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Role: Service Design lead

Improving diagnosis & treatment through online & offline service redesign

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The challenge

Chronic Kidney Disease (CKD) is common, underdiagnosed, and disproportionately impacts communities already facing health inequalities. While clinical guidance exists, early diagnosis in primary care remains low.

 

The aim of this project was to support earlier identification, improved patient outcomes and scalable change across the NHS. This project used large-scale population health data to pinpoint gaps in the system and to design small but high-impact digital and physical service interventions that could be embedded into existing care pathways.

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Service blueprint of key insights mapping to the clinical pathway and backstage processes

The approach

In partnership with AstraZeneca, Imperial College Health Partners, NW London ARC, and the London Kidney Network, we led service design and patient engagement to shape more effective CKD pathways. Using the NWL Discover dataset (covering 2.5 million patients), we identified gaps in diagnosis rates - particularly for high-risk and underserved groups.

 

We conducted indepth co-design with 21 patients and 19 clinicians, many of whom were working or living in communities affected by poverty, comorbidities and systemic health barriers. The design approach was trauma-aware and adapted to meet patients’ varied comfort levels with healthcare systems and digital technology.

 

The outcome

We developed and tested a set of targeted, evidence-based interventions including: improved digital coding templates, early-stage patient education materials and CKD screening prompts embedded into GP workflows.

 

These were tested in live primary care environments and demonstrated both clinical and economic impact, with a clear roadmap for national scaling across the NHS.

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A storyboards created to explain one of the intervention to clinicians

Creating a digital medication support platform

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