OurGP

OurGP Logo_WEB_HighRes
Creative, engaging, compassionate and clinically informed, mHabitat have been a highly valued partner on this ground-breaking project which successfully co-designed three innovative GP digital services with over 1,000 citizens and professionals in Scotland
Zahid Deen, The Alliance

The Project

OurGP sought to identify how people are accessing GP services, current challenges and barriers and then co-design future GP services that are enabled by digital. Why digital? Our research demonstrates that digital technologies, through enabling people to engage in peer support and self-manage their condition(s), can reduce the need to visit a GP practice. This can result in staff having more time to spend with the patients that need them the most.

Project Lead: Scottish Government eHealth division in partnership with The Health and Social Care Alliance Scotland (the ALLIANCE)
mHabitat – commissioned to lead the research, co-design activities with the public and professionals and ethnographic studies, leading to prototype development and strategic planning

    • mHabitat project lead – Alicia Ridout
    • Technical Lead – Steve Lloyd-Smart
    • Co-design facilitator and user researcher – Helen Fisher

The project also had clinical leadership throughout and support from the Mental Health Foundation, Scotland.


As with all of our projects we ensure that a people-centered approach is adopted, acting as facilitators to enable members of the public and clinical staff to generate ideas that work for them. We provide the context through secondary research and develop tools to stimulate conversation and encourage creativity. Here’s an overview of our process for OurGP:

  • Fig.6 - OurGP roadshow set upLiterature review to understand the context and published research in the area
  • Market review to see what’s already out there – what’s working and what isn’t
  • Quantitative surveys to gather data from a wide audience
  • Qualitative stakeholder interviews to hear stories and experiences
  • Co-design workshops to generate ideas with a diverse group of people
  • Ethnographic studies to gather an understanding of the context through observation
  • Ideas Roadshow to share ideas with others and further develop the details
  • Wireframe development and online survey to reach a wider audience
  • Show and Tell Event to share final outcomes with key stakeholders.

GP practices play a central role in the NHS – around 90% of all patient contact goes through general practice in Scotland. Many Scottish practices are offering digital services to their patients. Most have a website and around 40% offer the online transactional options of appointment booking and/or repeat prescription ordering. However, if offline processes are merely replaced with digital versions then the true benefits of technology enabled care are unlikely to be fully realised. Where technologies have failed it is often because they have been simply added on top of existing work patterns, creating additional workload for practitioners. We realised early on that engaging with patients and clinicians simultaneously throughout would help highlight any problems regarding integration and workflow, leading to outcomes that are more likely to succeed.


We held seven participatory workshops with a total of 120 participants (70% members of the public and 30% GP staff) in different parts of urban and rural Scotland. The purpose of the workshops was to develop a deep understanding of the challenges and opportunities of digital technologies as well as generate ideas for future GP services. Using a variety of creative approaches and service design tools we co-designed prototypes for digitally-enabled GP services.

We introduced each workshop with a question, which was deliberately broad and non technology focused in order to encourage participants to think widely: “How can we look after our health in the future, accessing GP services when we need them the most and in the ways that work best for us?”

The workshops were structured as follows:

    • Persona development – to uncover problems, challenges and Fig.3 - Ideas generated by young peoplegoals of different individuals, such as
      unpaid carers, busy mums and elderly patients with multiple long term conditions for example
    • Hopes and Fears
    • Storyboards and user stories – to gather experiences, identify opportunities and further understand what individuals might need
    • Principles – that the OurGP outputs should adhere to
    • Future focused idea generation – based on problems and opportunities in the room we imagined that it was 2030 and we co-designed a better future GP service aiming to meet the needs of everyone in the room
    • Prototype development – of favourite ideas using basic prototyping materials such as paper, pens, stickers, objects and plasticine in order to communicate ideas to the rest of the room, closing with a presentation of ideas, final feedback and voting
    • Clinical process mapping (with clinical staff) ran alongside the persona and storyboard exercises to pick out pressure points and areas to intervene – these were communicated within the room to enhance the idea generation phase.

Fig.4 - Clinical process map from workshop


Recognising that whatever we developed had to be feasible in everyday practice, we carried out three visits to GP services where we spent a day meeting with patients and practice staff alongside observing the setting. This helped us understand what could work and what might be less likely to work in a GP setting, alongside the opportunities and the barriers. An example of a common theme arising from our visits is that patients and practitioners told us that they want to use the waiting room space better whilst waiting for appointments and that the current method of communicating information through posters and flyers isn’t very effective.


A close up view of storyboards depicting different digital products that have been designed as part of the Our GP project.Our research outputs enabled us to select and develop the most unique ideas into paper prototypes ready for a roadshow across Scotland. These four prototypes were derived from the needs of patients and clinicians and were co-designed during our workshops and developed with input from our surveys and stakeholder interviews.
Steve and Helen spent two weeks travelling across Scotland from Fort William to Aberdeen and Inverclyde to North Berwick.

We based ourselves in health centres, libraries and other places where we could ask people for their feedback on the prototypes. In total we held 11 roadshow sessions and we had in depth conversations with over 100 people. People voted on their favourite ideas and left feedback – some stayed for 10 minutes, others up to 2 hours designing how they would like the digital tools to look and feel.

You can watch a video of our roadshow experience here


Fig.7 - Interactive wireframes developed by AyupWe were keen to open up the conversation to the wider public in Scotland who weren’t able to attend a workshop or the roadshow. We developed interactive digital versions of the three favourite prototypes (narrowed down during the road show) with Ayup – a creative digital agency based in Yorkshire (www.ayup.agency). We put them online along with a survey and explainer video (see – http://dhcscot.alliance-scotland.org.uk/ideas/#ideas), so that people across Scotland could tell us what they thought. We received feedback from a further 420 people (66% citizens and 33% practitioners) which lead to prototype refinement.


We finally brought all our learning back to a smaller group of key stakeholders and participants from our co-design workshops to share the OurGP journey. This was invaluable in helping us to shape the next steps. We asked participants to consider the implications of the prototypes for their practice as well as how they could support the innovations as they are taken forward.

The public gave us positive feedback on our people-centered approach, with some highlighting that they’ve never been asked what they want before and so this was a good opportunity to have their say. The workshops received an average score of 8.7 / 10 from participants and comments such as…

“very good, loved it! Need more of this kind of thing in the future”

 

Clinicians appreciated the time to reflect on their practice and think about the future…

“very welcoming – easy to engage with the team – interesting. Nice to get space and time to think!”

Fig.1 - OurGP project partners