A short(ish) history of the NHS design system, Part 6: 2022 — where next?

Dean Vipond
4 min readMay 9, 2022

It’s been quite a ride. From the NHS alpha phase, adapting GOV.UK design patterns, and redesigning the NHS website, through to defining and sharing a system, which would ultimately be used by hundreds of practitioners in previously unthinkable circumstances, where next for the design system and service manual?

It’s already being used in lots of different scenarios. Of course, there has been the massive-scale COVID response services, such as Book a Coronavirus Vaccine, and Get a COVID pass, but it is also being used elsewhere.

A variety of screens from the cervical screening user interface.
Some screens from the user interface of the updated cervical screening system

Clinical systems have been using it for a while. The NHS e-Referral service now uses the system for both the public-facing and staff-facing parts of the system, as does the newly redesigned services in screening. NHS Digital designer Tosin has written a brilliant article about it.

It was always intended to be adapted for different creative executions. Public health campaigns can adapt the design system for a whole new campaign brand with its own art direction, but maintain the accessible fundamentals that underpin it. Check out the Better Health campaign site.

A screenshot of the NHS Better Health website. It features a yellow header with a man doing exercise and smiling. The main part of the website features promotions for healthy eating and exercise.

Even more interestingly, non-NHS organisations such as Our Future Health, have transformed it, but kept core elements such as grid system, buttons, cookie banners, and so on. Exciting! The design system team would love some feedback from people using it in these scenarios.

Crucially, we saw the design system as a way of influencing the whole health and care system, particularly raising standards in design and accessibility across a fragmented digital estate.

A tool for regional services

It’s being used for GP websites, and other health organisations are using it to build tools and services in regions, such as a Digital Journey Planner for primary care networks — fantastic!

With NHS England having recently hired a Head of User Centred Design for the Regions (the very excellent Pete Nuckley), I see the service manual and design system being a critical tool in encouraging digitally-enabled services, of a consistently high quality, to be implemented across the health and care system. Hopefully we will see well-funded teams at local level, able to experiment further and contribute back to the central resource.

The power and value of a design system in the health and care system has been demonstrated in the unprecedented wave of urgent delivery over the past two years. It helped the NHS and its users during a moment of crisis. It will also be a key tool for the NHS as it faces the post-pandemic challenges ahead of it.

Investment and community

A design system is not, can not, be merely a collection of front-end components. A design system is the condensed learning of hundreds of practitioners. Every mistake, every wrong turn, every A/B test has contributed to the snapshot you see today. A design system thrives on the continued stirring in of new learning, new thinking, more and more diverse contributors, which is why continued investment in community management is so important.

If a design system atrophies due to lack of maintenance or new thinking, it will eventually become a risk to innovation, rather than the springboard we intend it to be. So if you have benefited from using a design system, please think about how you might contribute to its future. Share your learning, propose new patterns, and join the community.

I’m really excited to see what the design system will do next — what its focus will be, and how it will help in the coming years of the NHS. With NHS Digital’s merger with NHS England, there is a real opportunity to spread the standards and ways of working which have been trialled and proven over the past 6–7 years, and continue to make life better for patients, carers and staff.

Footnote: due to the dozens and dozens of people who have contributed to what now forms the NHS service manual and design system, I have not named specific people throughout this set of blog posts, as it would be unfair to pick just some out. But endless thanks to all the people I have worked with during my time at NHS Digital.



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