May Monthnote

Rochelle Gold
4 min readMay 27, 2023
The Flying Scotsman Train on outdoor rails
The real life version of my 8 years old’s favourite model train, the Flying Scotsman. We compared the difference between the model and the reality when we sat in its cab.

With all the bank holidays and some leave it made more sense to have a May monthnote rather than separate weeknotes so here is a summary of some of the things that happened this month.

I have been speaking with colleagues in my interim portfolio area to understand more about their work, challenges and context. In summary, like a lot in the NHS tech space, it is a bowl of spaghetti that you try to start eating by biting one strand off but then all the other strands are mixed up so you have to start eating them too. Then you realise there is a whole other bowl of spaghetti, in fact there is a whole table full of bowls that are all linked together and you can’t eat them all. There are then people looking through the window saying ‘Pasta that’s easy. I know how we could serve that all up as one simple dish and make it much quicker.’

I have had a number of conversations about what digital transformation means for people and what that means in certain contexts. Product and service definitions have popped up too as has that regular qualitative vs quantitative research challenge. I’ve also been working with colleagues to use service design to try to unblock assurance process issues and commercial colleagues to unblock a re-procurement that we need to get in train to ensure we don’t have a gap in capability.

I have been doing some work on UCD profession and practice capability for our new organisation and collaborating with Andy and Trilly to ensure we are aligned with product and engineering. I gathered the UCD heads of together to get consensus on how we present UCD in the new world. I also observed the now lesser spotted post it note when I came across Simon and Emma conducting joint user research analysis in person in the office. The bright colour codedness was a welcome break in the sea of now white walls that make up the office.

I was interviewed about leadership where I discussed the importance of creating the space for others to lead and balancing that with supporting them within that space. Sometimes, whether you like it or not, your job title gives what you say a heavier weight to conversations. Sometimes you have to work out whether your presence is supporting people, giving them confidence and bringing others to the table or whether it is unintentionally intimidating, curbing the space they feel they have to lead and skewing the conversation.

In my voluntary capacity, I attended a CanGene CanVar patient group meeting to discuss decision making tools and how we can articulate uncertainty to people and help them manage it. Our conclusion was just as relevant to my work context as my patient rep work. Being blunt, the only thing that is certain is that we are all going to die. There is no other certainty. We are all dealing with uncertainty every single day. These work and health contexts are just on a bigger scale. I manage that uncertainty in both my personal and work life by focussing on the things I can control whether that be what I work on or the lifestyle factors that could contribute to ill health. It is why I run — to manage my physical health, stress levels and have time to reflect on what I can control and what I can do to make a difference.

Research tells us that stress impacts your immune system. It also tells us that a healthy immune system is important to keeping us well and fighting off illnesses including cancer. When you have a cancer-causing gene mutation, your physical and mental health, nutrition, alcohol consumption etc. are things that you can do to control variables that could cumulatively make a difference to your future health. When things are uncertain at work, I focus on doing things within my power that I know could cumulatively make a difference either now or in the future. I can’t control or stop the uncertainty I am surrounded by, but I can do small things that cumulatively can change the odds of delivering good.

On a related tangent, as part of my voluntary work, I also attended the UK cancer genetic consensus group. I heard updates on the CanRisk tool development and pilots including patient facing tools and inputted to the consensus process to decide on guidelines for assessing risk of cancer. It was face to face and I reconnect with people that I hadn’t seen in a while and connected up a couple of pieces of joint work. The main focus of the day was about risk models for predicting cancer and one of the quotes used was coined by the statistician George Box who said:

‘All models are wrong. But some are useful.’

Whatever model you use to predict risk, whether it be risk of cancer or anything else, it will not give you a definitive answer of what is going to happen. Only time gives you the answer as you observe what happens. There are no certainties in life, only that it will end. We can’t predict the future, we can only estimate it and use our models to guide us to get to the outcomes we seek. As we go through the uncertainty of implementing a new operating model and the merger of 3 organisations, we will be using org models of how things are predicted to look in the future. They will all be wrong. They will however be useful.



Rochelle Gold

Head of User Research and User Centred Design @NHS England (formerly NHS Digital). Views my own.