Memorandum by the Design Council (WP 89)
INTRODUCTION
The Design Council, a Non Departmental Public
Body funded principally by DTI grant, works to enhance prosperity
and well-being in the UK by demonstrating and promoting the vital
role of design in a modern economy.
Through a series of three year Design Campaigns
we encourage the more effective use of design expertise at a strategic
level within the public sector and private organisations to enable
innovation in their products, processes and services.
In addition, the Design Council's RED unit uses
a design-based approach to challenge accepted thinking on central
social and economic problems. RED is currently examining health
issues, and in particular how design processes might be applied
to the prevention and management of chronic conditions.
Further information about the work of the Design
Council and RED is available at www.designcouncil.org.uk and www.designcouncil.org.uk/red
respectively.
SUMMARY OF
POSITION
The nature of the health problem has changed
from tackling infection and acute illness to the management of
chronic conditions. The Government's Public Health White Paper
recognises this and sets out proposals for addressing it through
a shift away from traditional models of health service delivery.
The Design Council strongly supports the agenda
set out in the White Paper. In the work of the RED unit we are
prototyping methods of delivering this agenda through the `co-creation'
of services—the active involvement of patients, healthcare
professionals, community organisations and others in the design
of new models of health management through the study of user needs.
SPECIFIC REMARKS
Wanless argued that the future of health care
in an era of chronic disease, would turn on the "full engagement"
of people in their own health care: "there are potentially
large gains to be made by refocusing the health service towards
the promotion of good health and the prevention of illness."
The key issue he identified was the need to
engage people in the responsible, collaborative maintenance of
their own health and the recognition of this need informs the
three underpinning principles of the White Paper's new approach
to public health—"informed choice", "personalisation"
and "working together".
The Design Council has been approaching these
issues in terms of a co-creation approach as set out in the RED
Publication, Health: Co-creating Services (appendix A). Pilot
projects are underway in Kent and Bolton.
This work suggests that adequate solutions to
preventing the emergence of chronic conditions or managing them
post emergence will have four key characteristics. They will need
to mobilise resources, know-how, effort and expertise distributed
across communities and households, rather than turning solely
to professional expertise located within institutions. Distributed
resources will be most effective when they can be used collaboratively
to share ideas, provide mutual support and give voice to user
needs.
Services will be co-created to address the particular
needs and circumstances of individuals and communities. This requires
interaction, participation and joint problem solving between users
and professionals. Distributed, collaborative and co-created services
will require radical organisational innovation on a scale that
goes beyond current models of public service reform.
Co-created service models demand new types of
interaction to take place between users, professionals, technology
and infrastructure. Developing such responses will require social
creativity, activating knowledge networks, resources and imagination
across society not just within the public service professions
and institutions. This, we argue, can be achieved by the effective
use of design and the design process, and which we are prototyping
in Kent and Bolton.
CONCLUSION
Effective responses to our public health problems
must encourage new norms of behaviour within society, developing
approaches in which those who use services become involved in
their design and delivery.
Developing co-created services will necessarily
be dependent on a set of key processes that support and enable
the distribution of resources and knowledge, collaborative approaches
and new interfaces between users and professionals across disciplines.
Communities of the kind we envisage are well
developed in software and over the last decade the principles
behind this highly collaborative approach have increasingly been
applied to other fields including professional associations, knowledge
networks and manufacturing. These open source style communities
offer a promising organisational model for "communities of
co-creation".
The decentralised, networked responses we envisage
will not emerge on their own accord. They will only come about
through concerted reforms to create more distributed capacity,
to provide spaces in which people can collaborate and devise co-created
solutions.
We should be pleased to explore these themes
further with the Committee.
January 2005
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