Day: 5 July 2019
Taking the leap: getting staff and patients to use the NHS App
This post – and the app it is about – stands as a kind of metaphor for digital public services much more widely. The app has a mostly slick front end, with a visual design which is both distinctively of the NHS and a clear descendant of the earlier work of GDS. But it sits on top of chaos which it can obscure only to a limited extent. It is a front end veneer for different systems, supporting different sets of functions and so fundamentally is not in control of its own user experience.
The post does a good job of explaining why that is and why, despite that, there is still value in the app. There is a circle which needs to be virtuous where a well-designed front end and a growing user base both demonstrate and create value to GP practices in improving their systems which in turn stimulates adoption and use by patients. But there is a risk that the circle turns vicious, that the expectations set by the modernity of the immediate user is undermined by the clunkiness of what lies behind. The good needs to drive out the bad, but the bad will not give in easily.
The (im)possibility of speaking truth to power
Speaking truth to power is often talked about as though it is a heroic endeavour, a point of challenge and catharsis, a showdown when either the message is heard or the messenger is shot. And of course if the norm is that power does not hear truth, none of that is surprising. But perhaps the more interesting approach is to ask why that is assumed to be the norm, and what might change it.
This post doesn’t – and couldn’t – answer that question, but it does shed some interesting light on it. If what is actually at issue is as much or more competing belief systems rather than competing realities, then solutions can’t be about piling up more facts, but might have to do with building relationships in a different way. The difficult bit in that, of course, is not the speaking of truth to power. That just takes bravery. The difficult bit is creating the conditions for power to listen, and that takes a much broader set of skills and approaches.
But as the post hints at, it would be better still to reverse the question. The real challenge is for leaders to show more clearly that they want to listen, not for courtiers to have to balance honesty and self-preservation.