Making your user research user focused
Many user research sessions have a standard flow. The researcher sets the guidance and aims in advance, recruits participants and plans in ~45 minute sessions at times that work for both people.
At least that’s how it looks on paper.
Despite complexities in every round of research, much of this is the same when researching with GP staff. Until it isn’t.
Across several rounds of research with practice staff in England, I learned that a well-planned session may need to pause, change direction or stop altogether. Patient care comes first, and urgent work can take priority at any moment.
That changed how I approached the research. Recruitment needed to account for last minute changes. Sessions needed room for interruptions. Staff needed to feel comfortable talking about the work as it really happened, outside of how a process said it should happen.
These lessons apply beyond primary care and GP Practices. They are useful wherever research participants work in busy environments, move between different systems and deal with changing demands.
A complex landscape behind the scenes
Let’s start with the side of primary care most of us know. Appointments, prescriptions and referrals. What we do not see is the work that connects them.
People don’t anticipate that beneath the outward facade there is a really interesting web of user groups and services which all need to work together to ensure patient care works. Practice managers, administrators, receptionists, and many other roles must all navigate legacy systems, handle highly sensitive data, manage immense public demand and context switch frequently to meet demand. Their work is interrupted, highly local and often far removed from the clean route shown in a process map.
This then asks questions of the day-to-day reality of research in a GP practice. How do you run a useful session when a participant may need to step away at any moment? What happens when written guidance and real experiences do not match? How do you create enough trust for staff to speak openly about workarounds?
The work behind the patient journey
No one GP practice behaves the same as another.
A national process map cannot capture every local route through the work in independent practices. Researchers need to see what happens in reality and understand why those differences exist.
Even practices using the same technology may organise the work differently. Individual users balance different ways of working and personal workarounds against centralised process documentation. Practice staff navigate their patchwork of legacy systems differently to others.
Each practice also deals with variance in staffing pressures, handling of highly sensitive data and other risks, whilst simultaneously managing immense public demand. One person might move between several tasks and tools within a short space of time.
A key learning from the research I’ve conducted is gaining an understanding of the level of context switching these staff have to do on a daily basis and the expert knowledge they have of the healthcare system and processes unknown to the general public.
Adaptation, flexibility and building trust
If the work does not follow a neat path, the research cannot either.
A patient may arrive at the desk during a session. A phone call may need an immediate response. A participant may step away or ask a colleague to join the conversation.
I set out five practical considerations for researchers working in this environment:
- Keep participation simple. Use short recruitment forms, offer a useful range of times and avoid creating more administration for staff.
- Plan for pauses. Patient care comes first. Sessions need enough flexibility to stop and restart when the practice requires it.
- Watch the work happen. Interviews and documentation provide part of the picture. Observation reveals tool switching, repeated actions and workarounds that staff may not think to mention.
- Handle recording carefully. Screen sharing can expose patient information. Discuss the risks beforehand and confirm consent again on the day.
- Allow for tangents. You can’t be rigid with your discussion guide. The patchwork of systems means that services are interconnected and research into one inevitably brings others into the discussion. Don’t fear these tangents because they can unlock insight into a behaviour or motivation.
The discussion guide keeps the main questions visible. It does not need to dictate every turn in the conversation.
Trust changes what people tell you
GP practice staff may enter a session expecting their performance to be assessed. Frustrations and undocumented ways of working are harder to discuss under that assumption.
Researchers need to be clear from the beginning. The session is not a test. Participants can skip questions, take a break or stop altogether. Consent continues throughout the session and can change at any point.
Anonymity matters in a close professional environment. So does the language used in the room. Broad praise for frontline workers can feel removed from the pressures being described. Listening carefully, protecting identities and respecting people’s time carry more weight.
Trust gives people room to describe the work as it happens, including uncertainty, difficult moments and the workarounds that keep a process moving.
The patient experience starts backstage
Patients never see most of the systems used inside a GP practice, but they experience the service those systems support.
Switching repeatedly between tools takes time and attention. Missing connections create repeated work. Processes that depend heavily on memory add pressure to already demanding roles.
Better staff-facing tools can free up more time and attention for patient care. NHS England also recognises the relationship between staff experience and people’s experience of care.
Staff-facing design forms part of the patient-facing service, even when patients never use the technology themselves.
