NEWSLETTER May 2026
From the editor
Good ideas are everywhere in healthcare. The conditions for them are not.
A talk with Daniel and Veron
Daniel: Veron and I are honoured to edit this month’s EHFF newsletter. It’s a bit like waiting a long time for the number 11 bus and then seeing two arrive together – two designers, both EHFF members, comparing notes on a view that has struggled to be heard inside healthcare.
We want to use the space to argue something direct. Design is more than how things look. Design thinking works in two movements, not one. The first ‘diamond’ diagnoses the system; the second designs its therapy. Both matter.
A conversation I had with George Findlay on LinkedIn this week framed the first half precisely. He’s a clinician and Chief Executive of NHS Trust. Looking at Mini’s car plant, he observed that Design thinking sits at the front of the system as a binding contract to consumer need. Engineering, supply chain, logistics and escalation routines align to that contract. Variation gets absorbed because the whole chain pulls on the same thread.
Healthcare faces the harder problem. Automotive variation is bounded by design intent. Patient variation is generated during healthcare activities, by the body itself. Clinical reasoning is built for that – diagnose, re-route, diagnose again.
Design thinking is not absent from European healthcare. It is practised thousands of times a day, in every consultation and every diagnostic workup. Clinical reasoning and design thinking are structurally identical: gather signals, frame the problem, generate options, test, refine, deliver. Clinicians design. Aesthetics sit downstream of that work, not at its centre.
What is absent is design at the system level. Above the consultation sits the architecture — pathways, procurement, transformation programmes — and the design discipline has been structurally excluded from the anchor function there. Findlay’s binding contract has no signatory.
Veron, you’ve worked the inside of more healthcare systems than most of us. What does that structural exclusion actually look like in practice?
Veron: Throughout my career – pharma patient support programmes, NHS digital initiatives, femtech, a SaaS supplier to the NHS, and most recently a maternity hospital in the DRC – the contexts could not be more different. But one absence keeps returning: not of good ideas, and not of good people. Every system I have worked inside is full of both. Clinicians, nurses, community workers, all carry a strong desire to see things work better. Good ideas surface every day, everywhere. Scaling them is hard. Sustaining them feels almost impossible. What is missing is not the seed. It is the conditions – the sun, the water, the ground – that allow good things to take root at all.
I have watched design slowly earn its place in healthcare, breaking walls, shifting conversations, producing work that genuinely matters. But I have also noticed that we tend to cluster in one of two spaces. The first is optimisation: reducing paperwork, improving communication, making the current system run more smoothly. I have worked in that space, and it has real value. The second space is harder to occupy and far less funded – what I think of as the green space: where designers step back from the existing architecture entirely and ask what healthcare could look like if we designed it from human need outward. Not getting people from A to B faster, but questioning whether A and B are even the right places. Too few of us occupy that space, not for lack of desire, but because it was never built into the blueprint. Nobody designed it out deliberately. It simply was never designed in.
Daniel: Veron, that ‘green space’ frame puts it precisely – and ‘never designed in’ is the diagnosis in five words. The cost of that omission shows up everywhere: pathways shaped around departmental convenience rather than patient journeys, technology procured before the work it must support is understood, transformation programmes that improve isolated steps while the whole drifts.
The timing argument is straightforward. Improvement methodologies have plateaued. Leadership programmes produce articulate leaders facing the same architecture as their predecessors. Change management frameworks deliver compliance, not change. The conventional toolkit has been tested at scale and the results are in.
Veron, you’ve taught and coached a generation of designers. Why has our profession itself stayed on the edge of this work?
Veron: Part of the design profession’s hesitancy, I think, is that we have arrived in healthcare carrying project logic — a brief, a deliverable, a handover. But redesigning healthcare is not a project. Terry Irwin and her colleagues at Carnegie Mellon describe this kind of challenge as a Transition Design problem: a deeply interconnected, “wicked” system that cannot be switched off and restarted, but must be guided, carefully and deliberately, from one state toward another. In healthcare, that means accepting that the journey will be long, that the current system must keep running while the new one takes shape, and that the metrics guiding us will need to change. Efficiency and cost-saving matter, but they cannot be the only compass on a transition that is measured in decades, not quarters. All these years working in design and healthcare has taught me that change is possible. What it needs most is not a better methodology — it needs people across this system to rethink the role they are playing. Are we maintaining what exists, or are we building the conditions for something better? Those are two very different jobs, and they need two very different setups.
Daniel: Veron, that distinction — maintaining versus building the conditions — is where the next layer of the work begins for me. Pursuing design thinking rigorously took me past methodology, into something deeper: a mechanism of organisational resistance encoded in the governance structures themselves. The first diamond gave us the diagnosis. The second diamond points to the therapy. That is the work ahead. EHFF, with its membership and reach across Europe, is one of the few places where the conversation can move quickly.
Written by:
Daniel Steenstra is Managing Director of InterAlign Organisation Ltd, with a career spanning medicine (clinical training, Amsterdam), professional design (11 years, including the Jaguar XK8 interior), and 25 years teaching design thinking at the University of Warwick. His book Design Thinking for Healthcare (with a foreword by Lord Darzi) publishes September 2026 (Routledge / Productivity Press).
Veron WK Lai is a Service Design Consultant whose work spans femtech, NHS digital transformation, charity, and global pharma. Previously Head of Design at Elvie and Accurx.
This month’s newsletter was co-edited and compiled by Edoardo Montin, a member of the EHFF.
The blind sport your craft wasn’t build to see
By Daniel Steenstra
Why the most capable people in healthcare miss the layer that’s doing the rest of the work – and what to do about it before the system does it for you.
Read the full article here: link
For more articles you can consult the full website: https://danieliao.substack.com
Listening to Staff Voice in Higher Education: Inside Making Connections
By Veron WK Lai
Earlier this year, we spent nine months on a project that started with a simple question: how does staff voice actually travel through a university? Not what’s on paper, but how it really feels. Where does it get stuck? What happens to it once someone speaks up?
The project was called Making Connections. It ran from January to September 2025, and brought together colleagues from the Service Futures Lab and the Social Purpose Lab at UAL. We were asked to look at how informal staff voice connects, or doesn’t connect, to decision-making and governance, especially around equity, inclusion and sustainability.
What followed was not neat. It was messy, relational, and sometimes uncomfortable. It reminded us that listening takes care and requires structure.
Read the full article here: link
For more articles you can consult the full website: https://medium.com
Upcoming events
Webinar on health foresight methodologies, 16 June
Join Kateryna Ostrovska and Agathe Acchiardo for an engaging webinar exploring health foresight methodologies and their role in shaping the future of healthcare.
Health foresight is a strategic approach used to anticipate future healthcare trends, challenges, and innovations through scenario planning, trend analysis, expert engagement, and systems thinking.
Whether you are new to the topic or looking to deepen your understanding, this session will offer valuable insights and practical perspectives.
More information and the registration link will be shared soon.
HTAi Annual meeting, Istanbul, June 6-10
EHFF Network Director Lars Münter is presenting frameworks for collaboration and trust in a digital age.
Hosted by Health Technology Assessment International.
Digital Public Health Conference – June 24-26, Barcelona (Spain)
EHFF Members Carina Dantas, Nina Soenderberg, and Lars Münter will be conducting workshop on persona-approaches to digital health in LMIC.
Announcements from EHFF
WHO/Europe Public Health Innovation Platform
The European Health Futures Forum and its members will actively contribute to the work of the WHO/Europe Public Health Innovation Platform. In particular, Lars Munter has been appointed as chair of the Public Health Communication & Trust working group.
The Platform is a collaborative, WHO-hosted initiative designed to catalyse system-level transformation in public health. The Platform brings together innovation institutions, Member States, intergovernmental organisations, WHO collaborating centres, and non-State actors to co-create, scale, and sustain impactful innovations that address health inequities and deliver measurable population-level benefits.
The Platform is fostering collaboration across a range of priority areas in public health innovation, from digital transformation and health systems redesign to trust-building, workforce development, equity, and emerging health challenges. The launch of the initiative brought together over 250 participants, reflecting a strong shared commitment to advancing innovation and collaboration in public health across the European region.
Through this contribution, EHFF aims to support WHO Europe by sharing emerging perspectives and innovative practices shaping the future of health. The work will build on the expertise and insights generated across EHFF’s eight working groups, which focus on areas including transformation, digitalisation, patient engagement, antimicrobial resistance (AMR), wellbeing economy, women’s health, mentorship, and other key dimensions of health innovation and system change.
Stay tuned!
Click here to learn more: link
New EHFF Podcast episodes out!
Episode 5, Rethinking Offender Rehabilitation Through Innovation by Shaun Charles Small
Episode 6, Design Thinking for Better Lives by Professor Daniel Steenstra
Stay Tuned and Take Action
Thank you for reading this month’s edition of the EHFF Newsletter.
We invite you to stay engaged, share your thoughts, and help us continue building an active and connected community.
If you are interested in shaping future editions, consider joining us as a Domain Expert and become Editor of the Month – just get in touch, and we will be happy to tell you more about it.
Received this newsletter from someone else?
Subscribe here to ensure you do not miss upcoming EHFF activities, announcements, and community opportunities.
Warm regards,
EHFF