Healthy Living for people with type 2 diabetes alpha assessment
This is the alpha assessment report for the Healthy Living for people with type 2 diabetes service, on 28th January 2020.
Digital Service Standard assessment report
Healthy Living for people with type 2 diabetes
| From: | Department of Health and Social Care |
| Assessment date: | 28/01/20 |
| Stage: | Alpha |
| Result: | Met |
| Service provider: | Changing Health |
Previous assessment reports
No previous assessments.
Service description
Healthy Living Diabetes is an online self-management support programme and accompanying structured education pathway.
Service users
This service is for adults with type 2 diabetes.
1. Understand user needs
Decision
The service met point 1 of the Standard.
What the team has done well
The panel was impressed that:
- the team has ensured research is inclusive, and a diverse range of users have been included in research
- the team understands some of the challenging needs, for example language barriers and the need to have a face-to-face connection in some circumstances
- there was a good mix of research methodology
What the team needs to explore
Before their next assessment, the team needs to:
- understand more about user needs in the sense of value, relevance and trust: whether users understand why they are asked to create an account
- do more research to understand how users deal with managing their condition at the moment - only five users for contextual research is not enough
- understand how users are dealing with their situation if they are at a risk of developing the disease, and ensure they are able to navigate and find the information they are looking for with ease
- continue researching and testing with all types of user across a diverse range of backgrounds (including users of assistive tech and those that fall in the assisted digital spectrum)
2. Do ongoing user research
Decision
The service met point 2 of the Standard.
What the team has done well
The panel was impressed that:
- the team is testing the service with a diverse range of users
- there is a research plan for the beta stage
What the team needs to explore
Before their next assessment, the team needs to:
- do ongoing user research, especially when new information will be added to the site
- reflect user research findings in design changes
- ensure the service is tested with users on different devices, tablets, mobiles
- test the end-to-end journey with users who fall in the assisted digital spectrum (users who lack confidence, have limited digital capability or who are offline)
- carry out further research to better understand the emotional needs of users, for example where or whom would they turn to for help
- do more research to better understand users’ need to trust the information and the need to feel like the service is of value and relevant to them
- address the very low number of users seen or spoken to in contextual research in order to understand the emotional, support and trust needs that have not yet been uncovered, for example users who live outside of the UK some of the time
- seriously consider an external accessibility audit of service
- test the service with a diverse set of users who would use the service now or in the future
- identify key scenarios when the user will interact with the service, clarifying their context and what information they might search for at different times
- use these scenarios to test key features and prepare for user behaviour to change in beta (for example, looking at how interactions change day-to-day and how the service fits into users’ daily lives)
3. Have a multidisciplinary team
Decision
The service met point 3 of the Standard.
What the team has done well
The panel was impressed that:
- there is a good range in digital roles, with one or two gaps (in particular an assisted digital lead)
- there is appropriate separation between roles, and individuals have distinct responsibilities
- the team can make and implement technical decisions quickly, and is attempting to keep improving the service based on user needs
- there is a specialist content designer improving existing licenced content (and feeding this back to the licence owner)
- there is a well-resourced user research team attached to the service
- the team is doing a good job of overcoming the logistics of working across different organisations and in different locations, using a selection of agile tools and methods
What the team needs to explore
Before their next assessment, the team needs to:
- hire or assign an assisted digital lead to carry out and/or commission the accessibility work that is required
- hire or assign a dedicated and experienced service designer to address end-to-end journeys and scope services to meet user needs in an efficient way
- describe its plans to transfer knowledge and skills from contractors (and subcontractors) after contracts expire
- keep doing user research, alongside its plans for quantitative analysis, particularly as the content will keep changing
- review the how user research and design colleagues work together, considering how user insights are translated into design solutions, to effectively improve the service
4. Use agile methods
Decision
The service met point 4 of the Standard.
What the team has done well
The panel was impressed that:
- there was good use of agile tools and techniques, and there seemed to be a good cadence of work
- governance is agile, based on clear and measurable goals, and the team has made a concerted effort to influence stakeholders towards more agile ways of working
- the team showed evidence of iterating the service in response to user research, but this was less extensive than the panel would have expected
What the team needs to explore
Before their next assessment, the team needs to:
- ensure findings from research can be used to challenge assumptions, rather than validate decisions that have already been made
- ensure the platform’s architecture does not limit the design decisions that user research indicates need to be made
5. Iterate and improve frequently
Decision
The service met point 5 of the Standard.
What the team has done well
The panel was impressed that:
- the team has established a process for identifying and prioritising insights from user research
- the team has an understanding of how user stories interact with the service to produce positive clinical outcomes
- updates have been deployed frequently
What the team needs to explore
Before their next assessment, the team needs to:
- keep asking wider questions about the overall approach it is taking to solving the problem
- continue to do user research, which will:
- enable it to gain a better understanding of prospective users
- improve the prototype(s)
- reduce the risks of the service being used in unforeseen ways
- be prepared to make larger structural changes to the service in response to user research and accessibility audits
- ensure the service is tested on different devices
- ensure all journeys are tested with all types of users including users of assistive tech
- be clearer on the journey of the service through the relevant phase
6. Evaluate tools and systems
Decision
The service met point 6 of the Standard.
What the team has done well
The panel was impressed that:
- the service will make use of GDS-compliant, up-to-date architecture, based on:
- Google Cloud
- Kubenetes containerisation
- Mongo SQL database
- Google Analytics
- the architecture makes use of microservices and loosely coupled building blocks to enable it to flexibly adapt, according to how the service requirements evolve
- the diagrams the team presented to the panel were easy to understand, pitched at the appropriate level of detail, and illustrated to the panel how the underlying technology supported the service’s business processes
What the team needs to explore
Before their next assessment, the team needs to:
- explore any ways in which service can be further automated from a technical architecture perspective
- explore the use of simulation tools (for example Simul8 and AnyLogic) to see if they will offer an efficient and scalable way to model the process and data flows that underpin the service, and compare these methods to the current tools
7. Understand security and privacy issues
Decision
The service met point 7 of the Standard.
What the team has done well
The panel was impressed that:
- the service is using GDS-compliant security technologies including: kuber and kuber libraries and Laravel open source libraries
- the service will follow OWASP, SANS (Institute) and WCAG 2.1 accessibility and security guidelines in implementing the service
- the service will be GDPR-compliant in its use of encryption
- annual penetration tests will be performed
What the team needs to explore
Before their next assessment, the team needs to:
- provide results of security testing taking place on the prototype service
- explore the use of NHS Mail for secure exchange of data
8. Make all new source code open
Decision
The service met point 8 of the Standard.
What the team has done well
The panel was impressed that:
- the team plans to make the service open source code (including Laravel open source libraries) to implement the service
What the team needs to explore
Before their next assessment, the team needs to:
- explain how it is making new source code open and reusable
- show its code in an open internet source code repository
9. Use open standards and common platforms
Decision
The service met point 9 of the Standard.
What the team has done well
The panel was impressed that:
- the team has explored integrating with third parties and is exploring moving away from scheduling
What the team needs to explore
Before their next assessment, the team needs to:
- explore the feasibility of incorporating NHS Login into the service
- explore the feasibility of incorporating the Personal Demographic Service
- explore if the JISC learning analytics service would be of benefit to this service
10. Test the end-to-end service
Decision
The service met point 10 of the Standard.
What the team has done well
The panel was impressed that:
- the team showed a coherent plan of how the business process will be supported by the underlying technical architecture
What the team needs to explore
Before their next assessment, the team needs to:
- present the results of how the service will scale as uptake increases, including the impact on cost
11. Make a plan for being offline
Decision
The service met point 11 of the Standard.
What the team has done well
The panel was impressed that:
- the team understands and articulates how the service complements face-to-face resources very well
- there is redundancy on Google Cloud and backups, and the service could be transferred to another cloud provider if necessary
- there is a service-level agreement with the platform providers for support, including disaster recovery
- the team aims to be back online within 24 hrs (RTO and RPO) after an outage
- there is an option to provide more extensive telephone support if necessary
What the team needs to explore
Before their next assessment, the team needs to:
- explain how unavailability of service will be handled by GPs and at individual trust level
- provide results of end-to-end service testing
12: Make sure users succeed first time
Decision
The service did not meet point 12 of the Standard.
What the team has done well
The panel was impressed that:
- the team has made a considerable effort to make the training content as easy as possible for users to absorb and retain the key messages
- the team is iterating and testing the prototype with users
What the team needs to explore
Before their next assessment, the team needs to:
- step back and explore a wider range of design concepts
- identify the main problems this service is solving for users and let this be the principle driving design decisions
- be more radical and iterative in its design process, for example creating wireframes to make rapid prototypes of pages that it can then discard, while measuring the practicality of design concepts
-
demonstrate how it has mapped out the user journey(s) for the service, including:
- user needs at each step
- pain points
- opportunities
- interactions between users and stakeholders who deliver the service
- other key parts of the service
- reexamine how the digital service complements face-to-face structured education, in particular which looking at where the different channels aim to solve different or overlapping problems
- look at best practice in digital education, publishing of trustworthy information and digital behaviour change, with the aim of incorporating the lessons it learns into the design the service
- consider what guidance they should provide for the users to be able to self-manage the service as far as possible
- identify any risks that would prevent everyone using the service and how these could be overcome
13. Make the user experience consistent with GOV.UK
Decision
The service met point 13 of the Standard.
What the team has done well
The panel was impressed that:
- the team is working towards following GDS standards, but complying to the NHS style guide
What the team needs to explore
Before their next assessment, the team needs to:
- consider how to deliver regular iterations and deployments to the service throughout the beta phase and be wary of viewing beta as simply implementing what was designed in the alpha phase
- ensure the service speaks users’ language, rather than trying to teach users new terminology in order to understand the service
- make sure the names of service features match the thing that users are trying to do, as reflected in their high level user needs, using their own language (for example, naming functions as verbs like “find out more information” rather than nouns like “reading room”)
- test the new service with more users with a wider variety of assisted digital needs and create an assisted digital support model
- plan to explore accessibility needs in beta and how the service will take the necessary steps to meet the accessibility regulation
14. Encourage everyone to use the digital service
Decision
The service did not meet point 14 of the Standard.
What the team has done well
The panel was impressed that:
- user stories took account of real users, user demographics, attitudes, behaviours and channel preferences
- the team has a plan for increasing digital take-up, balanced with delivery through other channels
- the team is making a real effort to serve hard-to-reach groups
- the team is looking at plans to make the service available in other language
What the team needs to explore
Before their next assessment, the team needs to:
- urgently engage an accessibility expert to audit the service and identify obstacles for users with assisted digital needs
- do much more than be aware of accessibility requirements, and actively start adapting the service so it meets them
- get the board’s buy-in to investigate how far the log-in process presents an unnecessary barrier to users accessing the educational content
- reconsider using geoblocking on the service, as this might exclude users who are on holiday or live aboard some of the time
15. Collect performance data
Decision
The service met point 15 of the Standard.
What the team has done well
The panel was impressed that the team:
- has plans to iterate and improve the service based on analytics
- says that it can push back against organisational pressures to collect audience insights, where this is to the detriment of user experience or outcomes
What the team needs to explore
Before their next assessment, the team needs to:
- ensure that measuring the benefits of the service by collecting user information does not undermine the benefits it can deliver
16. Identify performance indicators
Decision
The service met point 16 of the Standard.
What the team has done well
The panel was impressed that:
- has ambition to map usage to clinical outcomes
- the team is confident it can push back against organisational pressures to collect audience insights, where this is to the detriment of user experience
What the team needs to explore
Before their next assessment, the team needs to:
- understand where and how user journeys taper and end, including how user engagement continue in the reading room stage and what good performance looks like
17. Report performance data on the Performance Platform
Decision
Not applicable at alpha
18. Test with the minister
Decision
Not applicable at alpha
Published 11 August 2022