01 Guidance Solution

This is targeted at patients to help ensure they have all the basic information about the department and how it works.

02 People Solution

Provides a forum for staff working in the department, supporting their interactions with frustrated or aggressive patients.

03 Toolkit

Free high-level design recommendations available online for NHS Trusts to make improvements to their departments. 


01 Guidance Solution
An information package that greets patients on arrival to inform, guide and answer questions creating a positive A&E experience.

Designed to be implemented in any A&E department, this solution provides a platform to communicate basic information to patients; such as, where they are, what happens next, and why they’re waiting. 

Information panels are implemented throughout the department so patients always know where they are within A&E and at what stage of care. These work as standalone items, as well as a series, and are customised to each Trust. A process map forms the core of the communication, and illustrates the patient journey as a series of stages, with a pause (or wait) between each stage. Displayed at full wall height in the waiting room, patients and visitors can very quickly learn the process for receiving treatment. 

A patient leaflet supplements the signage with further information about the department and contact details for other urgent care centres in the local vicinity. An incorporated tear off questionnaire provides patients and visitors with an opportunity to give feedback. 

The print material is complemented by a digital stream that communicates live, up-to-date information about the department. Existing data stored in the computer systems automatically updates the electronic displays, providing accurate and relevant information at regular intervals.

The original programme also included web and app based information delivery, to help manage pre-arrival choices and inappropriate attendance, as well as the potential for personal information delivery at a later date. We are currently in talks with a number of Trusts about developing this element of the solutions.

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02 People Solution
Working with frontline staff through reflective practices to support their interactions with frustrated, aggressive and sometimes violent patients.

The second design output works with staff, recognising the key role they play in delivering a better healthcare service. We offer a two-pronged solution. 

For current staff, a reflective programme provides a space for staff to consider - without blame - those factors that undermine their capacity to care for patients. The goal is to identify factors that impact the collective mood and to work to remove the root causes and to prevent them from occurring in the future.  An 8-week programme is conducted by an external facilitator with 8-10 members of staff across the department. We have developed a new tool, called the Incident Tally Chart, which is used during the programme to help focus on different variables within the system that might hinder the ability of staff to deliver high quality care.  The programme findings are reported back to management, helping the department as a whole to understand, learn and improve ways of delivering care.

This is supplemented by an induction pack for staff new to A&E, to inform them of issues they may encounter whilst working in the department. This ensures that staff, such as trainee nurses and junior medics, have the required knowledge to work in this highly pressured environment. 

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03 Toolkit
Guidelines to help ensure the built environment is optimised for patient comfort.

This is an online guidance document that offers free high-level design recommendations, which are focused more on the built environment or service changes. It is aimed at NHS managers, clinicians and healthcare planners, who want to develop and deliver a better service in effective and inspiring environments. 

The toolkit breaks the patient journey down into its different stages of the A&E process and presents case studies of best practice that are in place at other NHS Trusts. It is intended to be used by all NHS staff, while also providing a reference source for architects or interior designers working on new-build projects. 

The toolkit can be accessed here.

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A number of documents are available to download. 

For information about the project, design solutions and implementation packages, please click on the links below.                                                                           

> Summary Document pdf

> Full Document pdf


If you're interested in information about the evaluation study of the pilot trusts as conducted by Frontier Economics and ESRO, please click on the links below.  

> Summary Evaluation pdf

> Full Evaluation pdf


The video below explains the problem, the design solutions and the results from the recent evaluation. 


Animation produced by Matt Wilson Designs for the Design Council.