This case study explores the successful implementation of an online GP registration service in the NHS, addressing inefficiencies in the paper-based process and enhancing accessibility for both patients and GP practices. We aim to develop a unified system in England that provides an automated process to help GP practices reduce registration burden.

GP Registration Service: Breaking Down Barriers for Patients and Practices

The NHS GP registration system Service design.

Responsibilities

As a Service and UX Designer, I played a role in understanding user needs, improving the user journey for GPs and patients, and addressing pain points through innovative design solutions.

Hypothesis

Streamlining and digitising GP registration will reduce administrative burdens, improve data accuracy, and enhance patient access.

Methodology

Utilised a user-centered design approach, involving extensive research, user interviews, and iterative prototyping to enhance the online registration experience. Collaborated with the GPReg team, incorporating agile methodologies for project development.

Goals

Simplify and unify the GP registration process.
Alleviate GP workload.
Enhance patient experience and reduce inequalities.

Key Findings:

01.

Over 750,000 patients used the service since its 2022 launch

02.

1/3 of GP practices now offer the online registration service

03.

48% of registrations occurred outside normal GP hours

04.

2/3 of patients used the service to switch GPs

Problem Statement

As a GP practice, I'd like to streamline the GP registration process by implementing a modernised digital solution SO THAT I can reduce inefficiencies, and confusion for patients and alleviate admin burdens on GPs.

UX Research Insights:

Navigating Confusions

Patients confused about registration location and steps

Users struggle
with content comprehension

Importance of clear registration location communication

Barriers and
Pain Points

GPs require additional questions

Patients face challenges with paper form registration

Streamlining

content to reduce overwhelm

Communication Challenges

Emails to GPs are often overlooked

Patient concerns about data privacy and Home Office sharing.

Need for clearer communication on rejection reasons

Language and Accessibility

Language barriers impacting registration

Uncertainty about language support at GP surgeries

Most spoken languages in the service are Chinese and Portuguese

Address and Catchment Issues

Manual entry required for new addresses

Lack of clarity on catchment areas

Difficulty registering without address documents

Accessibility
Audit

Duplicated Page Titles: Page titles now unique for better identification.
Non-Descriptive Image Links: Updated NHS logo description for clarity.
Time Adjustable: Aligned session time with NHS standards, exploring opportunities to extend inactivity duration.
Fieldset and Legend: Comprehensive update for various components; collaboration with the react component library owner for future improvements.
Unlabelled Form Fields: Explicit labelling for form elements, enhancing accessibility.
Low Colour Contrast: Updated the React library to meet NHS colour standards; coordinated with the component library owner for sustained improvements.
Conversion of Modals: Transitioned remaining modals to new tabs for improved accessibility; collaboration with design for content optimisation.

Journey Map

01

User starts registration

Language barriers. Provide language support

06

Completion

Address-related challenges Implement address auto-detection

02

Enters personal details

Confusing content. Simplify information

07

Feedback and additional information

Admin time concerns. Streamline feedback process

03

Chooses GP and submits

Registration barriers. Optimise GP process

08

GP staff

verification

Family registration difficulties Facilitate family registrations

04

Confirmation and
NHS login

Communication worries Clarify data usage policies

09

System checks and integration

Digital take-up obstacles. Improve user education

05

Verification
(if needed)

Technology confusion. Offer user support

10

Confirmation

Overall user satisfaction. Encourage feedback and improvement

Archetypes

The Efficiency-Driven GP

Characteristics: Seeks streamlined processes to save time.
Needs: A registration system that is quick, efficient, and minimises administrative workload. Prefers clear communication to avoid confusion.

The Efficiency-Driven GP

Characteristics: Prefers manual processes over digital solutions.
Needs: A registration method that aligns with traditional paper-based workflows. May require additional support during the transition to digital systems.

The Inclusive GP

Characteristics: Values personalized patient care and tailored questions.
Needs: A registration system that allows customization of questions to provide optimal care. Requires flexibility to adapt to varying patient needs.

The Tech-Savvy GP

Characteristics: Embraces digital tools and values efficiency.
Needs: Seeks a user-friendly, technologically advanced registration system. Appreciates time-saving features and is open to innovative solutions.

Cognitive Load Reduction

Simplified content to reduce cognitive strain during the registration process. Outcome: Improved user comprehension and a smoother registration experience.

Norman's 3 Levels of Design

Emotional, visceral and reflective. Outcome: A user-centric design that evokes positive emotions, aligns with user expectations, and encourages reflection.

Behavioural Economics

Persuasive design elements to encourage desired user behaviours. Outcome: Increased engagement with the registration process and improved adherence to the intended user journey.

Usability Heuristics

Applied Nielsen's usability heuristics to evaluate

system usability. Outcome: Identified and addressed usability issues, resulting in an intuitive and user-friendly registration interface.

Psychology of Design
Principles and Laws

Conclusions and Recommendations

Decisions

NHS Login Implementation:

Decision: Encouraged NHS login but made it non-essential.
Rationale: Balanced security and accessibility, ensuring a smooth registration process for users without NHS login.

Communication Clarity:

Decision: Emphasised clear communication and policy understanding.
Rationale: Addressed concerns related to data privacy, rejection reasons, and user confidence in the registration process.

Accessibility Prioritisation:

Decision: Prioritised accessibility in design and functionality.
Rationale: Ensured the online registration service is inclusive and user-friendly for individuals with varying needs and abilities.

Solutions

Simplified Language-Friendly Registration:

Implementation: Introduced clear and concise language, reducing complexity.
Outcome: Enhanced user understanding and reduced language-related barriers.

Family Bulk Registration:

Implementation: Developed a streamlined family registration process.
Outcome: Simplified registration for families, addressing the need for a cohesive and efficient approach.

Communication and Policy Clarification:

Implementation: Improved communication channels and policy documentation.
Outcome: Increased user confidence, reduced concerns about information sharing, and enhanced overall transparency.

Language and Accessibility Features:

Implementation: Integrated language support and improved accessibility features.
Outcome: Facilitated registration for individuals with language barriers and varied accessibility requirements.

Technology Usage Support:

Implementation: Provided user education and support for digital adoption.
Outcome: Addressed challenges related to technology, ensuring a smoother registration experience for users of all technological proficiency levels.

Impact

Time and Resource Efficiency: GP practices have reported saving between three to five minutes per patient registration, resulting in a substantial reduction in administrative burdens.
Transparent Communication: Clear communication channels and policy clarifications have built trust among patients, addressing concerns about data privacy and providing reassurance.
GP Rejections: Reduction on exceptions and rejections due to decrease in manual work.