Walking in others' shoes: service design and medical education

A 60 minute Case Study by:

Rodney Mountain

NHS Tayside

Hazel White

Open Change

About this Case Study

One of the aims of the Chief Medical Officer for Scotland's first annual report, Realistic Medicine, was to provide personalised care for patients. In order to do this health professionals must understand their patients' hopes, fears, barriers and needs.

Medical and dentistry education has a focus on building practical, skills-based medical knowledge. Once on the ward and in the community, doctors and dentists treat patients whose lives and experience are very different from their own. Service design methods offer an effective way of enabling trainees and clinicians to understand the needs and barriers patients face. This session shares how service design methods offer a safe, empowering way to step into patients' shoes and offer healthcare that meets their needs.

We discuss how service safaris and empathy and journey mapping have helped clinicians and dentists better understand barriers to healthcare. We will draw out conclusions on the lessons that can be learned and the implications for future medical practice and education.

'Hospital Service Safari' was a one day taster workshop at Ninewells Hospital and Medical School in Dundee introducing design thinking and service design techniques to healthcare professionals. Improvement staff, consultants and medical trainees navigated a large hospital to find clinics and experience them in the shoes of a patient.

'Chatterbox' is an initiative in Scotland to improve children's dental health. Scotland's children's oral health is amongst the worst in Europe. An awareness campaign launched to show children how to brush their teeth and remind parents to take them to the dentist had little effect as it didn't uncover the real challenges families had in attending dental appointments. A team from the University of Dundee's School of Dentistry worked with service designers to discover the issues, define the problem, develop ideas and deliver solutions that would enable families to attend regular dental check-ups.

In a two-day 'Service Design and Diabetes' workshop at the Dasman Diabetes Institute in Kuwait, family doctors, consultants and pharmacists explored how empathy mapping could help them understand the barriers people with diabetes have to understanding their condition and adhering to medication and lifestyle advice.

Outcomes include doctors and patients working together to better understand the experience and treatment of throat cancer, better attendance at dental check-ups and service design methods being incorporated into training in undergraduate dentistry and medical education and in continuing medical education.

About the Speakers

Rodney Mountain

Rod is an ENT cancer surgeon who has worked for the NHS in Edinburgh and Dundee for the past 30 years. He believes that health and social care is more art than science and that the patient experience should be enhanced by a design-led approach.

His CV includes a wide range of activity in cancer service provision, healthcare management, education and skills training, healthcare research and the design of novel surgical instruments. He has a commitment to creating an entrepreneurial and creative ethos within the public sector.

He facilitates links between health and social care, art and design under the philosophical umbrella of 'Healthcare Designed in Dundee'. This has led to a range of activities joined by principles of co-design, fostering healthcare engagement with citizens, the sciences, technologies, humanities, computing, gaming and the business sectors.


Hazel White

Hazel White is director of service design agency Open Change. She has 25 years' experience in design practice, research and education including setting up one of the first postgraduate courses in service design in the world.

She currently delivers a programme on change by design to 120 Queen's Young Leaders through the University of Cambridge. She has worked on strategy, service redesign, facilitation and training with health, government and business organisations including the Scottish Government, NHS Education, universities and colleges, the Scottish Public Pensions Agency, Dundee City Council and the University of Dundee's Medical School and Centre for Continuing Education. In addition to supporting organisations, she writes on prototyping, co-design and the value of design-led approaches to innovation.