Why introductions to design don’t work, and how you can better support your colleagues or organisation to get started with design
The problem: Introduction to Design
During my time with NHS Scotland, I was often asked to give short introductions to service design. Usually in the form of a presentation, people assume this is the obvious and easy way to start with design. Or to at least increase understanding and approval. Unfortunately, it doesn’t work.
I found that short introductions to service design were not well received. Audiences new to design find them difficult to relate to their own programmes of work or professional background. They don’t help people to understand what they can start doing now. And feedback often revolves around too much design jargon. Sometimes this jargon can come in the form of diagrams — yes I’m looking at you again double diamond slide. We are not equipping people with the understanding, tools, or methods needed to do design work. Sometimes we turn people against trying a design approach or seeing its potential at all.
Short introductions are also frustrating to deliver. They feel reductive and too simplistic. I knew I cannot do justice to the huge potential design holds for health and social care in 15 minutes. And I often felt concerned when people reflected back what they learnt. The understanding was clearly not there. Bad design can be harmful. Or become the empty new name for the same old things.
In a perfect world, we’d have lots of time and resources to better train and support colleagues. Or to consider if training healthcare staff in design makes sense at all. There may be better ways to bringing design into the NHS — but this is a topic for another day. In a perfect world, we’d also have a design friendly organisation which I discussed in my previous post. Teams and programmes need to be set up well for design approaches to make a difference.
But we definitely do not live in a perfect world. So what can you do next time someone asks you to give a short introduction to service design?
What worked well: Less showing and telling, more trying
One of the designers I look up to most is Giulia Fiorista. She is fearless when it comes to creativity. When you work with her, you understand that her fearlessness isn’t a character trait. It’s a rigorous practice cultivated over years. It means jumping in even when you don’t have all the answers, and trusting you will float. And being less attached to outcomes, but dedicated to making and exploring and acting.
When I think about good design, I don’t think of the double diamond. I think of Giulia, fearlessly jumping from the rocks in her Sicilian hometown and gliding into the Mediterranean, trusting she’ll swim. When she left NHS Scotland, this is what I missed most about working together. And what I wanted to convey to colleagues whose training revolves around avoiding risk, and adhering to strict procedures (rightly so!). And who work in an overwhelming, complex and layered system.
I grew up near the Alps and have a very different relationship to water. More on the carefully-dip-a-toe-in-and-likely-back-out side of things. But I wanted to ask people to ‘jump in’ — without sounding overly abstract or getting colleagues to literally hop into Loch Lomond (can you imagine getting this past health and safety, or worse my toe-dipping nature?).
What worked for me was taking colleagues along on a quick-and-dirty end-to-end design process in three hours. We worked through discover, define, develop, and deliver within this time slot. Yes, you got me, that double diamond slide made a brief appearance, but only at the end to help reflect on the day. I threw people in at the deep end otherwise to just have a go rather than think. The activities were deliberately unrelated to people’s ongoing work to avoid getting stuck in the complexity of it all.
I introduced a range of design skills, mindsets, and methods. More importantly, I invited and supported people to try them out then and there, on a low stakes example. It was fast paced, challenging, and playful, and worked with only a pen and paper. Key concepts included being uncomfortable, making a mess, starting now, capturing work, and showing work-in-progress.
This session did not prepare people to research, design, and deliver a complex health service in a person-centred way. And that’s okay. It’s time we stopped pretending that a few hours of lessons can replace years of training and experience in design. Especially when it comes to complex challenges such as we find in health and social care.
Based on feedback, the workshop did convey that service design is more than a set of fixed tools or procedures. It provided an opportunity to practice some design skills and mindsets to build on in future. And it gave people a better understanding of what’s involved and how it might be useful. They could then go away and look further into what worked for them on the day.
To sum up, do less double diamond shaped introductions, and more inviting people to jump in alongside you.