Manage your referral (MYR)

The MYR system is the component of e-RS that is designed to be utilised by patients. When clinicians create a shortlist of clinics for patients in e-RS, it is MYR that allows patients to then select and manage their referral and any appointments they may require as part of their healthcare journey within the NHS. The functionality of the service encompasses the following: It enables users to check the status of their referrals, manage any support services they may require, and make, review, rebook, or cancel any appointments that form part of their referral.

https://refer.nhs.uk/login

Challenge

The pre-existing version of MYR was notable for its inability to provide patients with sufficient, non-alarmist information regarding what they were supposed to do once they had been placed on a referral pathway. The ambiguity of the messaging, coupled with an overreliance on clinical terminology, often led to users either seeking clarification from their General Practitioners (GPs) or contacting the 111 service for assistance.

It is also noteworthy that many users reported that the perplexity surrounding the journey and the messaging was exacerbating their stress levels, which was an undesirable situation for individuals who were already grappling with significant anxiety due to their health status.

The pre-existing service had been delivered with almost zero design input, and this extended to the designs not conforming with the NHSE Design Standard, which was another issue that had to be addressed.

What we did

Understanding the problem

In order to ascertain the primary pain points of MYR users, the feedback received by GPs, helpdesk operators and administrative staff from patients was closely examined by the research team, who were working in conjunction with a Service Designer. The investigation revealed issues such as confusing and sometimes alarming messaging, insufficient explanation of certain key statuses (cancelled appointments, for example), and a lack of clarity around what certain available clinic types entailed prior to booking (referral assessment clinics, for example).

Gathering these insights was invaluable in providing direction for our onward design work.

Content is key

In view of the fact that the research indicated that on-page messaging was the most significant cause of user distress when using the service, it was evident that this was the optimal area to focus on.

In collaboration with a content designer, subject matter experts, and clinical specialists, a comprehensive analysis of the service's language and tone was conducted. This analysis aimed to identify opportunities for simplifying and refining the on-screen messaging to ensure it was more palatable for users. This initiative enabled the rectification of misperceptions among users regarding the nature of the process they were undertaking. The adoption of more accessible language proved to be a pivotal factor in the success of the initiative, as it not only alleviated concerns among users but also ensured the preservation of the fundamental service elements, thereby circumventing the need for substantial refactoring expenses. This approach not only saved the client time and resources but also ensured the continuity and integrity of the service delivery process.

Applying the NHSE Design Standard

As previously stated, the service had been delivered with minimal design input. This had resulted in the implementation of NHSE design components being erroneous, poor form validation, limited WCAG 2.0 compliance, suboptimal responsiveness on handheld devices, and a page structure that did not effectively communicate the status of a patient's referral.

The implementation of a streamlined page design template was undertaken to ensure that the core message or purpose of each page was articulated with clarity and conciseness via the H1, in addition to providing clearly defined, hierarchically structured sections that elucidated the subsequent steps required by the user. Furthermore, it was imperative to ensure that the culmination of any transactional segment of the service (for instance, scheduling an appointment) was distinctly marked using the requisite "Review" and "Success" pages. This is a feature lacking in the legacy service.

Testing with users

Prototypes were constructed and evaluated with users over a period of three months. A side-by-side comparison of the legacy and future service was also conducted with users, with the aim of eliciting meaningful feedback on content and design decisions.

PA simple login journey with 2FA ensures patient security and confidentiality

Empowering users to book appointments at a date and time that suits them.

Providing reassurances to the user about what to expect and what they need to do proved to be highly valued by our users.

A simple hub page allows users to keep track of all their referrals and appointments.

My role

In my capacity as a consultant for SPARCK/BJSS, I collaborated with both permanent NHSD team members and civil servants. My role was that of Lead Designer. The responsibilities entailed:

Outcomes

Following the implementation of the system, a significant decrease in calls to GP practices and the NHS 111 service has been reported by NHS colleagues. These calls pertained to patients in need of assistance with referrals. The MYR system has been integrated into the NHS app and is also available as a standalone service that can be accessed independently of the NHS app.