For the last six months, I’ve been working on developing a design system for the NHS website, and associated digital services. You may think that ‘working on developing’ is a bit of a pointlessly long phrase, but it’s right. If I just said ‘developing’, you’d think I was working directly on the system itself. Assessing the existing design, working out improvements, establishing patterns, grids, and all that. But that’s only been a fraction of what I’ve had to do, to be able to get to that.

Somewhat naively, when Sophie and Matt asked me to join the team as visual design lead, I thought I’d have everything wrapped up in a few months — at least a baseline of standards and patterns that the organisation can use to build reliable, trustworthy tools and services. But a lot more needs designing than just the typographic scale.

The NHS has lots of talented designers, developers, writers and researchers, often working in tiny teams, in far-flung pockets of the organisation. Matt has been working tirelessly to locate them all and get them talking to each other. We now have a growing community, able to share ideas and experiences, and help move us to a more consistent approach to designing things.

Is that it?

Reflecting on my first six months here, I was initially alarmed at how little actual graphic design I had done, and how much time I had spent in meetings. This is always an anxiety for a designer, and I think the one thing that stops designers taking the next step up to more senior design positions. “But I’m a designer. Spending my life on conference calls will stifle my creativity!” It’s easy to think that, and as I looked at the number of Sketch files and prototypes I had produced, I thought, “is that all I’ve managed in six months?”

But then I started to think of all those meetings and workshops, and what they were for: sniffing out the accessibility champions in the organisation, to assemble a team, to formulate our inclusive design policy; meeting with people from the Government Digital Service, to share notes and draw on their experiences of putting design at the centre of a large organisation; observing user testing session after user testing session; taking part in workshops to develop a set of design principles for everyone making tools and services for the NHS; sitting in on Show & Tells for everything from healthy eating videos, to chlamydia services; talking to data people to understand what browsers we need to support; liaising with third party suppliers…

I came to realise that this is all essential, foundational work that needs to happen (or at least be on the way to happening), before you can produce much actual design. When design as a culture in an organisation is in a relatively embryonic state, you must design the environment where design can thrive. You are designing the design.


This is the kind of thing you need to be ready to do, as you progress in your design career. Making the right connections across departments is as important as establishing a balanced colour palette. Your system of governance over design patterns must be as robust as your grid. Your route to senior management and their understanding of your value needs as much attention as your font pairings. And like that one project that seems to go on forever, you will never be finished. There will always be something that needs tweaking. But that’s fine.

The skills you develop as a designer — understanding a problem, identifying a creative solution, convincing others to take action — are still the skills you use as you assume more senior roles. The craft is still there, it’s just that the detail you craft is between people and systems, not in your umpteenth ‘settings’ icon.

Lead designer. Personal website:

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