To improve the NHS, we must look beyond it

I am far from alone in that deep appreciation. In England, the NHS is a national obsession. It determines election campaigns, shapes the budget, and perhaps most importantly, colors how we think about and act on our health. But alongside that feeling of national pride is an understanding that the institution is under far too much strain. There are currently 6.34 million people waiting for NHS treatment. Cutting waiting lists by making better use of the private sector is front and center of the Prime Minister’s latest NHS proposals. It is a top priority for the government as it looks to deliver on a promise to ensure that 92 percent of patients in England wait no longer than 18 weeks for treatment.

Over dinner recently, a close friend asked me: “You’re a designer. If you were going to fix the NHS, where would you start?”

My answer: “Anywhere but the NHS.”

The NHS is a world-class problem fixer. An emergency and acute care service that kicks into gear when we need it most. However, the NHS cannot purify the air we breathe, encourage us to move more, improve our relationships with others, help us develop healthy working patterns, or change the food we eat. To preserve our health, we need to address the causes of preventable lifestyle diseases like obesity, diabetes, and heart disease at their source.

That means turning to the spaces where our health must be built, maintained, and nurtured. Our workplaces, our schools, our communities, our supermarkets. That’s why the best way to improve the NHS actually lies outside of it.

Rethinking the way we generate health in the UK might sound ambitious, but for a designer who has focused on health for 20 years, it is very clearly the right brief.

So, where might we start?

Paint a new picture of health

My mentor, IDEO founder David Kelley, used to say, “Paint a picture of the future with your idea in it.” This is where design excels. We need to imagine a future where health thrives outside of healthcare settings, a future where preventable illnesses are dramatically reduced, and people live longer, healthier lives.

Imagine a future where waiting lists for heart surgery are a thing of the past, not because the NHS has magically become more efficient, but because fewer people need surgery in the first place. Or where at-home cancer screening frees up time for healthcare workers, and gives patients more control over their own health. One of our clients, Teal Health, partnered with us to create safe and accurate cervical cancer screenings that would allow patients to collect their own samples at home, giving them more agency over their own health.

Or consider mental health. Across the UK and the US, children and young people are in crisis. In California alone, more than 284,000 youth cope with major depression. Sixty-six percent of kids with depression do not receive treatment. Between 2019 and 2020, the suicide rate for kids ages 10-18 increased by 20 percent. These numbers are shocking. Imagine a future where children, their families, and schools had easy access to tools designed to combat those mental health challenges. This was the vision driving IDEO’s collaboration with Kooth, the State of California, and cohorts of young Californians to create Soluna, a digital mental health resource kids could access anywhere, anytime.

To drive a step change in the state of our health in the UK, we must allow ourselves to rethink the ways in which we keep ourselves and our families healthy. The National Health Service cannot be our sole partner in this endeavor.

‍Break taboos and engage in hard conversations

Taking health beyond the hospital will require us to confront awkward topics—conversations which we have become used to leaving at the door of the doctor’s office. We need to learn how to talk about menstruation, aging, mental health, and—dare I say it —poo, out in the open.

By normalizing these discussions and listening with empathy, we can begin to uncover the human challenges that impact our health, opening up opportunities for new products and services that improve health and drive economic growth.

Menopause is a great example. In our work with QVC, we learned that nearly 40 percent of menopausal women are being prescribed antidepressants to help manage their symptoms, despite four out of five describing the treatment as “inappropriate.” We also heard that nine out of 10 British menopausal women feel society and brands overlook them. Recognizing that its customer demographic makes QVC uniquely positioned to surface conversations and provide support to those dealing with menopause, the video commerce retailer partnered with IDEO to determine how it could not only meet customer needs but also flip the conversation about midlife, reframing it as a time of vibrancy and exploration.

Fix incentives to combat health pollution

The true financial cost to society of excessive sugar, saturated fats, and pollution is largely hidden. The sticker price is nothing compared to the cost of lost productivity, medicines, procedures, and NHS waiting lists they create.

Policy makers need to inspire innovative new alternatives and reward manufacturers who can create attractive products that do not come at the expense of our health.

In the US, an organization called Eat Real is working to scale access to nutritious, sustainable foods through healthier meal programs in public schools. Almost 30 million children in the US rely on public school lunches for more than 50 percent of their daily caloric intake, but these meals are often comprised of ultra-processed, unsustainable foods. IDEO collaborated with Eat Real to develop its branding and messaging in order to reach a new set of food philanthropists and scale their impact.

Be radically collaborative

Once we relinquish the notion that the healthcare system is solely responsible for our health, we are free to design a new system of collaborative forces to promote, maintain, and foster good health. What opportunities might we unlock if we brought together food producers, educators, employers, city planners, tech leaders, and content creators to co-design a new approach to health with policymakers? Already, some public/private partnerships have led to change. A few years ago, IDEO partnered with the NHS’s health tech unit and a company called Public Digital to create a suite of digital resources that enabled organizations across the NHS to transform their own services, allowing them to provide mental health support for the most vulnerable children and young people.

The opportunities extend far beyond the NHS

A healthier society is more productive and pays more taxes. It requires less healthcare funding and is less poverty-stricken. It can help us all to live happier, more fulfilling lives.

The tensions getting in our way—the short-term incentives to sell unhealthy products, reduce environmental regulations, and the challenge of breaking unhealthy habits—do not necessarily require a revolution in medical technology or vast sums of money to resolve.

They require a designer’s toolkit. A willingness to imagine a different approach to health in the public and private sectors, the courage to talk about health in the open, a realignment of incentives, and the willingness to experiment.

They also present a huge opportunity for any organization interested in building a business centered on improved health outcomes.

It’s time to take our health out of the hospital.