Engaging citizens through processes of co-production, co-creation and co-design has long been seen as a route to improving the quality of public policy and public services (Pestoff 2006; Brandsen & Pestoff 2006; Parks et al. 1981). In recent years, there has been increasing attention on the potential of design concepts to contribute to services which allow greater user involvement, and hence, co-create value. One promising concept is that of design affordances (Greeno 1994; Norman 1999; Norman 2008; Sharples et al. 2012), which refers to the range of possibilities offered by culturally created (service) artefacts, as perceived by the users (Kannengiesser & Gero 2012). In public service terms, this draws attention to the designed scope for users to engage and interact with services (and elements of services) heterogeneously, raising the potential for value creation. This suggests consideration should be given to the design affordances within existing - and potential - services, with examination of how services are perceived and engaged with, within contexts of use.
To investigate design affordances in public service delivery, we conducted qualitative research using multiple case studies of 27 self-service healthcare technology users in the English NHS. Data collection was through depth-interviews and observations of technology use within patient homes to explore how and why citizens use self-service technologies to co-create value in public services. Iterative thematic analysis of transcripts enabled major themes within-cases to be compared and considered across cases for further theoretical abstraction.
Our findings show how service users did indeed perceive and make use of affordances within the technology, which helped to address patients’ own interests in relation to their health and wellbeing. However our findings also show that users’ attempts to create value from provided services went far beyond the affordances of the service interface. Over and above adapting their approaches to technology use, service users were found to re-purpose technology in ways which service providers considered ‘deviant’, in an attempt to shape their access to health services. Extrapolating these findings, we suggest that alongside design affordances which can potentially be harnessed by service providers to encourage user involvement, consideration must also be given to the ‘institutional affordances’ (van Dijk et al. 2011) within particular institutional contexts. In other words, the scope for user action not only provided by the designed artefact, but also allowed (or otherwise) within dominant institutional arrangements.
This suggests that service providers may take account of the ‘desire lines’ of service users, for example by designing elements of services which fit with user perception and intentions. However, it should also be recognised that at times these user perceptions and intentions may cut across or challenge dominant institutional arrangements, with these occasions posing a more serious design challenge. Our paper intends to provoke consideration of the fundamental redesign of services to encourage co-creation through technology-based service use. In particular we contribute to the human-centred theory of affordance-based design (Maier & Fadel 2002; Kannengiesser & Gero 2012; Maier & Fadel 2009) for public management.
Design-led approaches to value creation in public administration
IRSPM_2018_Conference_Paper_sb_JGJ.pdf 