It is no secret that the public sector health and social care system is under intense pressure to do more with less. Providers, commissioners and local authorities are being asked to deliver better care to a growing, ageing population with increasingly more complex health needs, with less funding and fewer resources.
To add to this pressure, these changes need to happen in a relatively short timeframe otherwise the financial sustainability and future of the NHS is at risk.
The Five Year Forward view sets out £22Bn of efficiency savings that need to be made by 2020. However, traditional efficiency drives across the system can only takes us so far and will not be enough to deliver the stretching target, at a time when demand for health care services is predicted to be growing at a fast pace.
How do we deliver more (and better quality) services with less? We innovate.
Bárbara Tomé, a member of the Attain Strategy Team, discusses the role of innovation in public sector health care, what is hindering it and how we can actively promote it.
Myth busting: what innovation is not
Before we begin, there are a number of misconceptions and misinterpretations of what innovation means. Here we tackle a few of the most common myths:
- Myth 1 – Innovation = New technologies and devices
Wrong! A common misconception is that innovation is a synonym of new products and technology. Technology often does play a part and tends to be the one of the most visible and promoted forms of innovation, however the true concept of innovating is about doing things differently to improve, create or add value. This applies to care models, networks, systems, processes, services, delivery models, patient experience and more – gadgets and software are not mandatory!
- Myth 2 – Innovation is for start-ups and R&D labs, not for established organisations
Wrong! As interesting as it is to read about ‘shooting stars’ and ‘unicorn’ start-ups that revolutionise our daily lives a few months after creation, the undeniable truth is that now more than ever established organisations need to step up and embrace innovation, otherwise they risk collapsing under the pressure and become unfit for purpose.
- Myth 3 – Innovation is too hard and we don’t need to change
Wrong! Patients expectations regarding what a good quality care service should provide have evolved – they expect more to be delivered in a way that suits them. In a time where we can book almost everything in a couple of taps on our smartphones, does it still make sense to have to call and wait in queue to schedule a GP appointment, simultaneously tying up important limited resources by having someone full time to take calls in a practice? Reluctance to change is embedded in most organisations’ culture, however we can start by making small changes to improve both patient care, efficiency and making employees jobs easier. Breaking conventions and accepted wisdom isn’t easy but it is necessary.
- Myth 4 – Innovation is a responsibility of Chief Innovation Officers/Directors of Innovation
Wrong! If the outcome of innovation frees up time and money, improving patient care and making employee’s lives easier why should it rest on the shoulders’ of a single person to come up with all the ideas? The main role of CIOs/Directors of Innovation is to ensure that the organisation has the right structures and culture in place to foster new ideas and progress, aligned with its strategic priorities. CIOs are not the innovation silver bullet, and they are not meant to be idea fountains but rather facilitators. They ensure that when someone in the organisation has a good idea they have the proper channels, structure and support to further develop it. Innovation is everyone’s responsibility and none has better insights into your role/department/area/patients and how it could be improved than yourself and your colleagues.
- Myth 5 – Innovation is tomorrow’s problem
Wrong! Although tackling day-to-day operational issues affecting short term service provision might seem more important, not investing in innovation will make tomorrow’s problem significantly worse and compromise the viability of the health and social care system as we know it. Small innovations could have saved NHS millions of pounds if they had been implemented a few years before – the opportunity cost of not implementing changes now often trumps the initial investment cost. Doing nothing is not a sustainable strategy and will inevitably lead to failure. It is therefore crucial to have innovation high on the priorities list.
So if we are not a start-up, how do we go about it?
1. Cut the red tape
Embedding agility and flexibility into the culture and organisational processes is key. If an employee has a good idea he/she should not have to go through 50 gatekeepers, 15 different committees, fill out 100 forms and wait 1 year to hear back – this is one of the most discouraging scenarios for anyone wanting to make a real change.
Many beneficial ideas from staff will turn out to be simple changes and tweaks with little cost and no risks for patient safety, so why not foster these? Larger scale projects should require formal processes, but allowing people to test out small scale first if they have potential et safety criteria way is a good step towards fostering innovation.
2. Embrace failure and promote a learning culture
In the field of innovation, if you have never failed it is because you have not tried hard enough. Failure is inevitable once you step into the unknown field, but that is where progress happens. Ideas are not static, but rather they morph as they grow and we learn from previous experiences, both successes and failures alike. Rejecting the blame culture is imperative in order to learn from unsuccessful projects and do better next time.
This does not mean that we should let a thousand flowers blossom and see what happens. There has to be a clear strategy and processes in place. A crucial step in managing innovation within any organisation is making the hard decisions, and knowing when to end unviable projects.
3. Culture changes start at the top
Innovation is every employee’s responsibility but they can’t be expected to make change happen alone. Innovation leaders need to actively set the pace for change, aligning the organisations strategic goals to the innovation strategy, processes and structures, removing any existing obstacles as soon as they are identified. Leaders must promote a learning culture and ensure the right support network is in place to help employees explore and develop new ideas without fear of failing.
The importance of making change happen now
The UK public health and social care system is unlikely to become the next Google or Uber, however the delay in adopting innovation is costing the system millions of pounds in unexploited efficiencies and improvements that would simultaneous enhance significantly patient care, quality of experience and even safety.
There is no silver bullet that will fix these challenges overnight, but it is time to move Innovation up on the priorities list and rethink the approach in order to ensure the future sustainability of the health and care system.
To find out more about our work and how we can help your organisation develop and implement Innovation Strategy please contact Helen Pyecroft, Head of Strategy.
NHS England (2014), Five Year Forward View
Dixon-Woods, Mary; Amalberti, Rene; Goodman, Steve; Bergman, Bo; Glasziou, Paul (2011) Problems and promises of innovation: why healthcare needs to rethink its love/hate relationship with the new, BMJ Qual Saf;20:Suppl 1 i47-i51
Herzlinger, Regina E. (2006) Why Innovation in Health Care Is So Hard, Harvard Business Review 84, no. 5
Di Fiore, A. (2014) A Chief Innovation Officer’s Actual Responsibilities, Harvard Business Review
Omachonu, V. K., & Einspruch, N. G. (2010). Innovation in healthcare delivery systems: a conceptual framework. The Innovation Journal: The Public Sector Innovation Journal, 15(1), 1-20.
Maruthappu, M. (2016) We must foster digital innovators in health, HSJ