Blog / Digital ReSPECT - what's in an interface?

Jonathan Waldheim: February 19, 2020

When we talk about developing (making) software, it is easy to get lost in the technical aspects of the work. I won’t go in to depth about anything like that. Those are stories for software engineers to tell.

This blog is about the evolution of the user interface for digital ReSPECT, the first product from NDS which helps people say what treatment they would like in an emergency if they can’t communicate. The blog will focus on how it looks on screen and how we’ve progressed from the paper form to date.

To get there, I’ll talk you through five steps:

  1. The paper form
  2. The prototype
  3. The new user interface
  4. The trial
  5. The future

1. The paper form

ReSPECT is a process designed by the Resuscitation Council UK which aims to improve anticipatory care planning and end-of-life conversations.

A paper form, designed by the Helix Centre, supports this process and is focused on the conversation between clinician and person.

Respect form 1

ReSPECT form 2

(The ReSPECT form version 2.0. Published by the Resuscitation Council UK and designed by the Helix Centre.)

This form is the basis of the work we’ve been doing, and we wanted to see if we can improve the process by adding a digital element.

The differences between paper and digital are quite stark, but the form always reminds us that the conversation must be front and centre in how we design. The form is a tool to prompt this conversation, capture the information making it easy to share.

Read more about the ReSPECT process.

2. The prototype

Last year, NDS worked with the Ripple Foundation to create the first version of this application. This was to be a proof of concept. Something concrete that shows the potential of a digital ReSPECT form.

This application was used to test ideas and engage with the people who might benefit from a digital ReSPECT form.

As we grew and started to have in-house development teams, it gave us something to learn from and to build upon.

3. The new user interface

Deciding to change

As with any proof of concept, there comes a time when a team must decide to turn a great idea in to a brilliant product. In December 2019, we decided it was time to update and give it a new look.

One of the deciding factors for this decision was the process we follow to make sure our work meets clinical safety standards. I won’t go in to too much detail, since we'll be sharing more about our clinical safety process in more detail in due course.

Have a read through DCB 0160 and DCB 0129 on the NHS Digital website if you are interested.

What we did

To make the change, we discussed how we might create a new interface and decided to move to the NHS.UK design system and component library. This gave us something to build upon and allowed us to take advantage of code and visual assets that have been well researched and tested.

The video below shows what the interface looks like now, as with any product development, this is not the final version. User feedback will help us to understand what does and doesn’t work:


4. The trial

So our interface looks pretty good, now what?

NHS Forth valley: Ongoing collaboration

Throughout the development of the application, we’ve been working closely with a small team in NHS Forth Valley who have given us ongoing feedback and offered us a real insight into the ReSPECT process in action.

In fact, we recently ran usability tests with people from this group to understand how they would interact with the new interface. Sitting next to them as they tried out the system with fake patient data, we noted their every interaction before having a group feedback session afterwards. All useful for us to continue to make the digital ReSPECT the most easy to use product.

NHS Forth valley: Trial

In the spirit of this continued collaboration, we’ll go live with a small group of users in Forth Valley at the start of March in a small scale trial, before taking on board feedback and rolling out across the health board.

Forth Valley testing

(In the photo above, NHS Forth Valley Royal Hospital staff take part in usability testing with a software engineer from NDS.)

5. The future

Can we involve technology in the conversation?

While wrestling with this piece of work, two questions of real interest have come up:

  1. How can a product support a conversation?
  2. What does a post-form world look like?

To help us understand further, we would love to hear from you about your experiences with technology in healthcare.

Have you used a tablet in a consultation before? Has a doctor shown you something on their phone? Do you find online forms daunting?

Tweet us, leave a comment below or send me an e-mail:


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