Start page

[davidhunter08]

What

GOV.UK Design system suggests using the first page of a service (a Start page) to helps users understand:

• who the service is for
• what the service helps you do
• what you need to do to use it
• alternative channels to access it

There is already discussion about start pages in the GOV.UK community backlog.

I'm sure other work on start pages has been going on in the NHS - would be good to collate all examples and research insights here.

[monsterlimo]

Delegated Access - here a person using a health service and is wanting another person to act on their behalf within the selected service (a made up service here called myHealth)

[RichFlick]

We've gone with something similar to Start pages for 'leave a review' and 'report a comment' transactions with the new Profiles work. They're not really full services as such but do follow the 'step by step' approach. Here's a link to the 'Leave a review' prototype: -

https://nhsuk-org-review-prototype.azurewebsites.net/dentists/leave-review/

Overall it has tested well. However, we didn't focus particularly on the start page, more the main review journey. We did note that users appreciated the multiple page approach with minimal content at each step helping focus.

However, there was a general lack of understanding with regards to the moderation process and the steps involved after they have left a review. More explanation could help on the start page. Some also mentioned that the moderation rules appearing on the start page were off-putting.

PIMS Sprint 10_20190603 Dental Services Workshop_UR Update.pdf

[sarawilcox]

@davidhunter08 Have you seen this one? https://www.nhs.uk/using-the-nhs/nhs-services/hospitals/nhs-e-referral-service/

[devansXD]

Apologies Ive just seen this thread. We did change some of the content, but we know a lot more work is needed. Essentially no one really reads the page below the 'Start now' button.

[simon-davis-nhs]

Respondents mainly focused on the text ahead of the ‘Start now’ button and the bullet pointed list underneath this. Only one user read beyond the sub-heading ‘How to choose your hospital or clinic’. Users thought that the bullet pointed list under the start now button was what to expect when they clicked ‘start now’ and saw this as useful. This again highlights a need for reassurance and wanting to know what happens next.

• “I like this because it tells me what’s going to happen when I press start now” – P4
• “I like the bullet points tell me what to expect” – P1

One user was confused by the bullet pointed list under the ‘Start now’ button as it did not mention in this list that you could book an appointment. This led to hesitation for this user about what to do next.

• “It doesn’t mention that you can book” – P1

The links on the right of the page were largely ignored unless users wanted more guidance (1.7% of users a day click on these links). A lot of the content on this page is driven by policy and stakeholder needs (e.g. the PDF document), users largely ignore this type of content.

• From analytics CTR on the Start now button is 53%

We're planning on changing this page when e-RS goes live with NHS login in order to reduce the content on this page and explain the use of NHS login to also log in. Something like this:

Users saw this version as very straightforward and simple

• “Straightforward, tells me what to do, no beating around the bush” – P1

Users were not concerned that the information on the current version was hidden behind links in this version – as long as they were still available users were fine with this change.

Some users noted that the current version was more personal as it addressed the user in the text "if you" or "you'll need". This second version was more straight to the point and factual.

[davidhunter08]

[davidhunter08]

[scottsmith93]

Afternoon!

On NHS Jobs, we have designed a start page to go at the front of job applications.

We list the things that they'll be asked to complete for the application.

We hypothesised that by being clear and transparent around the information required from them to complete the task, it will make applicants feel more at ease and nothing will feel unexpected or out place.

Our research suggested that seeing this information upfront is helpful for many people who don't have dates stored in their head and it sets a clear expectation as to what is being asked of them.

When they hit this page, some applicants told us they'd go and get their certificates and other necessary materials first, based off what they have read and then will go through the application form once they feel they have the info they need to complete the form.

To date, we haven't discovered the need to have more information on this page. It feels a little lightweight compared to other examples here, but in our context, applicants understand what they're reading and have little issue with it so far.

Applicants had an understanding that they'd be taken a new page if they clicked the privacy policy link, but a mixed response in understanding if it'd open in a new window with the information stored on a different site, or if they were navigated away in the same window.

[StephenHill-NHSBSA]

Attempted conversion of current 'Check what help you could get to pay for NHS costs' service (NHS BSA) into using the NHS.UK Design System:

N.B. This is very much a work in progress!

[GrilloPress]

NHS App NHS website start page.

So a start page of sorts for the NHS App/

https://www.nhs.uk/using-the-nhs/nhs-services/the-nhs-app/

[alexparsons07]

The Design Working Group discussed this issue on 21/10/19. Feedback as follows:

• When developing the guidance, state that you may not need a start page

• Also, explore the idea of it not being a 'start page' but a pattern to introduce users to a thing (eg: a service or a form)

• Approved by design working group to be developed

[chrimesdev]

We recently used a start page in the 'Get a self-isolation note' service. I will attach user research findings when its put together but early findings were that people didn't really read anything below the button. We tried using the 'Before you start' heading but we ended up removing that.

[TJFDM]

We have similar pages in SCRa redesign - which is a little different in that the user is already inside a service and they're starting another service, but still within the first. We consistently find that users don't read the text of these pages and are completely drawn to the action - we've tested with green actiom buttons and action links. We've had comments made like "no one reads the text, if there's a button, I'm going to press it".

Couple of examples below - one with action button, one with action link. Note that whilst they are technically start pages, they live within SCRa.

[chrimesdev]

Isolation note start page:

[chrimesdev]

Order a repeat prescription start page:

[chrimesdev]

Ask for a coronavirus test start page:

[chrimesdev]

I recently got asked why Start pages live on Wagtail (CMS) opposed to just living in the application they're the Start page for (eg. a .NET transactional service). This might be NHS.UK specific thing, but I think it might be worth included guidance recommending to use a CMS for a start page and the reasons behind it.

The reasons being that Start pages are usually quite content heavy, so it makes sense for them to content manageable compared to having text hardcoded in code. This also means you don't have to do a code deployment everytime a word changes.

[bencullimore]

• benefits for having start pages in the CMS (for NHS website) is you get all navigational elements for free too - main nav, internal search, breadcrumbs and sideways - so if users are unsure the service is right for them if they want to know more proceeding if they land on the start page by accident - they have ways of correcting themselves.

Information Architecture should be considered with start pages too; no service is an island (living by itself) - it will always be a part of a wider service/topic.

We recommend possible running open card sorts to see how users group/label pages information around a start page (and including your service start page) and also tree tests to check users would find the start page in your proposed structure (along with usability testing but that's hopefully a given).

[bencullimore]

Start pages in the context of the NHS website are the start of a transactional journey.

A team working on a discovery into NHS transactions have a working definition of transactions as:

"A transaction is when a user offers or inputs something and gets an output that meets (or helps them on the journey to meeting) their need.

To a user, a transaction is something that helps them do something, and needs them to input something for that to happen."

Based on that definition, they've created a transactions catalogue of services linked from the NHS website (nhs.uk) - I've taken a screenshot from a number of start pages that feature in the transactions catalogue (see screenshot below).

From reviewing start pages I've noted the following inconsistencies:

- differing relationships to the website - some service start pages exist within the websites information architecture (see https://www.nhs.uk/nhs-services/hospitals/book-an-appointment/) others exist outside of the website without any relation/links back; see Sign up to be contacted for coronavirus vaccine studies

- URLs - whilst many service start pages follow the emerging standard for URLs on the NHS website https://github.com/nhsuk/nhsuk-service-manual-backlog/issues/265 giving users a view into their canonical place (see https://www.nhs.uk/service-search/find-a-gp) others force a false structure, for example, https://www.nhs.uk/your-nhs-data-matters/ and https://www.nhs.uk/sign-up-to-be-contacted-for-research which bare no relation to its place within the structure of the website.

- Header - whilst the majority of service start pages use the NHS website header and navigational elements (main nav, internal search, breadcrumbs, sideways navigation etc.) Sign up to be contacted for coronavirus vaccine studies does not

- Page heading - some verbs e.g. Get a shielding note some the name of the service The NHS website repeat prescription ordering service

- Various button/action labels; submit, start now, book my appointments, search, calculate, start

- multiple service start points on one page - https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/book-coronavirus-vaccination/ is the start page for 2 journeys (2 buttons)

- instances of form input fields being embedded into the start page - see Contact us about the NHS website which offers 'before you start' information and full service in one.

[bencullimore]

to build on GDS start page guidance, I would propose

When to use a start page

At the start of a transaction. A transaction is when a user offers or inputs something and gets an output that meets (or helps them on the journey to meeting) their need.

Where should a start page live

Services aren't islands, they're always certain to be part of a wider topic/services/websites - detaching them from a wider context and removing supporting navigational elements (such as main navigation, internal search, breadcrumbs and page to page nav) results in dead ends and users who don't feel confident they're on the right start page or that they'll know enough to complete your service.

The benefits for having start pages embedded in wider topic/services/websites are; you get all navigational elements, if users are unsure the service is right for them, or if they want to know more proceeding if they land on the start page by accident - they have ways of correcting themselves, finding more information.

We recommend possible running open card sorts to see how users group/label pages information around a start page (including your service start page) and also tree tests to check users would find the start page in your proposed structure following up with usability testing.

Technical considerations

Experience on the NHS website has shown information on start pages need to be regularly changed (especially during the Coronavirus pandemic) - due to policy or changes to questions/general content-based. Having your start page embedded in a separate application and only updatable by a developer; need to create pull requests etc. has proven to be problematic. Where possible, make it as easy for a number of people to amend content (ideally a content management system).

URLs

Having your start page embedded into a wider thing (service/topic/website) will give it a nice canonical URL that follows URL standards https://github.com/nhsuk/nhsuk-service-manual-backlog/issues/265. A good example being

https://www.nhs.uk/nhs-services/hospitals/book-an-appointment/

This clearly shows the start pages relationship to the website and the wider topic it sits in - book an appointment, at hospitals which are part of NHS services.

Vanity URLs can be created for promotional activities/letters which redirect directly to service start pages, for example, hospital booking (eRS) uses www.nhs.uk/referrals

The benefits to having a good start page

• It sets expectations; users know what to expect before clicking anything. They know they're in the right place, they know if they're eligible and they know what the outcome will be
• It helps users succeed in the transaction; users know what information is needed of them (and if they need other documents - letters, identification etc.)
• No dead ends

How it works

Start pages include 4 main elements:

The service name: this should help people understand what your service does and whether they need to use it (good services are verbs).

A short introduction to list things that most users will need to know, for example, what your service will let them do or how much it’ll cost.

The ‘Start now’ call-to-action button - this perhaps needs to be explored fully with NHS teams

A list of other ways to access your service.

[davidhunter08]

Draft guidance for the start page

[sarawilcox]

We tried a Do and Don't component on an NHS covid testing start page prototype. It worked well in user research but never made it into live as the NHS version was switched off.

[davidhunter08]

There was an issue raised regarding using do and don't lists on the NHS.UK prescriptions testing today service start page: https://github.com/nhsuk/nhsuk-service-manual-backlog/issues/159#issuecomment-628081380

[sarawilcox]

We're creating a prototype now, ready to share with people who have contributed to the issue.

[sarawilcox]

Start now buttons - alternatives to "Start now"

The current live National Booking Service uses : Book my appointments. In recent testing, the team tested a single start page for both journeys with:

• book my 1st and 2nd appointments
• book my booster appointment 12/12 participants were able to complete the booking and the start buttons weren't an issue at all.

As we're now splitting the journey we've simplified it to 'Start booking' as there's no context switching on the start pages.

[sarawilcox]

Feedback from Design System Working Group

We took the prototype start page to the DSWG. The page was approved with the following questions and feedback.

Comment: Are action links allowed to be used as start buttons? Do we need specific guidance on this? Response: We do not use action links on start pages. We've added a note about this to the start page.

Comment: Feedback to GOV.UK Design System (on their GitHub) our findings on this pattern and any places that we have diverged and why we have. Response: We can flag our new guidance on the GOV.UK GitHub issue when published and mention it at GDS Design System Friday meetup. @karlgoldstraw, @danjohnstonUX or @henocookie , would you be able to mention it when published please? Key difference are, we've:

• not used right hand nav to related info
• seen evidence that "Before you start" info (that everyone should be aware of) needs to be above the button
• added guidance about what makes a good start page
• included more info about accessibility plus some things we need to understand better

Comment: Should a Welsh version of the digital service be an option as standard? As per services through GOV.UK, via a link on the start and following pages in the service. Response: A Welsh version is not standard across all services on NHS.UK, which is primarily for England. It's something that needs considering on a case by case basis. The discovery into additional language support may feed into decisions about whether or not to provide a Welsh language service.

Comment about the page being quite long and a few sections not talking about the start page pattern specifically... "I wonder if this information should just be included in general IA guidance and linked to from the start page guidance?" Response: Yes, some of the information does apply to any page but our experience suggests that it is particularly helpful in the context of start pages. Once the IA guidance is ready to publish, we may be able to cut back the start page and link to IA guidance instead.

Comment: The start page guidance feels necessary. It is definitely addressing a need for consistency in the start pages, making transactions more usable (and potentially clinically safe) as repeat users will have a better expectation of what is happening. Do all services that involve user input warrant their own start page? Response: We don't think we can specify anything about this yet. For example, the website has ‘health tools’ (e.g. BMI calculator) into which users input data but they don't have a start page. We'd encourage teams to evaluate what's best for their service, user test and feedback here.

Comment: Can you have multiple call to actions? For example a start page with 2 buttons for split journeys within one service. Response: We don't have enough evidence to say anything about this yet. We'd encourage teams to feed back rationale and insights if they do use 2 buttons.

Comment: This is excellent work. Would be good to see the audit in the backlog. Good to include more info on apps or mobile settings. Response: Apps have a different context and different use cases, for example, users will already be "signed in". We'd encourage app teams to share their insights - perhaps in a different GitHub issue?

[sarawilcox]

Next steps

Publish the start page and ask people to feedback further.

[sarawilcox]

Published: https://service-manual.nhs.uk/design-system/patterns/start-page

[sarawilcox]

We say this in the Start page pattern: "There are good reasons to use context-specific verbs, like "Book now", "Check now" or "Start booking", but we do not have enough research to recommend these yet. Please let us know if you have research to share."

Feedback from usability testing for ‘Find a walk-in vaccination site’: "got some good evidence that the ‘Start now’ button on the start page was not working very well. We have since changed the start button on https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/find-a-walk-in-coronavirus-covid-19-vaccination-site/ to say ‘Find a walk-in site’."

@bencullimore, you may be interested.

[chrimesdev]

We say this in the Start page pattern: "There are good reasons to use context-specific verbs, like "Book now", "Check now" or "Start booking", but we do not have enough research to recommend these yet. Please let us know if you have research to share."

Feedback from usability testing for ‘Find a walk-in vaccination site’: "got some good evidence that the ‘Start now’ button on the start page was not working very well. We have since changed the start button on https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/find-a-walk-in-coronavirus-covid-19-vaccination-site/ to say ‘Find a walk-in site’."

@bencullimore, you may be interested.

Wondering if this may cause some confusion on when to use a "Button" vs "Action link". With the verb "Find" and "Go" being used more commonly on Action links eg. Homepage (https://www.nhs.uk)

[sarawilcox]

Update to the GOV.UK backlog issue for start pages:

"We’ve replaced the 'Start pages’ pattern with an expanded pattern to show teams more ways they can help users Start using a service.

The updated guidance removes the message that start pages is a set pattern that cannot be customised. For example, sometimes it makes sense to start a service journey within a multipart guide or use customised button text."

[Moll-Lee]

Feedback from Caroline Finucane on the guidance on this page, …feels there is more to add to it, for example:

how do we make start pages work for all devolved nations when it is a UK-wide service and DAs differ on policy? how generally can we keep them short when there is pressure to include various important public health and clinical messages, for example:

• consider placement of those messages later on in the service, at a more relevant and useful point in the journey
• consider linking out to more detailed guidance pages for the detail
• concertinas - a good think to include? We experimented with them, would have to dig out UR findings…

[sarawilcox]

Service specific links to terms and conds and privacy policy

Links from a start page to another website (for example, linking to NHSD's T&C from the NHS.UK website) should include the website name in the link text. Something like:

By using this service you are agreeing to the terms of use on NHS Digital's website.

[sarawilcox]

There's a conversation on the GOV.UK Slack channel about how to word the start button, with lots of service specific wordings like:

• Apply now
• Register now
• Book an appointment
• Make changes

[emma-nhs-vol]

On NHS Volunteering, we've designed two different start pages depending on the type of opportunity they have selected.

If they select an opportunity that collects applications (registrations) through the service, volunteers see this start page:

We assumed users would find it useful to know upfront what we will be asking them for. We also hypothesised that users will expect to be able to save and return. We have used an inset to explain that the application process will not create an account for them.

The content also includes a note about completing the application in one sitting.

Our research found that seeing this information upfront was useful and reassuring to users. Some users suggested they would prefer to gather some of this information before starting, such as the statement for volunteering. This would be to help them save time whilst filling out the actual form.

If they select an opportunity that uses a 3rd party link to collect applications, they see this start page:

We hypothesised that being transparent that the link was taking them outside of the service would reassure them. We've heard in both alpha and beta that our use of the NHS branding helps build their trust in the service. Our second user group, recruiters, will be adding these 3rd party links, and we assume some of their destinations won't look like our service or even the NHS branding.

In our research sessions, the users who saw both start pages generally understood the difference between the two, as most expected there might be different ways to apply for an opportunity.

[sarawilcox]

We should review our whole pattern in the light of changes to the GOV design system pattern. See https://design-system.service.gov.uk/patterns/start-using-a-service/.

[SophieMcCulloch]

Contact Us First Click Testing & Usability Testing of Start Page

Why we did the test

The Contact Us service wanted to ensure that users would only submit tickets to Service Desk on issues that directly related to the NHS website.

What we did

• We decided to test the ‘do and don’t' page against the existing start page with a first click test in Optimal Workshop.

• 25 users were recruited by Optimal for each test– these users were recruited by Optimal and did not come to the contact us pages of their own accord.

• The task was ‘Where would you go if you wanted to give positive feedback on your recent GP visit’ and then asked why they chose that option. This task was to see if users read and understood the page and didn’t click start now, which would take them to a form only for users who wanted to report an issue with the website.

• There could be numerous right places to click on the page.

Findings/results

Overall, the ‘do and don't page was more successful than the existing page with more users clicking in the right place (heat maps will be added at a later date). 52% of participants clicked ‘leave a review’ which was the correct option to click. Overall, participants said that this was most logical place on the page to click.

The next popular option was ‘start now’ with 28% of participants clicking this option.

Heat Map Version 1 (previous Start Page)

Heat Map Version 2 (current Start Page)

We also tested this page in as part of a usability testing sessions and the majority of users understood the page and where to go. When asked about the information in the “do and don’t’ boxes, participants understood what type of information can and cannot be submitted through the form, saying that it wasn’t for any personal details, confidential information or to seek medical assistance.

[SMorgan-Leith]

Child BMI Calculator (re-design)

When redesigning the Start Page for the Child BMI Calculator, we wanted to address users' expectations of the tool. User research had showed that many users were unclear about the capabilities of the tool and the type of results it would provide. By including a section titled 'This service does not:' we were able to clearly address the tool's limitations.

This section tested very well. Users slowed down their reading and became more measured when they reached this section of the page. During the unmoderated testing of the Start Page, we saw an increase in metrics around user's understanding of BMI. There were also no concerns raised about the limitations of the tool, which we attribute to this greater level of transparency.

Whilst testing the original design we discovered that users tended to scan through the start page very quickly. We found that the more information users were presented with, the more likely they were to ignore it and view the content as irrelevant to them. Larger sections of content appeared generic to users, who then doubted the relevancy of the information. As a result, we sought to strip back the start page as much as possible. We removed information about 'centiles' and 'how BMI is calculated', which allowed us to minimise the length of the page.