Clinicians as service designers? Reflections on current transformation in the UK health services


The British National Health Service (NHS) has been involved in profound transformation to
keep pace with, and shape, changes in our society. Innovation has been driven by the
necessity to transform old hierarchical and paternalistic models into a modern health system,
moving care closer to home, mobilizing and tailoring services to individual patients’ and their
carers’ needs through the introduction of radically new services. This paper explores a
particular element of ongoing NHS reform: Practice Based Commissioning (PBC). Based on
first findings of a research project called “Design in Practice. Change and Flexibility within
Health Providers” funded by the EPSRC research centre HACIRIC, the authors argue that
PBC formally recognizes important forms of grassroots service design, but also introduces
additional challenges. The project is based on case studies within the North West Strategic
Health Area (UK), and the study of PBC frameworks and everyday PBC practices in this
specific context is explored and contrasted with concurrent efforts to bring service design
into the public sector, which are focusing on co-design and experience-based design
methodologies. It is suggested that these have the potential to help NHS providers address
NHS policy demands to use patient feedback in transforming services (DH, 2009), and the
authors reflect on possibilities for potentiation through the application of Service Design
methods in this context.


First Nordic Conference on Service Design and Service Innovation _ Oslo, November 24th – 26th

Publication Date

24th of November 2009


CarrCarr Valerie Carr Design for health and wellbeing, therapeutic environments, workplace design, post occupancy evaluation, community engagement, design for social innovation, codesign
SangiorgiSangiorgi Daniela Sangiorgi Service Design, Design for Public Services, Service Innovation
CooperCooper Rachel Cooper Design Management, Design Policy, Design Thinking, Urban Design, Urban Sustainability, Socially Responsible Design, Design Against Crime, Design & Manufacture
JungingerJunginger Sabine Junginger Design in the Organization, Design and Change, Design Management, Design Thinking, Human-Centered Product Development, Design Theory
BüscherBüscher Monika Büscher Sociology / Anthropology / Cultural studies of mobilities, Technology (futures), Video Ethnography and Design, Ethnomethodological studies