Transformation Directorate

Why we involve people and communities in digital services

NHS organisations have an ethical, moral and legal duty to involve people and communities in developing and designing services.

The ethical and moral duty is enshrined as a fundamental value in the NHS Constitution.

The NHS Constitution

"The patient will be at the heart of everything the NHS does"

”It [the NHS] should support individuals to promote and manage their own health. NHS services must reflect, and should be coordinated around and tailored to, the needs and preferences of patients, their families and their carers… Patients, with their families and carers, where appropriate, will be involved in and consulted on all decisions about their care and treatment. The NHS will actively encourage feedback from the public, patients and staff, welcome it and use it to improve its services.”

The legal responsibility to involve people in developing and designing services is set out in 2 pieces of statutory guidance for involving people in health and care.

The involvement of, and collaboration with, people and communities should be incorporated into our delivery approaches as an integral part of the product or service development life cycle. As the statutory guidance outlines, involving people and communities from an early stage enables people to:

  • voice their views, needs and wishes
  • contribute to plans, proposals and decisions about services

It also generates a better and more sustainable outcome, and ensures we are producing what people need and want. We need to ensure that we build long-lasting relationships with people and communities, rather than transactional approaches.

Involve people at all stages

Developing policy and strategy

We should enable people and communities to participate in our decision making. They can provide critical challenges, ensure we are focused on the right things and help us solve difficult problems. This might mean having patient, carer or citizen representation on programme boards, advisory groups, committees or other governance structures.

Read more about how to involve people in decision making and governance.

Designing and building digital services

This includes gathering user requirements, testing, getting feedback, and ongoing improvements throughout the service lifecycle. This is typically through user research, as well as working with specific people, networks or groups.

Read more about how to involve people in research and service design.

Delivery and implementation

People and communities can play an important role in determining how users engage with our services and how we drive uptake and scale. They can also help with iterating and improving our services, and with how we communicate about them.

Read more about how to involve people in commissioning and delivery.

People and communities interact with our work in different ways

For some products, services and policy areas, people and communities may not be direct beneficiaries. However, as ‘shareholders’ in our work they have a ‘stake’ in making sure that we are focused on the right priorities and that we are delivering in the right way. We should therefore think about:

  • people, patients and service users as end users
  • people as beneficiaries
  • care professionals who will have enormous experience and insights from thousands of interactions with patients
  • active citizens, who are motivated to support strategic and policy thinking across our portfolio of work and programmes
  • carers who are supporting loved ones through illness or disability, and are likely to be actively involved in their medical and care journey