Envisioning the Future of Public Healthcare  — The Role of the Designer in Making Speculative Futures Tangible

by Alaa Alsaraji 

Commissioned by the Royal Free Charity, ‘Beyond the Fog: a future for public healthcare’ is a major new report recently presented at the Royal Society of Medicine’s Future of Medicine Conference and due to be formally published in September that describes a 10-15 year vision for person-centred healthcare in a technology-enabled 21st century.

The report looks at how the burden of disease has shifted from acute to chronic disease and takes a sweeping look at the major scientific, medical and tech trends impacting the health and well-being landscape. It re-imagines a future when all these trends have “landed”.

In the report, we have described the new capabilities likely to arrive at scale in the next 10–15 years and a vision that can embrace these to offer:

  • Transformational improvements in the nation’s levels of health and wellbeing
  • A pathway to building a sustainable, integrated 21st Century public health and care system
  • An engine for economic growth and social renewal

The ambition is to shift the focus of public discourse around the future of healthcare away from solely the short term, pessimistic attempts to shore up a system designed for a previous age towards galvanising the ambition and resources required to transition to a system fit to meet the challenges of the 21st Century.

IInitially, my role as the designer was, as it is often defined to be, the ‘communicator’. My challenge was to visually translate these complex and often unfamiliar ideas put forward in the report in a way that is both credible to experts across a diverse set of medical and technical fields and yet accessible to a wide range of stakeholders from politicians, to corporates, to the general public, without sacrificing nuance and detail. That manifested itself trough various diagrams and infographics accompanying the report.

However, we soon realised that we could do more to make this vision truly come to life and make the reader not only understand the information on a rational level but also on an emotional level. How can you communicate a holistic vision for the NHS while also translating that vision into the details of what these changes would mean for individuals? While it’s crucial to fully communicate the ‘big picture’ view, it is equally as important to bring the attention down to a ‘human’ level and make the proposed ideas relatable, making this speculative future more tangible.

This is when my role soon evolved from making the reader understand a new system to making the reader empathise with what this would mean from a patient’s point of view. How does this new health system change the way 68-year-old patient Peter receives his prescriptions? What does this mean for John’s access to mental health support after being told he’s at risk of developing diabetes?

In order to make the reader switch from thinking about this speculative future from a more abstract big picture standpoint to a more palpable ‘human’ level, we have developed a series of storylines aiming to make the reader empathise with the reality of patients in this future in a personal and more meaningful way. They outline individual patients’ interactions with the new health and wellbeing system and how each implemented change impacts their day to day life.


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This is where the role and aim of the designer shifts from merely communicating information to finding a way to create empathy and personal value for the reader. A major factor that allowed me to do this is truly being part of the process, throughout the development of the project, rather than ‘design’ being seen as an after-thought and the last step of polishing the outcome. As a designer, it was equally part of my role to develop the project conceptually, speak to junior doctors to develop storylines and scenarios. It was crucial to be immersed in the subject matter and develop an understanding for the complexities and nuances of the work, rather than sitting separate to the team, only being handed the work at the end to ‘make it pretty’ and hence feeling removed from the process, as is unfortunately often still the case.

You can find out more about the report and our ambition to drive longer-term thinking into the public healthcare policy debate at www.beyondthefog.org. The report will be launched in September and will be previewed at the Science Museum Lates event on 25th July.


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