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I don’t need to tell anyone about the importance of our health. Over the last weeks, physical health and mental well-being have been at the forefront of everyone’s thoughts and conversations. And even before the pandemic, we were reminded of how unequal health outcomes are in this country. The recently published report, Health Equity in England: The Marmot Review 10 Years On, shows that the UK has the highest levels of interregional inequality than any other large wealthy country and that life expectancy has stalled for the first time in over a century.
Conversely, good health and wellbeing makes us thrive. It is the thing every parent wishes for most for their children. It makes us get out of bed in the morning, be able to contribute to making the world a better place. It makes us feel good, smile, laugh and connect.
Health is not just about health services. It is about working with educators and employers to provide good work so people aren’t living in poverty or are able to reskill as technology changes job roles. It is about creating healthy and environmentally sustainable environments where people feel included and which promote activity and connection. It is about supporting communities and social networks to come together to help each other. It is about dealing with increased demand with fewer public sector resources in an entirely different way. Moving beyond traditional, in-person service provision to a more networked, digital and community-led approach.
The only way to improve health inequalities is by addressing the wider determinants of health, to focus on prevention and how people can maintain healthy lifestyles, and to draw in the resources and energies of businesses and other organisations to support a health and wellbeing goal.
Role for design: Design plays a huge role here. Good design within business creates profitable and productive organisations that create jobs (see our Designing Demand evaluation). Good design within architecture and the built environment creates healthy places with important features such as parks and waterscapes, and encourage cycling, walking and clean air (see our Healthy placemaking report). And good design within public services and adopted by social entrepreneurs creates user-centred services and initiatives that pass power to the people in communities running them (read our Transform Ageing Final Report).
Although we are in the midst of the pandemic, we have seen examples of how designers have quickly turned their hand to pivoting business production (e.g. from vacuums to ventilators, from high fashion to personal protective equipment, and from hotels to places for homeless people to self-isolate), how natural environments – like parks – provide essential services for physical and mental good health, and how community-led services have been creatively and resourcefully put together, showing design mindsets are not just the forte of trained designers.
Why Design Council?
Design Council is unique in that it offers services across key sectors which contribute significantly to the economy: business innovation, places, public services and social innovation. And we do this multi-disciplinary work in places and then use evidence it creates to influence national policy.
Design is also important as a strategic tool that can bring together different perspectives to solve common challenges. Health and wellbeing is a systemic challenge that requires different responses. The design process is a leveller. It can bring the individual resident and the collective voice into the room so that people can look at challenges in new ways, seeing the bigger picture and where they all can play their part.
We have a strong track record:
Design Council has been working successfully in health and wellbeing for a long time.
Some of our work has focused squarely on the most traditional of health spaces: the hospital. Our Designing Bugs Out and Designing Patient Dignity programmes set the challenge of reducing hospital infections or improving personal privacy to a number of fashion, product and interior designers, whose responses included newly designed robes, to chairs to infographics and signage). We’ve used design to reduce reported aggressive behaviour in A&E by 50% through graphic design which shows patients what to expect in the waiting process, and reduced frustration at the hospital pharmacy through creating more visibility of the medicine dispensing process, a private booth to discuss more discrete cases, and an information screen in the local café, where it’s nicer to wait.
We’ve also got an extensive back catalogue about how to design the built environment for healthy, active and inclusive lives. Our Active by Design guidance shows how to design places with physical activity at their heart, and our Inclusive Environments training, delivered to 500 TfL staff last year, shows how to create places and infrastructure which are not only accessible to all but also help ensure that every one of us feels entirely welcome. Inclusive design is a key part of our Design Review work, whether we are making sure that new developments in Thurrock have built in intergenerational connection opportunities or the new waterfront in Jersey maintains walking connections between the city and the green space beyond. And we draw on our vast experience and knowledge of creating places that work for everyone to influence national Government policy, for example through the National Design Guide (which we’ve just produced) or the High Streets Task Force (where we are using design tools and methods to challenge people to think innovatively about the future of their high streets, and sharing our expertise in inclusion, healthy placemaking, service design, and social and environmental sustainability).
Consumer products can have a huge impact on people’s health. Design Council’s product incubator, Spark, has for five years been supporting people – inventors and people with lived experience of caring for someone – to create objects that make it easier to live independently at home, reducing the demand on the NHS and making them happier in their houses. Winkey is a simple device that enables people with limited dexterity to open and close locks easily; Washseat is raised seat bidet is an affordable adaptation which allows carers to clean their loved ones with dignity and help them stay in their home, and Stablspoon is a stabilising spoon for people with hand tremors, developed to sell at a quarter of the price of what is currently on the market, making this accessible for a much broader range of people.
More broadly, we’ve been supporting public sector staff to create more user-centred services for the last seven years through our Design in the Public Sector programme, run in partnership with the LGA. We’ve supported over 70 councils to engage with residents, re-design and prototype services that have improved outcomes for citizens and increased the design skills and confidence of staff. Some of these are explicitly health related, summarised in a blog here.
Talking of digital and data, we’re currently designing ways to ensure that the Government’s data ethics framework – which sets out important principles in how our digital data is used for social good – is designed and communicated to the widest array of policymakers. Graphic design for policy impact!
But designing for health and wellbeing needs to not just be co-designed with users (understanding their needs and designing for that). It should also be co-produced with them. Proper prevention means people and communities taking ownership for their own health and wellbeing, and harnessing their incredible agency and skills to do so. Our Transform Ageing programme – which we have run in partnership with the National Lottery Community Fund, Unltd, Centre for Ageing Better and the South West Academic Health Science Network – supported 62 social entrepreneurs to create a greater choice of products and services which have improved the connections and health of people in the South West, generating £3.73m (for a £815,000 investment plus design support) and reaching 89,500 people. Impressive. But perhaps more interesting is that 46% of these products and services are led by people in later life, and they've created 193 jobs and 800 volunteering opportunities, meaning this is about people in later in life taking charge and being a catalyst for local employment (rather than being seen as a passive recipient of services).
Recently, we’ve been integrating our work so that our programmes stretch to involve many design disciplines coming together. Work looking at the wider determinants of health is a natural place to start. We’ve been working with the Wellbeing Collaboration (supported by the Health Foundation, and with Shared Intelligence and The Leadership Centre) to conduct action research with four local areas. We have been looking to understand the holistic experiences of local residents, which additional partners local areas might need to collaborate with to improve their health, and what support they need to do work together collectively. We’ve also been working with them on the Shaping Places for Healthy Lives programme (with the LGA), which has been merging user-centred design together with systems thinking, so they can toggle between the micro and macro – having deep empathy for the experience of citizens, while looking broadly across the system for unusual suspects with whom they can collaborate (and draw in further resources and energy).
But even where the issue has a more specific focus, the beauty of design is that the first bit is solution agnostic, and by bringing together a range of different disciplines (across design and beyond) we can come up with a range of ideas. That is because these are complex issues which require more than one answer. Recently we’ve been working with East Sussex council on suicide prevention. A design process starts with understanding the problem, and then opens itself up to different interventions: the built environment of the local area, the support services available, the way the local place is portrayed in books and films. And BBC Radio 4’s The Fix is a radio series that brings together people from different backgrounds and professions (and most importantly, people with lived experience) to explore the issue, come up with ideas and test and iterate them. Despite the title, and due to the complexity of the issue (debt) and the different types of people we had in the room, we can up with an ecosystem of different innovations, some already existing, and some new, which together might start to turn the dial.
The COVID-19 crisis has shown just how interconnected our world is. Not just in the way that the virus has spread, but also in the way that its effects and consequences are borne out, exacerbating inequalities that existed already and cascading impacts wider into society. Quarantine is impacting on domestic violence and levels of physical activity; furloughing and redundancy will impact on people’s self-worth and finances; there will be trauma through bereavement, through loneliness, or through increased poverty and homelessness. But we must remember that the positive behaviours and practices in response to this pandemic, like increased care, neighbourliness and social business missions can in fact be carried through to create a new system in the future.
Designers are synthesisers, seeing how something fits into the bigger picture. And designers act, trying things out and seeing what works.
So we need to act in ‘designerly’ ways across design disciplines: helping public services to offer their support remotely and supporting community-led responses, enabling businesses to pivot and adapt, and creating places that allow us to come together as safely as possible. Not just in the crisis but forward into the future.
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