Health and design

When we think of graphic design, the seductive packaging and branding of high street communications or the entertaining and eye catching gloss of the media might spring to mind. Graphic design helps to organise information, stamp identities onto objects and parcel up messages that are easy for us to access. While the majority of graphic designers work in commercial sectors the need to apply design thinking applies to all public information, none least so than in the National Health Service. Andrew Clement works for the Welsh Ambulance Service and is a student on the OCA’s Graphic Design 1 module talks about his own experiences of being a graphic designer in the NHS.

Background
There is a constant demand within the NHS for printed materials – posters, fliers, leaflets – to communicate messages about NHS Services, Healthy Living, Rights and Responsibilities, Medical conditions and treatments and a huge number of other subjects to patients, the public and NHS staff.
How individual branches of the NHS manage their communications is largely down to them, providing they adhere to NHS branding and corporate identity guidelines. Many NHS Trusts will have their own communications specialists who provide their graphic design services, while others will contract this out to external providers.
However, in the current economic climate, there is enormous pressure on the NHS to make budget savings wherever possible, and it is becoming increasingly difficult for budget managers to justify spending £1000s on professional designers.
So against this backdrop, and through a mixture of luck and opportunism, I have been able to carve out a role for myself as Graphics specialist for one of the biggest NHS Trusts in Wales, the Welsh Ambulance Services NHS Trust.
I put a business case together outlining how the Trust stood to save money by doing all it’s graphic design in-house instead of paying external providers to do it, as long as the Trust bought the software and agreed to pay for some training, which is kind of how I ended up on the OCA Graphics course. So I now design pretty much all of the leaflets, posters and printed materials produced on behalf of the Welsh Ambulance Service as part of my everyday job.
I am currently studying the OCA Graphics module primarily as a means to refine and develop what are essentially self-taught skills in graphic design. I came to the course with over 18 months experience of working from briefs, using graphic design software, producing finished artwork, liaising with printers etc, which has been a useful background to the course work. I’ve also been able to use some of my NHS work to use as examples in some of the OCA Graphics exercises.

Working with the NHS Brand and Corporate Identity Guidelines.
The NHS has tried to ensure standardised, consistent branding is used in all it’s marketing and communications since it brought in guidelines in 1999. Through a dedicated website – http://www.nhsidentity.nhs.uk/ it provides a range of resources and detailed guidelines to support NHS staff and external suppliers in meeting the requirements of the guidelines. The guidelines stipulate everything from permitted colours from the NHS palette (Pantone and CYMK), to acceptable use of fonts, logos and other branding devices. So, this helps to make sure that a visual consistency is maintained across all NHS communications materials.
Working to vague briefs within constraints
It can, however, also seem very constraining at times, as there is little room for being creative or innovative, especially in terms of type and colours – no scope for any V23 inspired baroque flourishes here I’m afraid. Furthermore, the Welsh Ambulance Services has its own royal crest which has to be incorporated into every piece of printed work we produce.  As it is technically owned by the crown, it can’t be adapted, altered or reworked in any way. On top of all this, all posters and leaflets are expected to conform to RNIB guidelines for producing printed work which is still accessible to those with some kind of visual impairment – so that’s absolute minimum 12-point sans-serif fonts, no italics, no text overlaying images, high contrast between text and background etc.

Then there’s the Welsh language – everything I produce has to be bilingual and therefore somehow include English and Welsh versions of any text.  This throws up it’s own particular set of problems, including dealing with some of the ‘unique’ Welsh punctuation symbols, and the fact that any given sentence when translated into Welsh can have up to twice as many characters to try and squeeze in to the design.
Despite these constraints, the range of work I’m asked to produce ensures that there’s quite a bit of variety – since doing this job, I have been asked to produce everything from simple web-graphics to public information leaflets, complex flowcharts for staff, wallet-sized medical information cards, complete brochures, pop-up banners and other large format displays.
Since starting the OCA course and becoming more exposed to new ideas, I’ve slowly started to try and develop a definite style for the work I produce for the NHS, while still operating more-or-less within their branding guidelines. For example, I pretty much always use Arial Black for all main headings, banners and titles, but will sometimes mix it up with a bit of italicised Times New Roman for that kind of early 90’s Guardian feel – used this approach a few times and have got away with it.
I’m also trying to stick to uncluttered, white backgrounds, with text and images pared down to the absolute essential minimum wherever possible.  This approach isn’t always appropriate as I’m frequently given nothing but pages of text to somehow incorporate into a leaflet. But wherever I think it’ll work, I’ll try and use it.

Fortunately, I’m not required to proof-read the next – this has usually gone through at least half a dozen re-writes, with input from various committees, boards, focus-groups, stakeholders and all the usual suspects before it even gets to me.  Frequently, the only specific brief I get is to “make it all look pretty”, but they usually seem happy enough with the results.
Interestingly, I also sometimes get the opportunity to get my work critiqued – any leaflet we produce for the public has to be submitted to a readers panel made up of patients, carers and members of voluntary sector organisations for their comments and suggestions before it gets sent for final sign-off by a multi-disciplinary internal scrutiny panel.  While it is a useful process to go through in principle, it often results in a needlessly drawn-out process at the end of which you end up with a kind of patchwork of lots of people’s ideas and opinions, rather than a coherent, strong message.
But I can’t really complain, as I’ve ended up doing that most elusive, of things, a job which I enjoy and which allows me to direct my creative energies into an activity which gives tangible outcomes, as they like to say in the NHS. It also allows me to put into practice some of the new ideas generated through doing the projects and exercises from the OCA Graphics course.

While all designers have a client to work for, Andrew has had to deal with a user group to inform his creative decision-making. This form of inclusive design process has many benefits, shifting the power relationship away from the designer onto the end users, but it’s not always easy juggling the needs of a group, especially when, as a designer you have a strong sense of where your design work should go. However this user involvement has parallels with commercial design that uses marketing and focus groups for similar ends.
Andrew may be asked to simply ‘make it all look pretty’ in reality his role has been one of drawing people in, organising and prioritising information and dealing with the difficulties of bi-lingual communications. By applying Andrew’s skills as a graphic designer to the Welsh Ambulance Service it has improved how users access information directly by also raises expectations of public information. Why should the commercial sectors be the preserve of the best designers and the time and attention they apply to solving communication problems? The Helen Hamlyn Centre for Design at the Royal College of Art has been asking this question for the last 20 years, exploring how design can contribute to improving people’s lives by working with industry, patients and designers. Design thinking is about trying to negotiate the relationship between information and the user, identifying communication problems and solving them.

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