Merge pull request #72 from NHSDigital/prevention-platform-first-post

Personalised prevention platform discovery summary post

Author: Demotive

.gitignore

@@ -2,3 +2,4 @@
 node_modules
 _site
 .DS_Store
+.nova

app/_layouts/product.njk

@@ -41,6 +41,9 @@
           "Record a vaccination",
           "Book a vaccination",
           "Select people for invitation"
+        ] },
+        { title: "Personalised prevention", services: [
+          "Personalised prevention platform"
         ] }
       ] %}
 

app/images/personalised-prevention-platform/2025/03/discovery-summary/prevention-platform-discovery.pdf

@@ -0,0 +1,191 @@
+---
+title: "Discovery summary"
+description: A summary post detailing our discovery into personalised prevention
+date: 2025-03-20
+tags:
+- discovery
+---
+
+## Introduction
+
+This discovery summary captures our insights into understanding the potential value of a “digital lifestyle platform” initiative as originally proposed by the Prevention and Long-Term Conditions Strategy team.
+
+The current situation is that:
+
+- many people are at risk of developing (or already have) single or multiple health conditions
+- only a small percentage of these people are reached and engaged by healthcare services that can support them to tackle those conditions
+
+Unless more can be done to target the individual (without increasing health inequalities further), the strain on the NHS of supporting people with preventable long-term health conditions will continue to grow and increase the burden on the economy.
+
+Can we help people to proactively manage their health, rather than relying on a reactive NHS?
+
+## Our problem statement
+
+<blockquote class="govuk-inset-text govuk-!-margin-left-0">
+  <p>Many people are at risk of developing - or already have – one or more health conditions.</p>
+  <p>People often don’t know where or how to access the services that could best help them manage or improve their health. Healthcare professionals can also struggle to find services to recommend.</p>
+  <p>We also often don’t know how well services are meeting people’s needs. That means if people do find and use a service, we don’t have a way to help them stay motivated to keep using that service, or to help them find alternatives if the service doesn't work.</p>
+</blockquote>
+
+Our current problem statement has evolved over the course of discovery as we learned more about the problem we were trying to understand. It may change as we learn more in the alpha.
+
+
+## Hypotheses
+
+We had 4 overarching hypotheses we wanted to explore during the discovery:
+
+1. We can provide a valuable, personalised service that can connect people to useful help and support.
+2. There is a serviceable cohort of people who will proactively manage their health to reduce their need for future treatment.
+3. The proposed service can complement other NHS services and handle the relevant data flows to keep them in the loop regarding the patient's overall healthcare.
+4. We will be able to reach people early enough before health issues become problematic.
+
+
+## What we explored
+
+### Understanding more about potential users
+
+We wanted to understand:
+
+- what users’ health and life situations were like
+- whether we could encourage users to use a platform that connects them to services that could help them improve or maintain their health
+
+### Finding out the best ways to start to curate appropriate services for a user
+
+We wanted to understand:
+
+- what information we can collect about users to begin to make recommendations
+- what factors matter most to users when choosing a service
+
+### Understanding if we could have ongoing conversations with users
+
+We wanted to find out if we could:
+
+- start an ongoing conversation with users about their health, keeping them motivated to use the services they’ve selected
+- find users alternatives if the service they chose doesn’t meet their needs
+
+### Understanding where medical practitioners fit in
+
+We wanted to understand whether this sort of capability could fit alongside the ways in which frontline medical practitioners already signpost patients to health and lifestyle services.
+
+
+## Who we spoke to and why
+
+### Primary users
+
+#### Users we focused on
+
+This type of service could have a very large scope so we started by focusing on the people we thought it could best help.
+
+We spoke to 24 people living in deprived areas in the UK, including Liverpool, Oldham, Rochdale, Bradford, Birmingham and Manchester. We targeted people who were most likely to suffer from deprivation by finding people in lower socioeconomic groups.
+
+We talked to people with these risk factors:
+- being overweight
+- being inactive
+- smoking
+- heavier drinking
+
+#### Why we focused on these users
+
+People in deprived areas have the worst health outcomes and tend to make the most use of the NHS. If we can provide a service that can help them to improve or maintain their health, we can help reduce health inequalities and reduce the load on the NHS.
+
+We wanted to focus on people who had existing health risk factors, but who had not yet developed a more severe health condition. We thought this could help us understand if we could prevent this group from developing those more severe conditions in the future.
+
+### Secondary users
+
+We also spoke to 5 GPs and GP practice staff in South West England to understand their experiences of patients with risk factors and how they recommend lifestyle and health services and resources to them.
+
+## What we did
+
+### User research
+
+We explored the user’s:
+-	life situation and the factors that would enable or prevent them taking action to improve their health
+-	existing knowledge of and engagement with health and lifestyle services
+
+We also used a series of design probes to begin to understand ways in which we could:
+-	activate a user to do something about their health
+-	understand enough about the user to recommend appropriate services to them
+-	find out what matters most to users when choosing a service
+-	check in with the user to understand how they got on with a service and recommend alternatives if necessary
+
+### Service design
+
+Alongside the user research, we wanted to understand the complexity of the service landscape in which a prevention platform might sit, and find out which approaches we could take to best support users.
+
+To this end we explored:
+-	starting points and motivations for preventative user journeys within and without the NHS
+-	the broad range of services that would potentially need to be collated to create personalised recommendations – their creation, provision, and how discoverable they may be
+-	how the NHS currently “does prevention recommendation” through the lens of social prescribing
+-	potential sources of structured information about users and services, and applicable standards
+-	broad concepts of how a platform might recommend the most appropriate preventative services to users
+
+![A thumbnail view of our mapping document used to explore the problem space.](prevention-platform-discovery.png "We mapped the problem space using broad stages of the user journey that could be experienced by people deciding (or being prompted) to act, choosing, then using a preventative service.")
+
+[Download a PDF of the discovery map (103kb)](prevention-platform-discovery.pdf)
+
+### Technical landscape
+
+We also examined the current, and future, NHS technical landscape. We needed a detailed understanding of the technical capabilities, both present and planned, to understand what could be reused, extended or built.
+
+## What we learned
+
+### We can encourage people to act after events like a health check or GP visit
+
+The design probes helped us explore which approaches might best get people to use a prevention platform to find the help they need.
+The most compelling way is after a health check or similar service that highlights health risk factors. Another way could be messaging linked to actions taken in other services.
+
+### People might use a platform unprompted
+
+People could use the platform without being sent there, but this relies on building awareness of the NHS as a place for managing and improving your health
+
+We saw that there were times in people’s lives when they would feel compelled or motivated to act. It is important, in these moments, that they know where to go or they may not capitalise on that motivation.
+
+### Users don’t know where or how to access the services that could help them
+
+Users have limited awareness of the types of service that are available to help them manage or improve their health.
+
+Users typically had little idea of what was available to them or how they might go about finding it.
+
+People had rarely – if ever – used a preventative service before.
+
+There is a clear need to help users find services relevant to their needs.
+
+Exploring the service landscape showed just how fragmented and difficult it is to navigate. There is a large challenge in either shielding people from this complexity or providing them with tools to navigate it.
+
+### Users are very positive about receiving recommendations
+
+Users are very positive about getting recommendations of preventative services and resources based on their selected health priorities and barriers to action.
+
+Most users said they had had no idea that certain types of services were available. They were often actively interested in the types of things they explored in the design probes.
+
+The technical hurdles we’ll need to overcome to give these sorts of recommendations are substantial, but not insurmountable. There is a lot of complexity we will need to handle.
+
+### We have a good idea of the types of criteria that matter to users when choosing services
+
+Cost was a key factor, along with whether the service was:
+-	online or face-to-face
+-	a group or individual activity
+-	local or national
+-	happening at a convenient time — one of the key barriers users cited in being able to take better care of their health was the lack of time they had around work and family or caring commitments
+
+### Moving from the platform to a service could be challenging
+
+After a user has chosen a service, the handover from the platform to a specific service is important to get right.
+
+This is a key point at which we could lose a user if the process is too long-winded or confusing.
+
+### Users providing feedback about services is important and expected
+
+We wanted to explore whether we could keep users engaged with managing their health because we thought that the prevention platform could better meet users ongoing needs if using the platform was more than a one-off activity.
+
+The research showed that users are open to providing feedback about services. They’re also happy to carry on using the platform to find services and resources that could help to maintain or improve their health.
+
+More than being open to providing feedback, users welcomed and expected it. The idea of being encouraged to continue or to be helped if struggling clearly resonated.
+
+### It’s important to have clear escalation routes out of the platform
+
+There will be times when a user has a condition that is too advanced or needs that are too complex or challenging. We spoke to a couple of people that were in that situation. For these people, it is important that the platform can identify that and escalate them to a practitioner who is better able to support them.
+
+If there are people using the platform who keep struggling to make change, we need to provide a way for them to find more involved support.
+
+