Add Invite pilot post 3 user research findings from pilot

Author: Jamiedoyle205

app/posts/screening-invite/2025/08/2025-08-13-invite-breast-screening-pilot-design-iterations.md

@@ -3,7 +3,7 @@ title: Breast screening pilot design iterations
 description: Content and interaction design work for the 2024 breast screening invitations Pilot.
 date: 2025-08-13
 ---
-Team Invite is working on inviting people to breast screening appointments using a digital-first communication strategy.  In our first post, we gave a high-level overview of the pilot work [we gave a high-level overview of the pilot work](https://design-history.prevention-services.nhs.uk/screening-invite/2025/06/invite-pilot-overview/). In this one we’d like to explain how we took content and interaction design decisions to address user needs. 
+Team Invite is working on inviting people to breast screening appointments using a digital-first communication strategy.  In our first post, [we gave a high-level overview of the pilot work](https://design-history.prevention-services.nhs.uk/screening-invite/2025/06/invite-pilot-overview/). In this one we’d like to explain how we took content and interaction design decisions to address user needs. 
 
 
 ## Designing for new touchpoints
@@ -77,7 +77,7 @@ This naming was due to the sender name being linked to an **Organisation Data Se
 
 Currently, sender names in the NHS App appear in **capital letters**. 
 
-Following the pilot, we agreed to update the name associated with the ODS code to **‘NHS SCREENING SERVICE’**, as it will be more easily recognised by users. This updated sender name will also be used by Cervical Screening. 
+Following the pilot, we agreed to update the name associated with the ODS code to **‘NHS ENGLAND - SCREENING’**, as it will be more easily recognised by users. This updated sender name will also be used by Cervical Screening. 
 
 
 

app/posts/screening-invite/2025/09/2025-08-13-invite-breast-screening-pilot-user-research.md

@@ -0,0 +1,121 @@
+---
+title: Testing digital breast screening invites
+description: User research findings from Team Invite’s digital-first breast screening invitations pilot December 2024 – February 2025 
+date: 2025-09-04
+---
+Team Invite is working on inviting people to breast screening appointments using the NHS App notifications, a text message or a letter if both digital channels are unsuccessful.
+
+In our first post, we gave an [overview of the pilot work](https://design-history.prevention-services.nhs.uk/screening-invite/2025/06/invite-pilot-overview/). 
+
+In the second post, we looked at [content and interaction design iterations](https://design-history.prevention-services.nhs.uk/screening-invite/2025/08/invite-breast-screening-pilot-design-iterations/). In this one we summarise what we found out during the pilot phase about user experience and operational impact. 
+
+
+## What we wanted to find out in the pilot
+
+We wanted to understand why someone might read a message in one channel rather than another. We also wanted to know how receiving messages through different channels affects attendance and overall experience.
+
+Some of the details we wanted to learn included:
+*	would not sending a map have an affect?
+*	would participants go back to their invite on their phone?
+*	would participants see the guidance link in the digital message?
+*	how might breast screening offices be affected?
+
+## The user research methods we used
+
+We didn't have a way to observe people receiving messages, or call them directly about receiving their invites.
+
+Instead, we started with some content and usability testing of the NHS App invitation to see how people responded to it.
+
+During the pilot we:
+* tracked who got which message and when
+* asked screening staff helped us speak to people – either after their appointments or when they called in
+* asked screening staff to call people who didn't attend.
+
+## Pilot participants
+
+We sent messages to 150 people across 3 breast screening offices. We chose specific people who were statistically most likely to:
+*	attend their appointment
+*	be knowledgeable of the screening process
+*	have the fewest barriers to attending their appointment
+
+This was so any issues we encountered were easy to attribute to the change in invitation channel. The number was set at 150 as it was seen as an easy number of participants to track.
+
+## What this user research is missing
+
+### Significant quantitative data 
+Most users saw the SMS messages. Just under a third of the sample read their NHS App messages and a few people received letters. You can see [how each type of message was sent in sequence in our earlier post on this](https://design-history.prevention-services.nhs.uk/screening-invite/2025/06/invite-pilot-overview/#:~:text=We’re%20using%20NHS%20Notify%20to%20send%20these%20messages%20through%20the%20NHS%20App%2C%20text%20messages%20and%20letters.).
+
+However, 150 people isn't a large enough sample. We can't be confident these results would be the same for all 6 million people who get breast screening invites.
+
+### An understanding of how this would affect underserved groups
+The sample for this pilot deliberately chose people with the least barriers to accessing their screening appointment. Our next priority is researching how digital messages affect people who find them hardest to access. This includes people with limited digital skills or no access to smartphones.
+
+## Noticing and reading messages
+
+We found: 
+
+1) **People noticed their messages because our fallback system found the places they tend to check** 
+This was clear as we asked participants if they received their invitation in a channel they usually check – the majority said yes.
+
+This is of course the purpose of the fallback system, to try digital messages first and use other channels when digital messages aren’t accessed.
+
+In this sample, concerns around not having read receipts for SMS messages were mitigated by participants being experienced in receiving SMS messages for healthcare communications.
+
+2) **Messages can be noticed even when sent using a digital channel**
+Even when participants received a message in a channel they don’t normally use, most of them still noticed it and attended their appointment.
+
+This is something to keep in mind as we roll out and potentially hear more concerns from people who are used to receiving letters. While people’s attitude may be one of concern, their behaviour can still mean they access messages and attend appointments.
+
+3) **Messages still work even when people can't remember them accurately**
+Many of the participants in this sample did not accurately recall the type of invitation they received. Some claimed they received an email, when we didn’t send any.
+
+People get lots of health messages on their phones. It's hard to remember which message is for which appointment. We also sent SMS reminders, which people sometimes confused with the original invitation.
+
+Despite this, most people still saw their message and attended their appointment. Many people didn’t mind what type of message they received. This suggests we can be flexible about the channel we use to send messages.
+
+4) **Most of the sample didn’t follow a link to further guidance as they didn’t need to**
+Each message had a link (or a QR code for the letter) to a gov.uk publication page. Most people in this sample didn’t follow the link because they had gone through the process before and the key information was quickly available in the message.
+
+## Attending appointments and finding them
+
+We’ve found out that:
+
+1)	**The change to digital messages will affect the people who use their letter as a reminder**
+ Two people said they forgot about their appointment because they didn’t have a letter, with one of them saying they need letters because they have memory loss issues.
+
+Letters have the advantage of being easily visible. Users put them on fridges or other places at home. Messages on a phone can be harder to remember. In previous research we saw people have issues relocating  NHS App messages.
+
+
+2)	**Letters do not need to act as reminders to people with strong calendar habits**
+Most of this sample added their appointment to either a physical or digital calendar. This suggests there could be a health inequality issue to consider here. 
+
+Our fallback to SMS works for those who are able to set up reminders themselves. But for people who are less able to set up reminders, letters work better than SMS.
+
+We cannot see the size of this potential issue due to a small sample size and it only containing people without 'special appointment' requirements.
+
+3)	**Late letters due to postal issues cause appointment problems**
+A participant had to reschedule their appointment due to not receiving their letter in time, despite the letter being sent 3 weeks in advance (over the Christmas period).
+
+## Getting to appointments without being sent a map
+
+Knowing the area or local landmarks can mean a map isn't necessary for finding the main hospital or screening location.
+
+In Dorset the screening took place in Beales Department Store – a known location to almost the entire sample. The invitation and text reminder told people Beales was the location and most people reported they didn't need a map since they already knew where Beales was.
+
+When we shared addresses, people only saw '64-68, Dolphin Centre' in the first line. This suggests we should research whether addresses alone are the best way to give directions.
+
+However, maps are often needed to navigate large hospital sites for example, from the car park or main entrance to the exact screening area. In South West London some people phoned to ask for directions to the exact building where the screening would take place. In this case, an address was shared for the hospital, but it still wasn't clear to all which part of the hospital to go to.
+
+## The potential affect on breast screening offices
+
+The breast screening offices in the pilot received very few calls that were related to issues with digital messages. This could be because this pilot only involved a small number of people who had been to appointments before, so the affect on breast screening offices will need to be monitored if we invite groups who might need more support.
+
+## Next steps
+
+Following the pilot, the invite team has been:
+*	refining the content and design of invitations, based on the pilot feedback
+*	exploring ways to help people reach their appointments without relying on a map
+*	preparing to scale by automating manual Breast screening office processes
+*	partnering with early adopters to run a private beta
+
+If you have any feedback to share, please contact us by email at [[email protected]](mailto:[email protected]).