User research in covid

By Rochelle Gold, Head of User Research at NHS England. 


For user researchers, the implications of the pandemic have been challenging.

The first lockdown in the UK prompted questions about user research. Should it continue? Could it be conducted remotely? Would we be able to get participants?

Our tech teams at NHS Digital had to deliver new products and services quicker than ever before. People questioned whether user research would get in the way and slow delivery down. They even questioned whether it was ethical to take time away from frontline staff by conducting research with them.

Research is more important than ever.

The reality is that during the pandemic it has been more essential than ever to carry out user research. If products are still being developed, then user research and user-centred design must still take place.

What’s worse? Taking frontline staff away from their work to take part in user research, or delivering a service that people can’t use, doesn’t meet user needs, and creates the need for workarounds for colleagues who are already overworked?

We do not have the time to create products and services that don’t work. For me, it is unethical not to conduct user research with frontline users.

Researching now saves time, money and energy later

Some organisations have spent years trying to get people to adopt and use their new product. But mid-pandemic, it’s more important than ever that our users’ needs are met so they can use things now. User research does not slow down delivery, it helps us deliver the right thing, faster. We are managing many risks, making many decisions very quickly, and doing everything at scale. We need information, evidence and data. User research gives us this.

How we adapted for remote working

Since lockdown, we’ve been using video or telephone calls for interviews and prototype testing, and using virtual whiteboard tools for co-design and analysis sessions. This means that we are not onsite when researching with healthcare professionals or patients, and we can’t observe people in their natural environment (an activity we call ‘contextual observation’).

In the past, user researchers at NHS Digital have conducted observational research in accident and emergency departments, operating theatres, screening laboratories and GP practices—even in the back of ambulances responding to emergencies. But now we have to prioritise patient, participant and researcher safety. This means that we’re unable to conduct contextual research in most settings, and we may miss some contextual cues.

Remote research has become contextual research (at least for now)

Everyone is working from home, including GPs and practice staff, user researchers, and users. But this is the context of use now. If we are developing services that need to be used during a pandemic, then this is where we need to study and research them. The use of video calls gives us a peek into their context. They help us to understand how people are working and interacting with services that are conducted over telephone or videocall. In fact, just by conducting user research by videocall, we have learnt a lot about the barriers and implications of interacting with people remotely.

Speed versus robust insights

Throughout the pandemic, we’ve been conducting user research on covid-19 services and sharing findings and analysis within days.

For example, user researchers working on a new covid-19-related service became aware of something on a Monday morning and delivered findings on Tuesday for something that went live on Thursday. This meant that in the early stages of the pandemic we were researching with people we could access easily; those who were online and those who had put themselves forward to take part in research. This biased our participants to a certain group.

In our push to deliver quickly, we were missing seldom-heard voices, often those disproportionately affected by covid-19. We recognised that turning user research around in 2 days was not sustainable. Nor was it a strategy for robust research findings. There is no point having insights if they do not tell you about those most likely to need your service. Sometimes it’s better to have no research, rather than research that just ‘ticks the user research box’ and gives people a false belief that they are delivering the right thing.

Throwing more people at the problem wasn’t going to solve it. We needed skilled user researchers and more of those participants whose needs are masked in large surveys and data sets. We needed to look up out of blinkered delivery mode and move to a ‘furthest first’ strategy of user research.

Services for everyone

We specifically conducted research with people recruited through community groups in Black, Asian and Minority Ethnic communities, and those with low digital skills and access needs. We also worked with interpreters to conduct research with people for whom English was a second language. The changes they highlighted were things that would support the needs of everyone.

It’s important to work with communities in the long-term to improve our user research practice. These communities have had enough of people dipping in to do their job and then disappearing once they have what they need.

There’s no doubt that covid-19 has accelerated trends in remote research, cross-organisational working and multi-organisational teams. Also, worryingly, the trend to tick the user research box. The demand for user research has never been higher, which is great. The rich, robust evidence base it can provide is essential when making high risk, high profile, quick decisions.

We need relationships with communities, the tools to deliver and leaders who are able to join the dots to ensure we are not excluding significant groups of people in our rush to deliver. We need to make sure that user research and service design are present at the same levels as delivery, product and development. We need to be truly multidisciplinary at every level.

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