How to make services Better by Design: The case of Eva

| No responses | Posted by: Laura Dosanjh, Lucia Caistor-Arendar | Theme: Work with Communities

Eva* was born in Egypt, to British and French parents. She speaks French, Italian and English fluently. In 1956 she was forced to leave Egypt and come to England with her mother. Never married, Eva used to live with her brother, but when he died 22 years ago she moved into sheltered accommodation. Here, at 92, she still lives independently and likes her flat as “it’s very sunny and there’s a good atmosphere”. Her corridor runs alongside the garden and she can hear the birds in the morning. Sometimes she will wander tentatively around the hallway outside her flat on her zimmer-frame, happy to see other residents and staff going about their business. She spends a lot of time listening to the radio (often French radio stations) and watching Al Jazeera news. Reading has become harder for Eva over the past few years as her eyesight has deteriorated.

Eva receives a telephone call every morning from the housing manager to check how she’s doing. If she doesn’t answer someone will come and check on her immediately. She describes the accommodation manager Amy as “an angel”. Eva also receives support informally from two carers and manages to do most of her cooking herself, cooking ready meals and freezer food.

Although she rarely leaves her accommodation, she speaks regularly with friends on the phone and she has two very good friends who visit a few times a week. She purposefully remains cheerful and bubbly, though in recent years has felt she has lost her sense of purpose; “I’m ready to go… I’m useless here … I’m getting tired of myself”. Though she has friends to turn to if she has a problem, she worries about being a burden, and often if she is worrying will choose to “keep it to myself in case people don’t understand”.

As a service user Eva could have been described in a single sentence: an elderly woman living alone with mobility problems, requiring 10.5 hours of care each week. But even the brief paragraphs above show us how we need to look deeper. Her service experience is about the relationships she has with different people, places and services, and perhaps most importantly, how she feels about her life and the world around her.

Ensuring services are tailored to the needs of their users seems like an obvious thing, but as organisations develop, it’s easy for them to become target driven and increasingly removed from the people they’re trying to serve. How can thinking of Eva as a unique individual, whose wellbeing is determined by many aspects of her life, create a better service?

The BIG Lottery Fund in Scotland have recently launched Better by Design – an innovative new programme, aimed at helping 15 voluntary and community sector (VCS) organisations deliver better outcomes. They are currently seeking applicants to receive bespoke support and undergo a service design process over the next two years. The Young Foundation, together with our strategic change and design partners Taylor Haig, will be running this programme.

The notion that there is real value in understanding the experiences of ‘service users’ – people like Eva – is at the core of service design. It is the starting point for thinking about how services could be improved. The value of a design-based approach is that it uses a set of tools that are generally unfamiliar to the third sector. These tools stimulate thinking in a different way. Ethnographies, service ecology mapping and user journey mapping for instance, are just three of the methods that can be used to try and bring into view the multidimensionality of Eva’s situation.

As demand for social support in communities around the UK rises, the capacity of the voluntary sector to meet those needs is becoming increasingly strained. Better by Design has emerged through a sense of urgency to rethink the status quo and work out how they can support people in better and more cost-effective ways. Organisations need to challenge assumptions about how they interact with their service users, how what they do adds value, and ultimately redesign their services to intervene earlier, promote independence and cope in a society with rising demand and less public money. Better by Design offers space for VCS organisations to step back and reflect on what this sector is really here to do and how it can do things better.

More information on Better by Design and the application form.

The deadline for applications is 13 May 2013. For more information contact or

*Eva was interviewed as part of an ethnographic study conducted in 2012 by The Young Foundation. Her real name has not been used.


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