Some design provocations about preventative healthcare and designing for the service loop …

Preventative healthcare: designing for the service loop

Also on Medium: medium.com/@richardj…

Includes: why designing for preventative healthcare is a bit like BERG’s Here & There horizonless projection map of New York

Some (slightly belated) thoughts on the UK announcability-first announcement on digital identity: Digital identity and the UK government’s announceability problem

Useful reminder from Julia Cream at the Kings Fund that reducing admin burdens requires leadership and intent

If it was easy to improve patient experience of NHS admin it would have been sorted long ago. The depth and breadth of admin failures that many people continue to experience suggest that fixing admin is a highly complex area that requires resources, skill, leadership – and, perhaps most importantly, standing in the shoes of patients and carers and seeing admin from their perspective.

First visit in years to the common land where I grew up. Hard to describe quite how much it is a part of me. The colour of the sand, the details of the small handful of types of plants that grow there are beyond familiar. Recognising individual trees from 40 years ago everywhere. Cheesy but true.

I enjoyed this interview with Michael Heseltine:

www.thetimes.com/article/9…

Hard to disagree with this diagnosis:

This repeated failure to deliver people’s aspirations after the 2008 crash, Brexit and Covid means we now have this political momentum for change and, with it, populism. It’s a race to the bottom and, sadly, Farage is winning.

I really hope someone makes a road trip film about this:

we [Thatcher and Heseltine] were never friends. Ken Clarke was a friend and so was Douglas Hurd. “We all went on holiday to the Galapagos and saw the blue-footed booby, an exotic bird.”

I keep wondering when the input methods for LLMs will start to diverge from familiar chat and voice interfaces. A few links to things that seem relevant:

This talk from 12 years ago shows a coder who created a domain specific language for coding python by voice:

[www.youtube.com/watch](https://www.youtube.com/watch?v=8SkdfdXWYaI

This paper discusses “Pen-Centric Shorthand Handwriting Recognition Interfaces”:

https://ieeexplore.ieee.org/document/4488861

SkipWriter was a recent attempt at LLM-Powered Abbreviated Writing on Tablets:

https://dl.acm.org/doi/fullHtml/10.1145/3654777.3676423

The authors say:

Abbreviating with LLMs presents novel and largely untapped potentials for text input.

Shorthand-Aided Rapid Keyboarding (SHARK) was a keyboard replacement for iPhone and Android:

https://en.wikipedia.org/wiki/ShapeWriter

A future where public servants spend their time on hold to Palientir to get anything done …

he complained in an email to Palantir. Four months later, his case was still visible to other officers, and he was still sending emails to Palantir to fix the problem

How Palantir, Peter Thiel’s Secretive Data Company, Pushed Its Way Into Policing | WIRED

I’ve heard the term “digital by default” pop up a few times recently, so I dug out the original definition from the UK Government Digital Strategy:

Digital by default means digital services which are so straightforward and convenient that all those who can use digital services will choose to do so, while those who can’t are not excluded.

I had an opticians appointment the other day and have some standard age + UV based degradation. The preventative healthcare answer to which is 1) kale 2) hats. So, London based hat wearers, any suggestion of hat shops for men of a certain age?

Booking marking this case study of GOV.UK Notify from Hannah White and @eaves.ca to wheel out next time there’s a bit of reductive technical solutionism about common platforms. Scale by starting small and thinking about adoption. Scaling Digital Infrastructure in a Siloed State

Sketching interfaces, riffing off Berg’s Here & There

Because software is eating the world, there are now theology articles in Wired. (I started reading and couldn’t stop).

Thoughts on the NHS 10 year plan (with a digital skew)

The UK government has published the 10 year plan for the National Health Service. It is based around ‘three big shifts’: analogue to digital, hospital to community, and sickness to prevention. Some people have said it’s less of a plan and more of a vision, which is probably fair, but also probably necessary to rewire such a complex set of organisations. I’d add that the three big shifts feel like incomplete sentences: “analogue to digital means …”. ... more

Milton Keynes marathon 2025

I was supposed to run the Brighton marathon last month, but bug between a charity’s CRM and the marathon meant I didn’t actually have a place. Lots of people very kindly sponsored me, so to make sure I delivered my side of the deal I ran Milton Keynes. I hadn’t done a very convincing job of training for Brighton because of other commitments. I thought a month more might mean I could make up for that, but that was wishful thinking. ... more

Administrative Fairness Lab Conference 2025

I was in York for the Administrative Fairness Lab’s conference. Somehow I’ve never visited before. The photo above is from York Minster’s stone mason yard, cathedral’s being things that are never done. One of the sessions at the conference, by Maria Lee and Sam Guy was about due process in the planning system. One of the key ideas I took away was that removing things like consultations doesn’t remove the contested viewpoints they exist to air. ... more

Designing the seams, not seamless design

Designing the seams, not seamless design On YouTube, there’s a compilation of Steve Jobs speeches where he says: ‘It just works. Seamlessly.’ There are ­forty-four examples in total. ‘It just works’ sums up Jobs’ approach to design: remove and simplify. He thought design should ‘get out of the way’. Products that just worked were not there to be meddled with either (when Apple discovered repair shops opening the iPhone 4, they added tamper-proof screws). ... more

Standing inside the machine

I was in the Netherlands to deliver a keynote at the User Needs First conference. While I was there I visited the Zaanse Schans open air museum. Windmills and other industrial buildings were transported and reconstructed there in the 60’s and 70’s. There’s also a museum of industry, mostly chocolate and biscuits. Compared to most preserved windmills in the UK, many of the windmills at Zaanse Schans actually work and it was a very windy day. ... more

Public sector design — time for a reset

Public sector design — time for a reset Public services should work much harder for the public. However, the new UK government isn’t going to meet its aspirations for digital and data unless it resets the public sector’s approach to design. The approach that grew from GOV.UK and the Government Digital Service was, if not flawed, at least incomplete at source. It ended up prioritising utilitarian simplicity, at the cost of designing government out of the way, and shunned technology as inconsequential to the design of services. ... more

Public sector design — time for a reset

Public services should work much harder for the public. However, the new UK government isn’t going to meet its aspirations for digital and data unless it resets the public sector’s approach to design. The approach that grew from GOV.UK and the Government Digital Service was, if not flawed, at least incomplete at source. It ended up prioritising utilitarian simplicity, at the cost of designing government out of the way, and shunned technology as inconsequential to the design of services. ... more

Digital talent and precariousness in government

Given there’s a UK election coming up, there’s going to talk about how to get more tech talent into government. Most is probably going to be encouraging ‘tours of duty’ from the tech industry. That short-term engagements are the way to get people with digital skills in to government. I thoughts I’d share my experience from 2011 on the precariousness that creates. I originally joined the civil service on a 2 year fixed term as a civil servant. ... more
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