Research

My aim is to research whether other users are experiencing similar issues, and what issues are most prominent.

Face-to-face interviews: users

Name: Linda

Job: Studio Manager and Mother

“Booking appointments is an involved process… It can be difficult to plan my day around them.”

• Has been to the doctor seven times in the past three months (twice for herself, three times for one child, and twice for her other child)

• For urgent appointments, she has to phone between 8.30 and 10.00. The duty doctor will get an idea of the problem and phone back with available slots. This is annoying as you can come down with something after 10.00. She’d have to call back the next day or call A&E which could be unnecessary

• When she phones, they ask if she’s booking for herself or someone else. Her old practice prioritised babies and young children

• It’s an involved process and sometimes you have to call back if the phone is engaged. In total, the process will take about half an hour. It can be difficult to plan her day around the appointment

Name: Francis

Job: Digital Marketing Executive

“Sometimes I’m put on hold for a long time.”

• Has been to the doctor three times in the past three months

• The last was booked over the phone, and this is how he normally books them

• Is sometimes put on hold for what he considers to be a long time – normally 5-10 minutes

• There is a lot of back-and-forth when it comes to choosing a time

• Would like an easier, more accessible way of booking appointments

Name: Drew

Job: Facilities Manager

“I normally book my appointments three days in advance just in case.”

• Has been to the doctor twice in the past three months. Has regular appointments as he suffers from asthma

• Tries to book first thing or after 15.00 so the process does not effect his 9-5 job too much

• Often able to book next day appointments at his doctor, but often books three days in advance just in case

• The last time he booked an appointment was over the phone, and on calling, the receptionist asked what the problem was

• With asthma appointments, the doctor will book them two months in advance, and send reminder letters ever six months

Name: Catherine

Job: English Teacher

“I’ve found it difficult finding and booking specialist services.”

• Has been to the doctor once in the past three months

• Rang her local surgery far in advance to ensure she would get an appointment

• Was able to book straight away but thinks it would be more difficult closer to the time of the appointment and in this case, would have to go very early or late in the day

• Has had difficulty finding and booking specialist services so has had to visit different surgeries

Telephone interview: GP Receptionist

Name: Louise

Job: GP Receptionist

Location: Reading

Hospital: Spire Dunedin Hospital

Department: Cardiology

”All cardiology appointments go through the reception desk. The majority of which are made by phone.”

Booking appointments

• All cardiology appointments go through the reception desk. The majority of which are made by phone

• If a patient has been asked to come back in say three weeks time, the GP will bring the patient over to the reception desk, or send them a message

• DGL Practice Manager is the appointment booking system used by 90% of private practices

• NHS use a choose and book system. Receptionists give patients a code and they will can log in online

Busiest times

• The busiest times for phone calls are Monday mornings and Friday afternoons

• Wednesday afternoons are the quietest times

Issues with booking on the phone

• Sometimes private patients get annoyed when they can’t get the appointment they want. The GPs also take NHS appointments and so I have to explain this to them

Total Health

• Total Health is a system used by one of the cardiology consultants to promote their practice. Louise will receive an email telling her that a patient has requested an appointment and will phone them back to see how she can help

• In the cardiology department, there’s a lot of information that the receptionists need to obtain from the patient before they come in. This is because the GP can offer different tests and they need to identify which will be most useful to run

Reminders

• The receptionists run a report once a month to remind patients that an appointment is due

Cancelling appointments

• If a patient cancels their appointment, the receptionists will call them or send them a letter asking them if they want to rebook their appointment

Updating details

• When a patient books an appointment, they’ll be asked whether their details are correct. If they’re not, they’ll update them over the phone, or email them to the practice

Changing practice

• When a patient wants to change their practice, they will normally send a request to their current practice which contains details for the new practice

• Alternatively, the new practice can request the patient’s file from their current practice

Dependants

• Children are not connected to the family members on the system. For patients under 16, correspondence is addressed to their parent/guardian

Typeform survey: users

Using Typeform, I surveyed 50 participants about their experiences surrounding booking doctor’s appointments for either themselves, or their dependents. I attempted to receive balanced feedback from a broad group of participants – from different ages categories and professions – so that results were as representative of the population as possible. 

Personas

Persona 1: Books regular appointments

Name: Daniel

AGE: 27

JOB: Digital Content Manager

LOCATION: Sheffield

LIVING: shared accommodation 

STATUS: Single 

“The process of booking a doctor’s appointment is stuck in the past.”

BIO

Daniel works at the office between 8.30 and 18.30, Monday to Friday, but often stays late to keep on top of managerial responsibilities. He has a good understanding of digital technology and keeps up-to-date with the latest trends.

BEHAVIOURS

• Has booked doctor’s appointment three times in the last three months

• Suffers from asthma and uses an inhaler on a daily basis

FRUSTRATIONS

• Daniel is on his commute when his local doctor’s surgery opens. He therefore finds it extremely inconvenient booking on the day appointments at the reception or through the phone

• The last time he booked a doctor’s appointment, he was put on hold for 15 minutes and was unable to book an appointment until the following week

GOALS

• Would prefer to book her appointments during his commute to work or on the weekend

• Would like to be able to book an appointment in under five minutes

Persona 2: Books appointments on behalf of her child

Name: Maria

AGE:35

JOB: Part-time teacher

LOCATION: Exeter

LIVING: with family in a rented house

STATUS: Married with baby

“It’s difficult to plan your day when you’re restricted to doctor reception’s opening hours.”

BIO

Maria works three days a week as a junior school teacher while her baby is in a day care centre. For the rest of the week, Maria spends the majority of her time at home, looking after the baby.

BEHAVIOURS

• In the last three months, Maria has booked six doctor’s appointments via telephone, on behalf of her baby

• Maria often requires urgent appointments for her baby. Due to the reception’s opening hours, she can only phone between 8.00 and 9.00 to get an on the day check-up

FRUSTRATIONS

• Due to her working hours, she is only able to phone the surgery and attend appointments between these hours twice a week

• Maria often finds the phones are engaged and has to call back. In total, the booking process will take about half an hour, and she will have to care for her unwell baby simultaneously, which can prove difficult

• It can be a challenge planning her day around the process of booking the appointment

GOALS

• Would like to be able to book on the day appointments on behalf of her baby at a more convenient time

• Would like to be able to book regular appointments with the same doctor

Persona 3: GP Receptionist

Name: Emma

AGE: 46

JOB: GP Receptionist

LOCATION: London

LIVING: with husband in owned flat

STATUS: Married

“Working in reception can be overwhelming and frustrating at times – demand is high but our resources are limited.”

BIO

Sonia works five days a week as a GP receptionist. She works between 8.00 and 16.30 and is one of three receptionists at the practice.

BEHAVIOURS

• Sonia is responsible for taking appointments both over the phone, which includes 70% of bookings, and at the reception desk, which accounts for 30%

• Sonia uses a GP booking system on a day-to-day basis

FRUSTRATIONS

• Sonia’s practice does not currently offer an online booking system to patients, which means phone lines are often engaged or queues develop on the phones, especially on Monday mornings and Friday afternoons, which becomes overwhelming

• Managing telephone bookings alongside reception desk bookings is a challenge with so few staff members, and patients can become frustrated with waiting, which is unpleasant

• It is frustrating when patients do not turn up to an appointment, and there is currently no reminder system in place which could help tackle this issue

• The process of patients updating their personal information (using a printed form) is out-dated and data entry takes a long time. There’s also plenty of room for human error

GOALS

• To ease the demand at the reception desk (queuing, the number of people calling up) by offering patients more control over their own bookings remotely

• Would like a system in place that would remind patients about their appointments and offer a way to cancel them in advance to keep the booking system accurate and up-to-date

• To keep patients’ personal information as accurate as possible on the system for example, if they move house

The top three pain points

Calling by phone

The research suggests that the most commonly used method of booking appointments used by 88% of participants – calling by phone – comes with many issues. Being put on hold was the most prominent issue. One participant said they ‘had to wait up to 20 minutes until [their] call was answered’. Having to call the reception during working hours was another prominent pain point, with one participant commenting that ‘between 8am and 9am, the lines are busy and by the time [she] got through, it was too late’ – no same-day appointments were available. 

Urgent bookings

The availability of urgent bookings was commented on by a number of participants. One said ‘the next available appointment was over a week away, and my problem was urgent’.

Seeing your doctor of choice

The research has revealed difficulty in booking an appointment with a doctor of choice. Often people feel more comfortable with a doctor they know and trust.

The proposed solution

A centralised NHS mobile application could help overcome many of the issues that users are currently facing when it comes to booking their doctor’s appointments.

Solving the problem

Accessibility

Users will be able to book appointments on the go, at a time that suits their schedule. They will be able to book appointments during their commute to work without other people overhearing their personal information on the bus, for example.

Time-saving

The process avoids being put on hold or any back-and-forth with a receptionist. The aim is that the user will be able to book an appointment faster than they would using existing methods.

Local practice

The application will store information about each local practice, including contact numbers if the user decides it will be best to phone, say, because they have questions they want answered.

Urgent bookings

The user will be asked whether their appointment is urgent at the beginning of the booking process. The earliest time slots available will be listed.

Planning ahead

A calendar format will help patients plan appointments in advance.

Preferences

The application will be able to store personal preferences, including specific doctors or whether they would prefer to see a male or female doctor.

Notifications and cancelling

The application will send the user a reminder the day before their appointment. It will allow them to cancel it to avoid missed appointments, and free up slots for other users.

Receptionists

The solution will help reduce the number of patients calling the reception. This will reduce the amount of time the people who do ring up are put on hold.

Real time

The system will update in real time so that receptionists do not double-book a particular slot with, for example, a patient on the phone.

User goals

Users need:

• to create an account. Data will will be synchronised with the surgery’s booking system and so log in is required for data verification

• to create an account for dependants

• help understanding how to use the app

• to log into their account

• to update personal details (synchronised with the surgery’s booking system)

• to select/change preferences for themselves and their dependants

• to be asked whether they are booking for themselves or a dependant i.e. child

• to book an urgent appointment

• to book a future appointment

• to review up-coming appointments through a ‘my appointments’ area and have the ability to reschedule or cancel appointments

• to review previous appointments

Content strategy

Why

Reputation of the NHS

I intend to help improve the relationship between users and the NHS. 42% of participants I surveyed said that they came across problems with the process of booking their last doctor’s appointment, and this does not reflect well on the service. There is an opportunity to learn and improve existing systems.

User experience

I intend to create an experience that puts the user first by focusing on approachability and accessibility. The user is trying to overcome three main pain points, and so these will be taken into consideration throughout the development of the app:

• Issues surrounding booking by phone (not getting through, being put on hold, limitations of reception opening hours)

• The lack of availability of urgent bookings

• Seeing a doctor of choice

What

The tone of the content needs to be professional, approachable and trustworthy. It needs to reflect positively on the NHS. Meanwhile, the user must feel they are able to personalise the app to suit their needs (through preferences, for example). The key message I want to portray, is that as a user, you can rely on a modern NHS system for an easier, faster, appointment booking process.

Who

For data purposes

User must belong to a surgery to use the app.

Age

There is currently no minimum age when it comes to booking a doctor’s appointment in the UK without a parent’s permission, and so the app will not require a minimum age limit.

Location

Across the UK.

Accessibility and convenience

The core purpose of the app is to enable users to book their doctor’s appointments quickly, and at a time that suits them. It is also important that they can book for dependents, including children.

WHERE

The NHS mobile app will be available to people across the UK, through the Apple Store, Google Play and Samsung Galaxy Apps.

Why develop a mobile app?

Mobile apps enable push notifications – the app will remind the user of their appointment 24 hours in advance and they will have the opportunity to cancel the appointment at this point.

How

Content will be designed to fit mobile screen dimensions. Icons and text will be used to guide and instruct the user. Clearly labelled forms will be required when it comes to logging in to the app, and updating details A calendar format will also be required when it comes to booking appointments.

When

The app will be published when it is usable in its most basic form (lean design). Users will be prompted to leave feedback, and notified of any updates to the system.

Concept model

User flows

The key user flow explains the process of booking an appointment, from the stage of logging into the app.

Sub-user flows include:

• creating an account

• rescheduling an appointment

• cancelling an appointment

• adding personal notes to an upcoming appointment

• reviewing personal notes made on a past appointment.

Wireframes and feedback

I created a set of wireframes to get some initial feedback from potential users. I focussed on the ‘happy path’ – the most common way in which the user will navigate through the app. I used POP to develop a working prototype.

Dr Hall, Doctor

• The patient’s issue will effect the practitioner that can to see them. Therefore it is worth listing appointment types so the right practitioner can be found for the patient

• There should be a cap on the number of appointments a patient is able to book

Francis, Digital Marketing Executive

• Switch order of appointments on past appointments page so that the newest appointment is listed first

• Would like the acknowledgement that the appointment has been booked before it takes you to the upcoming appointments page. Perhaps a screen that pops up for, say, two seconds that then fades would work well

Katherine, Allocator

• Thought ‘male’ and ‘female’ referred to herself, not the GP

• Potential to add appointments that have been booked at other clinics. She mentioned that she also goes to a family planning clinic and it would be useful to her to be able to log such appointments

Adam, Retail assistant

• Would like to select days using a calendar view

• Was unsure whether doctor was able to see notes

Hannah, Product Manager

• Needs more space for finger to scroll (work into designed up versions

• Could provide options for only showing early and late appointments and have ‘show all’

Sophia, Marketeer

• Unsure whether appointment has been confirmed

• On the review appointments screen it could say ‘next appointment’ for clarity

• Could users be separate on the review appointments screen

• Can doctors see notes? Could replace with ‘personal notes’ if not. Would this screen allow you to add free notes, or would it feature fields such as medication name or dose

• Filter section could have show/hide options

• Click to call option

Client feedback: UX Lead at NHS Choices

Name: Sean Russell

Location: London

Job: UX Lead of the Digital Campaigns Team

Workplace: NHS Choices

Create an account

• Emphasise the fact that data will be sent securely (see Dropbox and how they deal with payments) – secure logo

• Sign up could be more instant – remove personal data fields from ‘Create an Account’ page. Prompt user to edit this information later in ‘Accounts’, if anything changes

• ‘Create an Account’ page could be simplified to email address, password, mobile number, patient number and practice

• Show password automatically – shut eye icon to hide

• Autocomplete suggestions field for list of registered practices

• A text message verification number could be used for security (see mobile banking apps such as Natwest and Barklays)

• Replace ‘account ID’ with ‘patient number’. Replace ‘submit ID’ with ‘retrieve personal data’ – ‘we can autofill your details’

• If the user doesn’t know their patient number, they should ring their doctor

• Labelling should sit above the fields. Fields can be used to present supporting information such as DD/MM/YYYY

Booking appointments

• When it comes to booking an appointment for someone else, could the core user book their appointment, but not see their notes?

• ‘Confirm appointments’ page and ‘appointment confirmed’ could be merged

• Map – show how far away it is from current location or your home address

• Map – green dot to suggest ‘open’, red to suggest ‘closed’?

On-boarding

• Consider on-boarding screens. What will capture the user’s attention and guide them through the service? Mention security. And don’t forget you can edit your account later…

UI design

I have designed an interface with a consistent aesthetic that is compliant with the NHS brand guidelines. Feedback from wireframe testing has been worked into the design.