These days designers don't just do dresses, they can also sketch out new environments that can improve the lives of patients and public service staff, says Deborah Szebeko

People often get confused when I say I am a designer working in health. The common perception is that designers create dresses or buildings, rather than work alongside doctors and patients.

Yet in the last few years a rumble has started in the design industry and more designers are now starting to look at how design can solve social challenges, including those faced by the public sector.

An example of this is the Design Council's project Design Bugs Out, to engage the UK's design and manufacturing community to create and prototype concepts to reduce healthcare-acquired infections.

My own experience of being a designer working with the public sector started through a background in advertising, followed by volunteering at Great Ormond Street Hospital for Children in 2003. Here I used design methods and processes to run a range of small projects for frontline staff. These involved looking at improving patient experience by providing better information. I could see and hear the impact small pieces of design had made to patients' experience and the working environment for staff.

There were no jobs for designers working to improve health services and patient experience at the time, so I set up Thinkpublic, a social innovation design agency. We now work with public and third sector organisations to involve users and providers in designing and improving public services - in health, education and local government. This year we were awarded Young Design Entrepreneur 2008 by the British Council.

Creative flow

The common perception about design is that it is expensive, flashy and something that has little to do with healthcare management and service improvement.

The Treasury's 2005 Cox Review of Creativity in Business reported that creativity cannot be viewed as a skill possessed by the gifted few and that it needs to pervade the thinking of whole businesses and be embraced within public services.

Over the past five years we have seen that design processes and methods can help identify what people think about public services and assist them to identify ways to make them better. This confirms that patients and healthcare professionals can apply design thinking and enjoy the process and the benefits it produces.

A 2006 report from the Demos think tank, Journey to the Interface: how public services design can connect users to reform, points out the service economy now makes up 72 per cent of our GDP.

While giving and receiving service has become an unmistakable part of everyday life, people's day-to-day experience of this is often alienating and frustrating. Yet design and service innovation frequently allows itself to be pushed into the margins of "nice to have" components of a healthcare project - the work you would do if you had more time and money.

However, organisations are now beginning to experience the benefits of working with design processes. They are also thinking through a project's life cycle and starting to reposition it as a central focus for delivering a quality and efficient health service with a positive patient experience. In fact, the UK Design Industry skills development plan states "design's potential impact on the public sector is becoming apparent to government - it is likely that understanding of, and demand for, design services will grow significantly".

Creative thinking about Alzheimer's

Last year Design of the Times 2007, a Design Council initiative to promote design in the North East, invited Thinkpublic to work with regional branches of the Alzheimer's Society, to investigate ways of improving the lives of people with dementia, their carers and service providers.

To gain first-hand insight into living with dementia, the preliminary stage of the project involved interviews with people whose lives were affected by the condition. A workshop was then held to train people with dementia in film-making and interviewing.

The resulting insights and ideas fed directly into design workshops, and an 18-minute documentary film was produced. The investigative and co-design process led to a number of recommendations, including a dementia signposting service, a mentoring programme for carers and the design of a safe "wandering garden".

These recommendations fed into the national dementia strategy. Thinkpublic continues to work with the Alzheimer's Society to develop the signposting service, which it is hoped will be implemented nationally.

In recognition of its success and innovative use of design thinking, the Alzheimer100 project was highly commended in the Design of the Times awards and also won a place in the resulting exhibition, in Newcastle/Gateshead.

Why use designers?

Design aids a better understanding of the people who use and provide services, then offers a range of tools and processes to support working together to develop and make improvements.

We call this co-design, a process where patients and staff come together to share experiences and ideas. They agree opportunities for improvement and form teams made of up patients, carers and staff who then use simple design tools and processes such as storyboarding, ideas generation and prototyping, to visualise ideas and make them tangible.

The stages of the process

  • Observing to understand

  • Capturing patient and staff experience

  • Mapping the service process and experience

  • Bringing people together to share experience and identify challenges

  • Generating ideas and opportunity mapping

  • Prototyping

  • Testing and gaining feedback on prototypes

  • Designing final output

  • Implementation and social marketing

  • Evaluation