I’ve spent the day running through the feedback from our NHS Citizen design workshop in Bristol the other week and scratching my head on where we go next with the tech side of things. We’ll be publishing the feedback once we have chance to process it a bit but I wanted to muse a little bit on one particular issue that keeps coming up – are we just making the whole thing too complicated?
There seem to be two different senses in which this could be true:
1. Are we using inaccessible language?
2. Have we over engineered the process?
I think the language point is a completely fair cop – we are still in the habit of using expert language and its just not necessary – its a professional habit that we have all got into and we need to reeducate ourselves. Being very honest I need to reeducate myself – I have a ferocious but perhaps unhelpful attachment to complicated words. What this means is that if we are using a specialist term we have to find a simple way of decoding it – explaining it in more basic terms – and making it more accessible. If we don’t do this then we have no hope of getting all the ‘experts’ in the system to do the same.
The process engineering is a more difficult issue to address – on the one hand as one participant said at the Bristol event ‘well it really is simple, we talk about stuff and then it goes to the assembly.’ However there is huge complexity in how that process works and how we make it fair and accessible. Each part of that simple sentence can be taken apart; who are ‘we’, where and how do we talk? How do we decide what goes to the Assembly? These are the questions that then lead us into the complexity and mean we have to draw on combined experience and knowledge to design how things could work.
I think it is possible to make the NHS Citizen process present in a simple way – it really is all about getting people together around an issue, working out what they want to do about it and then taking it to the Assembly or somewhere else for resolution. However we can only present the complexity that is lurking underneath in a simple way if people trust NHS Citizen to be making good choices about how things work. If NHS Citizen is about shifting power towards citizens as decision makers then trust in the system will be essential.
Perhaps the thing we need to join up and make more obvious between our design process and the system is the fact that we are working openly in order to build trust in the process. We are trying to design what we are doing it in public, opening up the detailed workings and being as transparent as we know how to be. One reason for this is that once (if!) it is up and running we can present it in a simple way and people are more likely to trust it because they can see how it was built.
Put another way, we currently have all the bits of the model out on the table (lego, air fix, meccano – chose your own model metaphor!). You can see all of the parts and hopefully how it fits together. Once it is working however you should just see the model but you will still know what is in there.
So – are we making it too complicated – yes we probably are. Is this a valuable part of the process? If we can get the language thing right then I would argue that it is – NHS Citizen is a complicated thing and its important that we expose and make open all of its elements if we want it to be trusted and understood.
I want the final design be simple and elegant – I just don’t think we can do that without some complexity on the way.