Designing the national vaccinations booking service

Ten weeks (ish) ago I wrote about finding my feet at NHS Digital. A matter of days after I wrote that piece my role changed and I moved full time onto the COVID-19 Vaccinations Programme.

After 12 years working primarily in small, independently owned design agencies, being involved one of the biggest programmes in the NHS felt like a gear shift to say the least.

Feeling like you’re working on something career defining is both exhilarating and horrifying all at the same time. I joined the programme when teams were still being established and a vaccine was a faint hope for the future. Looking back 3 months later, it’s fair to say I learned a lot.

Starting is still hard

Moving roles was hard. Right after the difficulty of starting, I had to down tools on a job I’d only just started to figure out how to do and learn how to do a new one. I’ve wondered a few times why this wasn’t easier for me considering my history as a consultant, shifting projects used to be second nature to me. On reflection, I think it was the lack of an ending. The move happened fairly suddenly, I didn’t get to finish what I started, I just had to get up and walk away.

As I’ve said before, I find starting difficult. And this was no different. I distinctly remember our first Show and Tell happened to fall the morning after my partners birthday. Over cocktails I was obsessing over the challenging governance structures of the programme. I wanted everything to be ‘just right’ for me to slot in and add value to the work. At the time, this worry felt overwhelming. I was obsessed with shifting the governance because I felt out of control.

The morning after we delivered a positive show and tell and in the days and weeks that followed my anxiety started to fade as I found my stride.

Uncertainty is still hard, but there are ways to manage it

Working in a new environment, with new people, delivering a service to requirements specified by others, for a vaccine that doesn’t yet exist is an immense amount of uncertainty to sit with.

I constantly struggle with uncertainty. To the point where I sometimes wonder why I do this job as it’s pretty obvious it will always be a part of my work.

One particular challenge was being a service designer working on part of an end-to-end service. NHS Digital will often get commissioned to deliver technical solutions that form part of the whole user journey. This was difficult because I could see the need for design elsewhere, but it wasn’t within my remit to provide it.

Learning to identify what I could and couldn’t control helped. The concept of influence became important. Identifying where and when I could help shift something that wasn’t necessarily our problem to solve, without it getting in the way of the scope of our delivery. Alongside this, knowing when to step aside was equally important. Keeping a list of 3–4 things to ‘keep an eye on’, that changed over time, helped me stay focused without trying to boil the ocean.

I never actually sat down and did the Circles of Control exercise but the concept lodged in my brain following some training I did and it provided a helpful framework.

Meaningful work takes its toll

I’ve been working with a coach since July and one of the most useful things she’s helped me with is identifying my values. This is something I’ve done before but laboured over somewhat and they never really stuck. This time they came quickly and I kept it simple. 5 values, 1 word for each — easy to remember.

One of my values is impact. When applied to work, I interpret this to mean the work I do has an impact on people’s lives. It makes things better in some way. Working for the NHS is very in line with this value but the vaccinations work really felt like it got to the core of this.

One reason for this was the scale. This was a service that could potentially be used by everybody in this country. While this came with a feeling of pressure it also meant small wins were amplified. I felt the joy of fighting for something to change, having a win and realising I’d helped make something better for millions of people.

However with meaning comes deep care.

Working on something that means so much to the whole country has an impact. I didn’t always feel it day-to-day but looking back I can see how the work really brought out the highs and lows in me to the point where I almost felt like there were two versions of myself on the loose.

Most people who know me will say I’m a person who likes to ‘get shit done’. I’m a doer and I often thrive under pressure. However I am equally capable of absolutely crumbling. Sometimes this all happened in the same day.

I can’t claim that I kept great self-care practices up during this period but I think I’d laid enough foundations to ensure I didn’t fall over. I took a full lunch break most days, blocking this in my calendar weeks ahead. I started going for morning walks to make sure I got a daylight hit. I said no to a weekend workshop because I was at breaking point. I was also privileged to learn from the past experience of colleagues who’d struggled with previous COVID related work — I heeded their warnings.

It’s difficult to put yourself first when you’re working on something that means so much to you but it should always be your number 1 priority.

Understanding how technology works is critical for designers

I’m still learning when it comes to technology but I learnt so much through this work. The biggest take away for me will be how much designers need to understand how services actually function. Too often do I hear designers shy away from understanding what actually happens when someone checks this box or pushes that button.

Having the opportunity to work side-by-side with a technical architect through this work has helped me see the need for design and technology to work closely together and really understand each other’s skills and expertise.

I have much more to say on this subject but that’s for another day.

I’ve now moved back to my original role within Citizen Health Tech, working with the NHS.uk, Login and App teams to design and deliver transactional services.

This weekend I’ll be excited to watch from the sidelines as the Book a coronavirus vaccination service (or national booking system as Boris enjoyed calling it) is launched and feel proud of the contribution I made working with an exceptional team.