Reports & Insights

Exploring small scale experiments for potential change within our health care systems

This report reflects on a healthcare experiment aiming to improve patient understanding by extending GP appointments. Despite shared enthusiasm, the project was not delivered due to misaligned expectations, system pressures, and capacity challenges. Key learning includes the need for early co-design, inclusive engagement, and recognising structural barriers.

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Executive Summary

This learning report from Nifty Sustainability documents the development and challenges of a small-scale healthcare experiment undertaken as part of the Healthy Communities Together (HCT) project. The experiment—co-developed with Leeds GATE, MESMAC, and Middleton Park GP Surgery—aimed to explore whether extending GP appointments by five minutes could improve patient understanding of health conditions, medications, and referrals. It was designed to trial a simple, human-centred intervention grounded in principles of equity, user-centred design, and compassionate care, particularly for marginalised communities.

Despite shared commitment and goodwill from all parties, the experiment was not implemented within the planned timeline. Through detailed reflection, the report identifies a range of interlinked challenges that hindered progress. These include mismatches in understanding and expectations between partners, structural pressures within primary care, historical mistrust and marginalisation, and the difficulty of isolating a single intervention in a complex, overstretched system.

The report highlights the critical importance of early and inclusive co-design, involving representatives from all relevant roles—especially those delivering care. It underscores how resource constraints and power dynamics can impact even well-intentioned initiatives and stresses that meaningful change requires space for lived experience to be heard, acknowledged, and responded to with genuine intent. The authors recommend considering Adaptive Action as a future method to support more reflective, equity-driven system change, and hope that the insights shared will inform the design of future interventions that are both practical and rooted in community experience.