With the population growing, people living longer and patient volumes increasing, local GP surgeries are facing an uphill battle to manage communications and ensure patients are treated effectively and efficiently. To help ease the burden, NHS England is aiming for 25% of all appointments to be booked online. Encouraging patients to channel shift – where appropriate – away from the traditional methods of calling or heading into the GP surgeries is crucial to meeting these objectives and, as a result, the NHS South West Region Digital Transformation team commissioned Spindogs to deliver a new, standardised GP website solution as part of a pilot digital transformation scheme, aimed to boost the use of digital channels, encourage patients to utilise self-service where possible and alleviate pressure on GP practices and their staff.

The need for digital confidence

A lack of confidence in the current digital offering of GP practices is cyclical, causing patients to bypass GP websites entirely, as well as preventing GPs from having the confidence to signpost patients to digital channels. This is reinforcing a drive to favour traditional communication channels – telephone conversation and onsite visits – further adding to the workload of GP practices. It is evident there is a need for realignment of expectations and behaviours to give both patients and GPs confidence in their websites, in the form of recognised and familiar design, easily accessible information and self-service opportunities.

A patient-first approach

Over a 3-month period a comprehensive Discovery process was conducted to ensure our solution delivered against our patient-first objectives. This enabled us to establish a clear project framework, define technical requirements and create a considered sitemap for the standardised GP website.

The website Discovery process was aided by prior NHS research, consulting with GPs, end patient user groups and stakeholders to provide a data-led report on existing solutions and common user frustrations. Following a session with the NHS research team, we applied our Discovery methodology, incorporating Insights, Exploration, and Definition phases to develop a considered and actionable solution

Working with the NHS South West Region Digital Transformation team and pilot participants we agreed simplifying and encouraging the online completion of the following user tasks as the focus of our solution:

  • Make, change, or cancel an appointment
  • Obtain a fit note (formerly sick note) for work
  • Request a repeat prescription
  • Access test results
  • Register with/join a practice
  • Find practice hours, phone number, and address

Stakeholder engagement throughout the process revealed common issues such as information overload, inconsistent visual frameworks, accessibility issues, content discrepancies, too much inward facing /technical terminology and varying levels of editing capability and analytics understanding among GPs. The structure of the GPs also varied, with some being individual practices and others part of Primary Care Networks (PCNs). Whilst we aimed for a single standardised solution, it was clear that further consideration to tailor options for group level would be required.

We proposed a solution that was accessible and inclusive, adhering to NHS Digital Services Manual systems and principles to increase patient trust and produce a simple and clean user and editor experience, with a ‘patient-first’ approach to content that would empower patients to shift to online self-service.

An accessible experience for all

Accessibility was at the forefront of our thinking when it came to developing the GP website designs. To ensure compliance with WCAG AA accessibility standards, the website designs were evaluated and subsequently praised by Tetralogical, a third-party accessibility compliance specialist. We also conducted several user testing sessions with patients with a range of different accessibility needs, gaining valuable insights into their requirements for navigating the website and ensuring we designed and developed a website that prioritised their needs and provides an accessible experience for all.

This patient-first approach, combined with meeting AA standards, made the adoption of the NHS visual framework for the creative solution a no-brainer, enabling us to deliver a consistent, familiar, and trusted visual experience to patients. We approached the creative solution mobile-first to ensure that usability was foremost, with the vast majority of patients accessing their GP website on mobile. We designed a series of page templates and customisable content blocks that adapted perfectly for mobile, providing a fast, compliant, and accessible experience across all devices. Additionally, we introduced the option for GPs to incorporate a controlled element of branding, such as a logo and hero image, allowing them to showcase their personality and increase recognition amongst patients.

Promoting digital engagement

To help GP practices promote their websites and empower them to maximise their digital engagement, we also created a suite of marketing materials to be used across digital channels and within the surgery environment. These included a series of social media posts, newsletters and printed materials that GPs could choose to promote the website, and to start shifting patient behaviour.

“Beyond the functional outcomes of a project such as this, we are also grateful for the trust placed in us by the NHS South West Region Digital Transformation team. The Spindogs team has benefitted hugely from our involvement in the pilot. From the personal pride in making a genuine realworld difference, to the professional growth experienced by our exposure to NHS frameworks, accessibility experts and the patient groups, we are a better business for it.”

— Daniel Lewis Strategy Director, Spindogs

Empowering GPs with an intuitive CMS

AA standards don’t end with the design, and the implementation of compliant code was key to making the website reading experience truly inclusive. Our frontend code was similarly tested by Tetralogical to ensure compliance, and our CMS solution ensured an accessible experience for editors as well. Designing and developing with an accessible remit helped to ensure that UX was streamlined, and the reduced weight of the visual brand ensured that the standardised solution is incredibly fast loading. Allied to server-level compression and a dedicated hosting solution, the standardised sites ensure the swiftest experience, regardless of device.

A simplified editing experience

With often limited in-house digital maturity and a chronic lack of resources, it was imperative that GPs had an intuitive editing experience to minimise time spent maintaining their website once live. We delivered semi-rigid templates for brand consistency and accessibility, along with flexible page-building tools including a host of component parts, from accordions to forms. These tools allowed GPs to manage their website without compromising the visual framework, maintaining control to structure pages to suit their objectives.

Inclusive and accessible content

To further support accessibility, we created a detailed exemplar content pack with standardised copy for all web pages defined in the sitemap. Ensuring the content was inclusive, we aimed at a reading age of 10 to include non-native English speakers and those with challenges reading online content. This provided GPs with a baseline for their content and guidance on adapting their own copy to meet practice needs while mirroring the NHS language framework.

To ensure GPs were confident in managing their website, we provided comprehensive training and provided detailed training packs to guide GPs on maintaining and updating their websites, including best practice guides for writing online content, accessibility standards, and SEO tips. They also have access to training resources and continued access to Spindogs’ Support team post-launch, to continue to help them feel empowered in using and maintaining their website.

“Staff find it easy to maintain and like to have more forms come through electronically. Patients have found the website easy to access the relevant information”

– Concord Medical Centre

Instilling confidence with data

All sites involved in the pilot now have access to and ownership of their website analytics. The implemented data management strategy used the Google marketing suite: GA4, Google Tag Manager (GTM) and Google Search Console (GSC). GPs have direct access to individual analytics accounts, and individual reporting dashboards that offer a high-level overview of key data and measurements, showing patient engagement across all websites by region. The dashboards present key metrics including:

  • Key site measurements such as active users, new users, engagement rate
  • Key user journeys such as appointments, register, prescription, fit note requests
  • Popular pages
  • Broken pages

The new analytics suite allows PCNs, GPs, the NHS digital transformation team and project management teams to more quickly understand if the standardised GP website is increasing online appointments and reducing workflow pressures on GPs, specifically when used in conjunction with other metrics such as phone system data.

Driving lasting change

The standardised GP website solution has delivered genuine digital transformation, with measurable improvements to the experiences of both patient and practitioner, intent on driving lasting change to patient ownership of their mental and physical wellbeing. Since the launch of 17 sites as part of the pilot, early results have been positive and the viability of a patient-first, standardised solution has been established. With over 197k active users, 67k appointments initiated online and 3k new patient registrations in the first 3 months since launch.

The subsequent post-pilot Phase 1 rollout indicates a strong appetite for adoption from upwards of 50 surgeries in the South-West region and, with a further national rollout anticipated in time, the impact of the solution will be felt strongly and broadly for many years to come.

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