A short(ish) history of the NHS design system, Part 5: 2020/21 — the COVID years

Dean Vipond
3 min readMay 9, 2022


There’s not much to say about what work happened on the design system in 2020–21. The information architecture of the service manual had been reviewed and iterated. The team were taking stock and thinking what to do next.

The NHS website content team had been working since January on a new condition page about ‘Wuhan flu’, which was being updated regularly.

At the beginning of March, I and a few others travelled to London for a meeting with some policy people, folks from the Department for Work and Pensions, and the Department of Health and Social Care. We were briefed about coronavirus, and how serious it was. We learned what contact tracing was, and we learned about the importance of making people who might have it, stay at home. It was chilling, and a bit unreal, but then we had to facilitate a workshop around what would become the Get an isolation note service.

And this is where the power of a solid design system really becomes clear.

“Number 10 wants it by Thursday”

We had two weeks to design and deliver the first iteration of this service. I shan’t go into the details of the service itself, but having robust components and patterns, meant we could focus on the actual problem in hand. Because of the design system, we didn’t need to:

  • think about how to ask for people’s personal details
  • think about the graphic design of components
  • think about how to code the interface.

Not thinking about those things allowed us to focus on:

  • what the service should do
  • how the service should function
  • what people’s needs would be
  • how we explain the service
  • technical stability and resilience.

We still managed user research (a couple of heroic researchers went and spoke to people on the street, just before lockdown, about what self-isolation would mean for them). We also quickly made a prototype to test with users, even when we just had a fortnight.

So, a small, agile, multidisciplinary team were able to spin up a simple service in just two weeks, thanks partly to the work we’d already done (as well as the team already being a high-performing one). Everyone was already well versed in user-centred design and build for health. We knew the components, standards and style guide well.

Designing for health? Right this way…

But there was about to be an explosion of activity, with huge numbers of practitioners new to health, many new to public sector design, that would need to be producing new services under incredible pressure.

I shudder to think of the disarray we would have been in, had we not a design system and service manual to give to people suddenly working in this field. We had researched patterns for common (but awkward) things like asking people for their NHS number. Suddenly we had GOV.UK colleagues having to publish health-aligned content on government sites, and we had style guidance for that.

Of course, things weren’t perfect, but our existing resources provided a grounding for teams. Those of us in more established roles could spend our time guiding new teams and refining their basic designs, instead of having to tear everything up, or have endless discussions about logo and button placement.

The service manual team itself had to be redeployed onto urgent services, so, quite understandably, running the design system and service manual itself had to take a back seat.

What next?

With the urgency of creating new COVID services now behind us, the team finally has the opportunity to take stock of the past couple of years, and look to the future. My next post will look at the variety of places the NHS design system has been used, and hopes for its future.

Read part 6: 2022 —what next?



Dean Vipond

Design leadership and human-centred stuff in general. Previously lead designer @NHSDigital and lots of other things. He/Him. http://www.deanvipond.com