS needs design

Design may not be something we associate with the healthcare sector, but better practices could reduce the number of accidents, says Colum Lowe

The healthcare sector is increasingly looking like a valuable source of work for consultancies, yet experts in the market are relatively scant. It sounds surprising when you think the NHS is the second largest employer in the free world, second only to the Indian Railways. It employs 1.3 million people and has an annual budget of roughly £70bn, which represents nearly 9 per cent of GDP.

Then again, the NHS is not a large investor in design, relatively speaking. According to Design for Patient Safety, a joint report published last year by the Department of Health and the Design Council, the NHS is seriously out of step with modern design practice and fails to understand what design thinking can bring to an organisation. A consequence of this has been a significant incidence of avoidable risk and error.

Why should this have happened, considering the proof that links design to gain? This fact is demonstrated by the Design Council’s latest publication Design in Britain, which reports that the companies that invested effectively in design in the past decade outperformed the FTSE100 by 200 per cent. The readership of Design Week obviously needs little convincing about the effectiveness of design. Unfortunately, the healthcare sector does.

Why is design so important in healthcare? Because according to the best available data, roughly 10 per cent of all inpatients suffer a patient safety incident (accidental harm), with roughly 8 per cent of that 10 per cent resulting in death. When you consider that the NHS treats 9 million patients a year; well, you do the maths. Bad design is not wholly to blame, but it is certainly a contributing factor in many situations.

Why is it we seem to focus most of our efforts on how pretty or sustainable our hospitals are, rather than on how safe they are for patients? When designing a nuclear power station, what is the overriding priority: make it attractive or make it safe? This is obviously a rhetorical question. Why do we not apply the same criteria to the design and build of hospitals? Do we not consider healthcare to be a safety critical industry? With tens of thousands of accidental deaths every year, I think we can safely conclude that it is.

Obviously, there are design consultancies such as PearsonMathews that work in healthcare. Some groups, such as Hothouse and Creative Leap, have even won International Design Effectiveness Awards for work on projects as diverse as MRI scanners and medication packaging. But expert designers in healthcare remain surprisingly few.

We are trying to rectify this. The NHS National Patient Safety Agency has sponsored a research graduate at the Royal College of Art’s Helen Hamlyn Research Centre. In conjunction with the Design Council, we have set a brief for the 2005 D&AD Product Design & Innovation Award, and, with Almus Pharmaceuticals, we have set another brief for the RSA Design Directions student award programme.

Organisations outside the public sector are also pushing the healthcare design agenda. Following on from their JoinedUpDesignForSchools initiative, the Sorrell Foundation embarked on a JoinedUpDesignForHealth drive. John and Frances Sorrell have the ear of some influential people in Whitehall. I’m not saying there is going to be a landslide of fees as the DoH redistributes chunks of its £70bn budget towards design, but I believe public sector healthcare may prove a financially rewarding market segment for design.

If you are going to design in healthcare, there are a few things to know. This is not a market for aesthetes, it is for grown-up designers who understand that design is a user-centred problem-solving process, not a veneer applied to finished products. Whether you are designing graphics, devices, environments or services, it is important to understand that healthcare is a safety critical industry. Issues concerning performance reliability are paramount, as are accident-proofing and the standardisation of safety critical features.

An in-depth knowledge of ergonomics and usability is also vital to ensure that designs are safe and appropriate. But the most important aspect when designing for the healthcare sector may be a detailed knowledge of the healthcare system itself, and the realisation that designs might be safe within themselves but dangerous in relation to other elements.

Working with the health sector

• be pragmatic, don’t get caught up in aesthetic issues

• remember healthcare is a safety critical industry

• performance reliability and accident-proofing is essential

• always understand how your design affects other elements in the system

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