2004 – 2005

Joinedupdesignforhealth explores ways of improving the patient experience of the National Health Service (NHS) through design interventions.

In partnership with the NHS, a client team of front-line clinical staff are paired with a multidisciplinary team of designers and researchers. The client and design teams, in consultation with patients, examine current practice in NHS hospitals in a series of workshops and meetings.

This process identified six ‘critical points’ that represent the most universal and emotion-laden moments in the patient’s experience. These include arriving, registering and waiting in the Emergency Department, as well as On-Ward admission, independence and treatment. These points affect large numbers of people and tend to shape perceptions of the NHS as a whole.

Arriving at the Emergency Department: Redesigning this first critical point in the patient journey enhances first impressions


Registering at the Emergency Department: A redesigned registration desk addresses issues of visibility and patient privacy


Waiting in the Emergency Department: The waiting area is enhanced with better communication systems and increased patient comfort


On-Ward Admission: A carefully designed letter provides coherent and clear information to patients before arrival


On-Ward Independence: Design solutions that enable greater independence significantly enhance a patient’s hospital experience


On-Ward Treatment: Redesigned bedside furniture provides additional space and a more organised approach to patient treatment


By analysing these critical points and applying new design thinking, small interventions to the built environment, communications and equipment have the potential to make a major difference to both the delivery of health services and the patient experience. For example, busy entrances to Emergency Departments often compromise hospital security and patient privacy when ambulance cases are brought in. With the provision of a dedicated ambulance bay and turning circle, and a canopy to protect its entrance, ambulance arrivals are screened from other patients and visitors.

“Hospitals are not comfortable places. You’ve got the hospital bed, high-backed chair and a serviceable locker. There are certain things we can’t give them, but if things can be done to help the patient environment, that would make a big difference”.

– Senior Nursing Manager

“We need a more structured and organised approach to how we deal with large volumes of people. When patients get no information at all, they become very anxious and difficult for us to deal with”.

– Emergency Department Nursing and Service Manager

“Our weak point lies with admissions. We’re so rushed, we don’t have time to orientate people properly. It’s hardly, ‘Have a nice day’!”

– Junior Ward Sister

“One of the biggest problems is space to turn around; we get obstructed by other vehicles dropping patients off or police vehicles. Sometimes we can’t leave the bay after drop-off”.

– Ambulance driver


By redesigning experiences at these critical points, overall perceptions of the NHS can be improved. The client team’s first-hand knowledge informs the design outcome showing the value of involving front-line staff in decision-making.

Joinedupdesignforhealth works as a catalyst for change, setting out the case for an integrated design approach across all NHS hospitals, and showing how the NHS can benefit from the skills of the UK design industry.

The client team of clinical staff at the Whipps Cross University Hospital


The client team of clinical staff at the Whittington Hospital NHS Trust


The client and design teams at Whipps Cross University Hospital discuss current practice focusing on the on-ward environment


The client and design teams at Whittington Hospital NHS Trust discuss current practice with an emphasis on Emergency Department arrivals



Critical Points

This study documents research conducted at two London NHS hospitals. It was commissioned in response to the NHS London Design Advisory Group, which brought senior NHS policy-makers and design leaders together for the first time to share ideas and knowledge.

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