SPEAKER_00: 0:00

Welcome to Problems Worth Solving, the podcast where we explore transformative approaches in health and care through the lenses of human-centred design, service design and digital. I'm Sam Mentor, the Managing Director at Healthier, the collaborative service design consultancy. Find us at healthier.services. Join me as I speak with the people shaping the way health and care is delivered. Leaders and changemakers from public health, not-for-profit, health tech and life sciences. We'll explore how putting people at the heart of service design can drive impactful change. In each episode, we'll share insights and inspiration from real-world examples, like using co-design techniques to improve mental health services, or digital tools that empower patients to take control of their care. Today I'm joined by Rochelle Gold who is Head of User Research and User Centred Design at NHS England. Rochelle has been instrumental in establishing a user research and a user centred design capability across the organisation over the last few years. I first met Rochelle at a conference where she was talking about the challenges of applying user centred design to a patient pathway when that pathway can touch on multiple teams, multiple services and multiple systems. I was thinking about Rochelle's work in the context of problems worth solving. And what's the problem that Rochelle has been trying to solve through her work over the last few years? And it's a big one, really. It's how do we make the digital side of the NHS more human so that we meet real needs and we improve outcomes? So welcome to the podcast, Rochelle. It's great to have you here. Maybe just introduce yourself to get started and tell us a bit about your experience that led to you working on this problem.

SPEAKER_01: 1:51

It goes back many years. Depends how far you want to go back. But yeah, I'm Michelle Gold. I'm Head of User Research, User Head of Design. And I started off my life and my career, I trained as occupational psychologist. And it's really strange because I know when I was studying at uni, I absolutely hated research, which is really weird because that's my life and my job right now. But one of my first jobs was actually doing psychometric testing of offenders. But the other half of my job was doing research in university and academic research. And after that, I then went into various other roles, including going into business consultancy to try and move towards being a chartered occupational psychologist. But I kind of realised maybe that wasn't my interest, which is a bit of a shame because that's what I trained to be, and actually took voluntary redundancy from that role and then just turned to a local university. For some reason, whilst I was there, I managed to get my own module in teaching undergraduates in violent and sexual offending behaviour because I did work with sex offenders and high-risk offenders in my research and my psychometric testing. And then after that I actually got a role working for what has become CQC when it was the Commission for Social Care Inspection and then got a role heading up the research department at West York's Probation Service. So essentially up until this point now I have spent the past 25 years working in research and different types of research and then when a role came up at what was the Health and Social Care Information Centre, which was a precursor to NHS Digital. I saw it and thought, actually, being a user researcher, going back to research practice, having been managing and leading a research department, that might be quite a nice thing to do, to go back to practice and do my craft in a new sphere. And that's how I ended up here. in the role as a user researcher in health. But when I arrived here, there were five user researchers and no career ladder, no infrastructure, no tools, not even job descriptions. We were all matched to project manager job descriptions. I was looking around me thinking, yeah, I've gone back to practice. I've moved away from leadership. I've moved from having responsibilities and leading a team and leading a department of people. And thought, yeah, but then there's all this stuff that needs to be done that could really make it much better, much easier to do our job, enable us to have more impact. And it started from there where we got together as a group of researchers and built a profession, a community, a capability. And I built the career ladder that led to me becoming head of user research.

SPEAKER_00: 4:41

It's impressive stuff. I'm curious as to what the driver has been for you. What is it about this discipline and health that has kind of pulled you into this seat?

SPEAKER_01: 4:49

The discipline of research in general, I just love learning something new every single day, specifically user research. I have worked in academia. I've worked in social research. I've worked in policy research. I've worked in all different types of research. But the thing about user research is that you see things The impact of what you're learning and the actionable insights that you're generating, you see it make a difference and you see it change things and you see it happen in front of you. You know, you could be doing research on something one week and a few weeks later, there you see the change on the product or the service. And I think for me, thinking back, I talked about how I didn't actually like doing research when I was at uni. I hated it. It's because it didn't mean anything. You didn't see anything happen. It was all very small things that you saw and you learned, but you didn't have an impact. And the amazing thing about user research and particularly user research in health is that you have an impact. You have an impact on people's lives and you are doing research that can help to keep people well, make people better and often potentially in the long run save lives. So that's why it's huge.

SPEAKER_00: 6:05

I love it. Those are some of the same things that drew me to this craft and this profession and a lot of the people that I work with and meet in the industry. It's that actionable research. It's not buried in months and months of deep academic research, where obviously there's a very important place for all types of research. But it's that actionable side of it that I find really engaging. For people who are listening who maybe don't know what user research is and how that might differ from other types of research, could you just give a very quick summary of how you would define user research?

SPEAKER_01: 6:34

I think the key thing to say about it is it still has the same robustness, the same standards, the same ethics, the same principles, the same safeguarding that we all have to adhere by any other type of research. Like I say, I've worked in academic research and a lot of our researchers, user researchers, come from deep research backgrounds. But I think the difference is it's about generating actionable insights but from understanding and looking at and observing behavior. So it's really not about what people say or people think or their views or their preferences. It's really about understanding behavior and from understanding and through that understanding need and unmet needs. So one of the examples I always give about this is that I was once in a hospital and I was observing someone using one of the systems there, one of the digital systems, and I was doing research with them and understanding what was going on and how it was working for them. And they said, look, what we really need here on this screen, we need a button that says print. And I was like, okay. You need a button on a screen so that you can print it. Okay. And you know, you could go away and say, users are saying, or people are saying that we need to be able to print from this screen. You can go and spend however much money in developing that. But actually when you sit there and watch, you understand what they're doing and what their need is and the outcome they are trying to achieve is you realize that the reason why they need to print that screen is so that they can put that screen print into a pile of paper. And there is someone who's, day job is to scan all those screen prints into a document management system and attach it to a patient's record so what is actually needed there isn't a button on that screen so that they can print it it is for the information on that screen to actually be able to be into this other system this other product whatever it is into this person's patient record And that's the example I always give about the difference between other types of research and user research. It is about getting to the crux of understanding what's going on and what the unmet need is so you can make recommendations or give actionable insights to the development team or the design team to help them to understand actually what is the problems we need to solve here and how can we solve them.

SPEAKER_00: 9:05

And in NHS England, is user research always tied to digital or does it get rolled out across patient experience in other areas as well?

SPEAKER_01: 9:14

It's interesting because there's different types of research. And I think there's a lot of research with patients to try and understand the patient experience in hospitals and everywhere else. And all these different types of research absolutely are valuable and have their space, part of understanding the whole wider picture. I would say user research is mainly based in the digital space. But when you are working in the digital space, particularly in health, there's always something physical. There's always a person. Whatever the health issue is, whether it's mental health, whether it's physical health, whatever, there's always a person in it. And there's no way that as a user researcher, you can just focus on the digital thing. Because actually, digital isn't always the answer. And when we are thinking about what we're doing in health, we need to think about the outcome we're trying to achieve. And that outcome is never going to be achieved just by a digital thing. It's just one part of helping us to deliver stuff for patients and for the front line. So whilst our user researchers are mainly within the digital area of NHS England, I think that's a legacy thing of where we've grown the capability. There is a lot of what we do that can inform everything that we do with patients. And actually, I think almost like the next step is to be working much wider than that and working with our other colleagues and other researchers across the business to collaborate on that end-to-end service and understanding what's happening out there.

SPEAKER_00: 10:52

And how does the user research approach fit alongside the kind of patient involvement side of things?

SPEAKER_01: 10:58

They are... two separate things, but they are both really important. Our user researchers, they do research with different people every single time they go and do research. They're new members of the public, they're new professionals that we've not worked with, interviewed, observed, tested our stuff with. And that's really important. I actually, outside of work, I'm a patient rep also. And so I have, I almost have both hats and Both things are really so important because that patient voice in our sort of more senior strategic decision making, bringing that patient voice into that is really important. So you've almost got two sides of it. You've got a lot of the detail in terms of our product and service design and development from user research, the insight from that. And then you've got the patient reps who are experts at representing that patient voice in a room, probably where the stakeholders and the decision makers are trying to make the decisions and making them attune into the patient voice there. So they work together and I've got close relationships with our patient voice and patient involvement groups. I think where they're really important, I think, It's slightly different as opposed to patient voice and patient reps, but working with local community groups, particularly community groups working with people who face the most barriers to accessing service or have lower trust in public services, that's where that patient reps and patient voice are really important and really powerful.

SPEAKER_00: 12:36

So your user researchers, when they're doing the broader discovery research for projects, rather than the kind of more tactical, making sure that the things are working type of research, when it's that earlier doors discovery research, the insight that comes out of that must be really useful and relevant to patient reps as well.

SPEAKER_01: 12:52

The insight we get from discovery has wide relevance and wide information. Like I say, it doesn't just focus on the digital, it focuses much wider. So that discovery information, absolutely. It's not just the patient reps, actually. It's almost helping to be the voice of all the users that are out there. As a patient rep, I have lived experience of one particular aspect of being a patient and I can advocate for that and I can talk about that. The value that often comes from the research we do with users is that we get a much wider, varied spread of lived experience to bring into those discovery ports and give a balance of the different needs of a wide variety of lived experiences.

SPEAKER_00: 13:38

One of the things we can experience sometimes is that research can be quite siloed. So you'll do research on a particular problem and it will be for a particular team to solve a particular challenge. actually there's always insight that comes out that's relevant to other teams and maybe it's other user research teams, but it might be other teams, for example, patient reps. Have you managed to solve that as a problem inside the NHS?

SPEAKER_01: 14:00

So there are two things about that. I think there are two aspects to how do you enable everyone to have access to the insights that you're generating and make sure that we're not working in silos across the business. I mean, organisations are... just by the fact of the word organization. They're always going to organize themselves in some way. And those ways they organize themselves are always going to be some sort of silo. I just think we're never going to break all the silos down. But I think there's two things. One thing is probably core to the way I operate, actually. It's people. So everything you do is about people and people enable everything to happen. So by having things like the community practice that we've developed at Clark, probably 150 members at the moment the user research community practice where we are sharing we are doing show and tells we're doing things like that so there's that more about how do you get people to work together to communicate to surface their knowledge to share their knowledge and there's other communication things like really active slack channel little things like that where someone can do a shout out but one of the things we have invested in and i know thousands have died on the hill of this and i don't want to use the word i am going to use the word the idea of a repository of research knowledge i do hate that word i need to call it something else but i think we've called it i've actually called it user research finder so let's sack off the repository word user research finder and we've actually used ai technology to develop a user research finder where people can query what do we know about this And we've got our user research uploaded into it and people can do that. It's in a private beta at the moment and we're just redeveloping it further. But things like that, when you've scaled to the scale that we are, are actually really important to have people different ways and different mechanisms for people to communicate and access knowledge.

SPEAKER_00: 15:48

I love the way that you dropped in. We've actually used AI to develop this kind of research tool. Actually, that sounds like an incredible thing. Can you tell me more? Can you say more about what you're doing with AI and research insights? Because that's the first time I've heard of someone using AI to organise research insights.

SPEAKER_01: 16:04

Yeah, it's just a language model that you can use to interrogate our user research? I think people use the word AI and they think it's this big mysterious thing and I think it's a lot of people are talking about it and be in the future but it's a large language model that we've used and it's got a front end that's built from using our prototyping kit as part of our NHS service manual and we've worked with people who know about this stuff and to be able to build this thing And we are just testing it out and making sure it works for everybody. I think one of the challenges with it is you don't want to just suck in absolutely everything. You want to make sure it's robust user research. So that's the challenge of making sure it's pointing to the right information sources.

SPEAKER_00: 16:51

So essentially, you've got a big pile of insights that have come from all this research that's going on all the time across the NHS. then you've got a layer that is doing the same thing as chat GPT in terms of the organising and the filtering of that content. So you can go in and you can ask a question about a research topic that you're about to dive into and see what the system already knows. Is that right?

SPEAKER_01: 17:13

Yes.

SPEAKER_00: 17:14

That's amazing. That is moving things forward so fast.

SPEAKER_01: 17:18

I mean, we're cautious about it because obviously we're developing this in a user-centered way. We are iterating. We are trying to break it. We want to make sure that it works for user researchers, but it's not just a user research tool. It's a tool for anybody who wants to find out about the user research that we're doing. Like you say, other researchers across the organization that aren't necessarily working in user research.

SPEAKER_00: 17:40

People will come to researchers with a brief, won't they? They want them to find something out for the tool or the service that they're developing.

SPEAKER_01: 17:47

Yes. The amount of times I get asked, what do we know about this? Because I've had a user research, you should know about every single bit of research that is going on across the whole organisation. But when you've got 130 user researchers who are going out, every single day they're doing research or consolidating evidence or planning research. Every single week... There are people in our user research lab conducting user research. There are people outside, on-site doing research. I have a decent brain, but I cannot tell you about every single piece of research that we're doing or every single insight that we've gained from that. We need something like that to be able to interrogate. It's really about knowledge management, isn't it? It's not about... Just about user research, it's about good knowledge management. And I think it's a proof of concept that we've got. And once we know that it works really well, we will talk about it more widely and people can learn from what we've learned because we're not here to hold on to good things that can help other people to do their job.

SPEAKER_00: 18:51

And would it be in a model that could be shared with other NHS departments or other government departments?

SPEAKER_01: 18:56

I think theoretically, yeah.

SPEAKER_00: 18:58

Great. Tell me a bit more about the work you've been doing to involve excluded groups in research and why that's important.

SPEAKER_01: 19:06

I can't claim to be the person that's done it, but I can tell you what we're doing in terms of our user research capability. A lot of this started by a collective of people a few years ago during the pandemic who We're just like, we need to do more about exclusion in health and care and in human-centered design in health. And that had a number of different aspects to it. It included things that we've done to be more inclusive in terms of our recruitment. So we make our actual teams far more inclusive and representative of people with lived experience. But one of the other focuses was about our user research practice, the people we were conducting our research with. So we started to develop relationships with community groups. So in the same way that a lot of organizations have contracts with recruitment companies to bring in participants for user research, why aren't we utilizing groups within the community to do that? Why aren't we reinvesting in our communities, particularly those communities who don't necessarily trust the NHS? We know that. People talk about NHS being a trusted brand. It might be for the majority of people, but actually there are a significant number of people who have had poor experiences of government and the NHS, and actually that trust isn't necessarily there for some people. And we need to be hearing those voices. We need to be listening. And we need to be equally, as user researchers, we need to be reflecting on our practice in relation to that. So we have... a number of community groups that we work with. And we do co-design, we do research with them, but also we work with them to understand how our practice impacts them and where we need to improve as user researchers. And I think there's been some quite open and forthright conversations about challenging some of the privileges that we have as individuals, which have really helped to improve our practices as user researchers. So I think at one point people talked about accessibility and how one in six of your users should have access needs. With our research, what we're trying to do is focus on those groups who are most excluded, who face the most barriers to accessing healthcare, because if we understand those barriers if we work with those groups then we will actually make it better for for everyone else that's what we're doing so we focus our research not on the general person who finds it very easy to navigate their way through healthcare systems or digital systems or for whom it's so A lot of our products focus on the average person, whatever that is, and we make sure that we recognise that there's no such thing as an average person and look at how we break down those barriers through understanding, through evidence, the lived experience of those people who experience those barriers.

SPEAKER_00: 22:06

One of the phrases I've heard you use before is research vampires. Can you tell me a bit more what you mean by that and how you avoid being a research vampire?

SPEAKER_01: 22:17

So I think this actually came from the work we did with one of these community groups during covid and it's as researchers any researcher user researcher academic researcher what happens is you go into a community or you go and do an interview with someone you take the research you take their evidence take the information then off you go and that's it it's almost you drain them of the information you drain them at the knowledge and they don't get anything back And so it's that relationship that we've built up. And Lisa and our team has worked really hard at those relationships and pulls us all up if we do anything that is going to do anything at all that was detrimental to that relationship. And it's that that is really, really important. So you're not just a research vampire. You are improving your practice. You are going back to those communities and working with them, not just taking things from them. Exclusion. is a clinical risk and it's not enough just to make something accessible we have an nhs website who you know which you know we do research we design it we try to make everything we do is accessible everything can always be better but we try to build accessible products and services and tests to make sure they're accessible but if they're not inclusive then that leads to clinical risk if if you're talking about a skin condition and you only describe that skin condition about how it presents on white skin that is not inclusive and that actually is a health inequality which means that somebody whose skin isn't white cannot identify what this might look like for them, what might seem for them, and it could be actually quite a serious problem. So it's a clinical risk if we are not inclusive in what we do. So working with community groups, working with people with lived experience is essential to ensure that we are delivering health services that actually do help to save lives.

SPEAKER_00: 24:16

That sounds like an evolution of the usability as a clinical risk, which was a phrase that I remember hearing a few years ago being used in NHS England.

SPEAKER_01: 24:24

It is.

SPEAKER_00: 24:25

I love talking to you, Rochelle, because we go off on these kind of paths and it's very easy for one thing to lead to another. What I was going to get to earlier on in the interview was asking you to zoom out a little bit. If you're thinking back about the work you've been doing over the last few years in NHS Digital and NHS England, How would you summarise the big problem that you've been trying to solve through your work?

SPEAKER_01: 24:47

Probably the way to summarise what we're trying to do is, I guess, put the human into digital in health and care. The health service as a whole, it is all about people. It's all about humans. You talk about patient-centered care. And that is a real solid part of how our health practitioners work. Then when you start introducing tech, that kind of seems to be forgotten. And it seems to be lagging behind. And you're almost trying to fit the user, the human, the people, the patient, the health professional. You're trying to fit them to the tech that you're deciding to deliver. and not considering the context of use of that or the actual underlying needs. I guess the problem we're trying to solve is how do we inject that human into how we deliver health tech.

SPEAKER_00: 25:33

And from your perspective, why is this a problem worth solving?

SPEAKER_01: 25:37

Well, health is literally a matter of life and death, isn't it really? The work that we're doing. And digital is part of that. The human, the people... That's a core part of health. And the context of use of all our digital products and services, it's in patient homes, but it's in GP practices, it's in hospitals, it's in our communities. And if something doesn't work or something goes wrong here or something falls through the gap or leads to delays in care... At best, that's something that means that someone's going to wait a bit longer to get some treatments or health and care. But at worst, it's literally people being too ill to get well. The reason why this is worth solving is that we can help to save lives. Human-centered design is all about, I've talked about moving barriers to accessing health care, but it's also removing barriers to delivering health care. And if we've got really poor tech where our health professionals are having to Think about workarounds on paper. I've seen this in practice. I've seen it in context. Or systems that take too long to get into the information that they need to be able to work with a patient or takes any amount of time from patient care. One minute of time away from patient care is a minute wasted in the NHS. And if you think the amount of people who work in the NHS who take one minute of their time away that we don't need to, that's a pretty unethical thing to be doing. And if tech is doing that, If the products we're delivering, we're not making sure doesn't add extra burden or don't take away that time, then we're working unethically and we really have to be thinking about what we're doing in health and digital and tech to make sure that doesn't happen.

SPEAKER_00: 27:25

We've done work across the NHS where we see people struggling with sign-ins to multiple systems that take a very long time to load up patient data. And once you combine all those things, it's almost such a spaghetti of systems and processes. You can just see a point where actually it's not possible to do any patient time in the future because it's all tied up with using services and systems.

SPEAKER_01: 27:45

I once described health tech in relation to spaghetti. It's actually somebody that I was working with who talked about being spaghetti. And I elaborated on it and sort of said, actually, it's not just that it's multiple plates of spaghetti and they're all joined up and what happens is you start eating them and what you realize is you can't just eat one plate you need to eat all the plates and so you're going to be sick but then you've got someone outside quite frankly knocking on the window going oh i could make pasta okay and they look at it from the outside and go yeah what are you worried about what's the place yeah i can make pasta i'll solve it all And that's how it feels in health tech to some extent.

SPEAKER_00: 28:25

And there's someone in there who's, actually, we haven't tried that sort of pasta before. That would be really tasty. Let's have some of that in the mix.

SPEAKER_01: 28:30

Yeah, but you always need to have the pasta there, otherwise you actually can't function. That's the other thing. You always have to have the live service. It's not like you could just, you might want to burn it all, but it's not like you could just set it all on fire and start again.

SPEAKER_00: 28:42

So thinking about the problem you're trying to solve is how to make the digital side of the NHS more human. How many barriers or what barriers did you experience in trying to solve this?

SPEAKER_01: 28:53

Oh, shed loads.

SPEAKER_00: 28:56

And I imagine a lot of them are still there. Does it feel solved?

SPEAKER_01: 28:59

Oh God, it's never going to be solved. I think, okay, when we, and I mean we, because it isn't just me that's helped to make it more human. And when we first set out on this journey, we came in and if just from a user research perspective thinking about that people like what's your job isn't that what i'm doing or i got told you're here to tick a box for a gds assessment or you're here to tell the stuff we already know or there was that sort of barrier where people felt it was a threat some people maybe for their roles their job or whatever because yeah anything new or seemingly new, people will say it's not really new, or it feels like a threat. So I suppose that's Barry from the start, but once you almost start delivering, you get people who see the value. So it was about starting small, starting in one area. So the area that first kicked off working in a user-centred way, was real human-centred way, was when we moved what was the Choices website to the NHS website that we see today. And that's where it started out and people saw the value. They saw what was happening. They saw that actually people were talking about this in a really positive way. And even if you're someone that was adverse to change, or someone that actually wasn't necessarily on board. If you were someone who maybe looked over and thought, this is something that people are talking about, I'd better get on the bandwagon. You've got some people who may be more resistant going, yeah, this is a way we should be working. And then they started seeing the value and other people see the value and demand gets more and more. But I think the point at which I think it really matters open the floodgates was during the pandemic because this was a time where nobody had experienced this before it was really ambiguous situation there were lots of people who were working in this new area but they had to make lots of decisions and they had to do that in a context that was constantly changing where the policies hadn't even been written and we had to constantly flex ourselves. And what was really apparent is that this was something where human-centered design and user research excelled. It gave senior decision-makers the ability to almost de-risk their decisions because it gave them just enough information to enable them to make some sort of decision with some sort of evidence. And it meant that we could be flexible. We flexed the product. We flexed the service really quickly. We turned things around really quickly. It's where our design system and service manual came into its own because you could quickly spin up things using it. And I think that really did solidify that working in this way actually helps us to deliver well, deliver faster, deliver more robustly, more efficiently. I think really shone through and made some people who maybe were more sceptical or not on board really stand up and listen and realise the value of this work.

SPEAKER_00: 32:10

At the same time as being a really stressful environment, it must have been a really exciting environment to be working inside the NHS during the pandemic.

SPEAKER_01: 32:17

Yeah, it was really tough because people had pressure of work that was going on, the rapidity of it, the very short notice of actually what needs to be delivered that week. And sometimes that was actually announced in the press before we even knew about it. But there was a huge reliance on technology and it being remote access to care and we were spinning up new products and services within days and it was an unsustainable pace I would say but what happened was parts of the organisation that really need to work together to collaborate had to and were forced into a situation where the only way to deliver was to do that and to some extent I look back now and go we did it then we could do it now we had You said design folk, policy folk, operational folk, all working together to deliver an outcome. And that's exactly how we should be working. That's exactly how we should be working moving forward. And that was the real huge benefit and value in COVID was actually just working in that way because we're forced into doing it. Because that's the only way we could deliver for the country and deliver that rapidly was if we actually did collaborate so closely. And I think... That's where we need to be moving to on a more permanent basis now.

SPEAKER_00: 33:36

It's interesting because we talked earlier about user research being used in the context of other disciplines and other challenges. And actually what you're talking about there is that discipline collaborating closely with policy. And that's an area that we've worked in a bit ourselves and just feels like the right way of working because there's the insight, what should we do about it as an organisation?

SPEAKER_01: 33:55

Yeah, absolutely. And almost, I think the policy was being developed by developing the user-centered products because there was no policy. And so as you're designing who gets access to tests, how do we develop the test system? How do we develop the vaccination system? Who are we going to allow access to book a vaccination or get a test? you're developing the policy that wasn't there and the user research and insights you're getting from that was helping our policy colleagues to make those decisions and it's almost like that's we should never go back to working at that pace with that much pressure in that sort of way again because we will burn every single person out but that joint working and collaboration is something we should try to keep from that situation.

SPEAKER_00: 34:46

We work in these product teams where you've got various disciplines from tech, from content, from design. If you could have a policy person involved in that product team as a way of working as standard, it would move things forward.

SPEAKER_01: 34:59

Yeah, and I think there are some teams who do have that, but I think it's in the minority and I think it's rarer than it should be. And I think it's not even just policy folk, it's the operational folk on the front line as well, the people who are working in the context too. the people who do the implementation and the change across the system. That's really a truly multidisciplinary team. I think people talk about multidisciplinary teams in a sort of standard, whatever a standard product team is, a product manager, a delivery manager, design, content, business analyst. For me, the truly multidisciplinary team, and we're looking at this in terms of health, is about having those policy folk in, operational folk, improvement folk. That is where we really should be moving towards.

SPEAKER_00: 35:45

So you talked about there being, I think, five, people when you joined the organization five researchers how have you gone from five people up to 100 and how do you find the right people and nurture the talent when you you find those people

SPEAKER_01: 36:00

yeah how did i go to five people to 130 that's a really good question you start you just start and you just build it over time actually this is probably where my background in occupational psychology comes in quite well because a lot of that was recruitment selection assessment and career development and organizational design and organizational development and organizational change and I think what happened was I seized on an opportunity at this point I was I was a user researcher and they brought in someone to lead what they were calling the digital delivery profession. So develop the profession of digital delivery folks. So that was product delivery, design, content and user research. And I basically contacted that person and spoke to them and said, look, how can I help? This is my background. And having gone into the job thinking, I don't want any more responsibility. I don't want any stress. I don't want to be responsible for a team, people, department. I couldn't help myself. I couldn't help myself and try and solve the problem. I don't know. I just saw stuff around me and I thought we could do this. We could do that. I could do the other. And so I spoke to this person and looked with them to look at how we can expand it. So it was about slowly growing. But I think the key thing for me was to first start off with what are the core competencies we're expecting from people in user research, making sure we actually had job descriptions that were user research job descriptions not not not maxtra project manager project managers are brilliant there's a different job description for a user researcher but also creating a career ladder for people so that when we got people in there was somewhere for them to move through and move up to i mean i created the career ladder that i moved through i moved to senior i moved to lead and i moved to head of it i was almost put the rungs out in front of me as i moved up from them actually and And then once you start expanding, you need the tools, you need the infrastructure. And there wasn't necessarily funding for that tools and infrastructure. So I almost got the community itself to start looking at, okay, what are the things we need to develop? What are the things we need to do? And they led on certain aspects of that. And that sort of provided the proof that actually we need this function. We need this capability, which led to a individual doing research ops, which then led expanded when we realised actually there's so much more we can do, there's so much more we should do I took advantage of the fact that I was given the central UCD budget to look after and we had some vacancies and we could use that vacancies to do some good work and I suppose I just saw things that needed doing and I worked out ways to get them done and I got people on board and I got people on side I think we had an exec director that came in and we had something in common so I got in touch with them and said oh and by the way when was the last time you observed user research and would you like to observe some user research and I spoke to her about the work that we did. And then she advocated for us at her SLT and got me there to talk to her directors about what user research was. And I think it just gathered momentum and gathered momentum. It was a great group of people, some brilliant people across the community who wanted this to happen, who worked together, who collaborated. The user research community in NHS England are, I don't know, they're one of the best parts of my job. supportive, skilled people who know so much about this work and other work and I think it just snowballed and gathered momentum and I knew I wanted to be at a point where user research was embedded in our product teams. Initially, my role working for the person who's heading up the digital professions was almost to bring people in, get a pool of researchers and allocate them to places and almost like an agency model. And when you've only got a few user researchers, that's okay. But really you need people who are embedded in the products, who understand the products. And it'd be less about the people pulling research in But the research, user research has been in there to advise them about what user research needs to happen. Because I think by the time people think about user research, sometimes it's almost too late and the time has passed. So I think I just saw a lot of problems to solve and I wanted to solve them and I couldn't stop myself.

SPEAKER_00: 40:34

And what's it like now in comparison to when you first started at the NHS and tied to that? Do you feel responsible for some of that change and feel a bit proud?

SPEAKER_01: 40:43

I'm incredibly proud of the capability that we have in NHS England, the user research capability. I'm incredibly proud of the people that we have in it and the people that have developed through that. There are people who started off as graduate UCD folk who have moved up for larger. There are people who started off as associate user researchers who are now lead user researchers. There are people who have gone on to other places to greater things. And it is... I'm incredibly proud of every single person within that community and what we have achieved together as a collaboration. To some extent, we're victims of our own success. We still don't have enough people to do everything we want to. But what I think is brilliant is that it's no longer me advocating for user research or user-centered design. It's no longer even just our URs or our UCD folk advocating for it. It's now got to the point where I've been in meetings and someone said something and one of our directors has advocated for working in a user-centred way or doing user research and challenged other people in that room to work in that way. That's when you've delivered on what you're trying to achieve, when you're no longer the people or the person that's advocating for it. It's someone else and you don't have to be in the room for people to be advocating about it. I remember Someone was telling me about one of our clinicians who I worked with in the very early days who was quite skeptical about user research. Then she saw how it was identifying clinical risk and someone told me they were in a meeting with her and she was challenging everyone in the meeting going, where's your user research? Why are you working in a user-centered way? And I don't have to be in all the meetings anymore. I don't have to be the voice talking about this in the meetings anymore. I think we still have our challenges. It's not perfect. It's not a utopia. but there are more and more spaces in the organisation when our researchers, our designers, our content folk don't spend half their time advocating just to be able to do their job. It's just part of the way the team works. And that I see as a huge success.

SPEAKER_00: 42:54

And what's next for you, Rochelle? What's the next challenge that you're working on? What would you like to move forward?

SPEAKER_01: 42:59

I think it's that thing I was talking about earlier I think it's about how do we bring the digital policy and operational together to work at and understanding how we deliver youth-centered services across the NHS we can't deliver out into the NHS we can't deliver services for the NHS without working across digital policy and operational and I think that's where My passion at the moment is in that space and wanting to bring that together and look at how do we do that.

SPEAKER_00: 43:31

Thank you so much, Rochelle, for taking the time to talk to me. I look forward to our next conversation at some point, whenever that may be. Have you got anything that you would like to close on?

SPEAKER_01: 43:39

I think I would say, I say this a lot in relation to my job, it's the closest I am ever going to get to using my skills and abilities to save lives. And I don't think there's any job in the world that's more valuable or better than that.

SPEAKER_00: 43:55

problems worth solving is brought to you by healthier the collaborative service design consultancy for transformation in health care and public services find out more about how we can help you deliver user-centered change at healthier.services