5. What sort of work
What’s the
work?
Who does the
work?
Technical Apply current
know-how
Authorities
Adaptive Learn new
ways
The People
with the
Problem
Heifietz and Linsky 2002
8. What the Future Looks Like?
Who will have the economic power?
Agricultural Age – Land
Industrial Age – Iron
Information Age – Data
Alec Ross 2016 The Industries of the Future. Simon and
Schuster
9.
10.
11. What’s going on round here?
Data for Social Innovation
• What do we know?
• How do we know?
12. Data for Innovation
Question: Is it possible to predict the weekly
number of people coming to A&E with a
Fractured Hip and the time of day they will
turn up?
A Yes
B No
C Not sure
15. Incoming Calls to GP
Question: How many calls do you
think a 5 GP practice in Leeds takes
on a Monday morning?
A 200+
B 500+
C 1000+
D 1500+
16.
17.
18. SYAJBSPGWSF
20
18
16
14
12
10
8
Minutes
Interval Plot of SF, GW, SP, JB, SYA
95% CI for the Mean
GP
appointments
In this practice
one GP takes
much longer with
his/her patients
than all the
others.
Question: Why
is that? Who is
the best GP?
A B C D E
19.
20.
21. If you want to change in a complex
system…first you have to perturb it
• Clarify the boundaries of the system (usually a
question)
• Provide more/different (or just some..) data
• Create space and time to make sense of that
data
• Diversify who is involved (new eyes/ emerging
leaders) – connecting the system to itself
22. Data Theme
1. Demographic/ Geographical – our health needs
2. How the system currently operates to meet needs.
3. How people behave in the system to meet their own needs
and that of their community.
4. How data is currently used for change
5. How this system learns
6. How adaptive and resilient is this system
7. Is this system fit for the future?
23. So far
• Without data we rely on personal
preference, assumptions, and prejudices
• Without data power rests with the few
• But data is all around us
• Perturb the system…
• Generate data that helps us know what is
going on here
29. Bolton NHS Foundation Trust
• Unexpected deficit of £14.4m (2012/13) to
a surplus in 2015/16
• In the first year of activity they made
£18.3m in income and cost improvements
(6.4% of income), last year it was £21.2m
(7.3%), and this year £15.3(5.3%).
38. Come and see….
“I urge you to take your colleagues down to
the Bromley By Bow Centre and let them
see what has emerged from nothing. Its one
of the most impressive displays of social
entrepreneurship anywhere in Europe”
Lord Brian Mahwinney
39. Qn: What helps innovation
happen? – the most important
1. Create incentives
2. Disseminate good practice
3. Have different people involved in working out
what to do and the doing it together
4. Require performance through commissioning/
contracting/ regulation
5. Trust professionals to find the best solutions
6. Learn from others
40.
41. Innovating health systems
• Get out more to discover
• Know their own system
• Are open to learn
• Work with the assets of their communities
– really engage
• Are not threatened by diversity but see it
as strength
43. The Leaders of the Next
Generation NHS
• Can grasp what the future could look like
• Are willing to give up territory
• Are prepared to do the work of generating a
shared view
• Can stay focused
• Are prepared to sort out the systems issues that
are their responsibility.
44. Change that Sticks
• Discover what others have done
• Be honest about what we (the system) has
energy for and can commit to
• Coproduce and prototype solutions, iterate
or let go.
• Test and Review
45. So far
• The future is already here its just not
evenly distributed
• Frustrated and passionate
• You can only do it together
• Through networks
• Diversity a condition of success
• Test out and iterate
50. Purpose
Goals
Results
Pathway 2
Innovation & Change
Pathway 1
Judgment and Choice
Measure to
assess, choose &
hold to account
Measure to
understand and
improve
Knowledge
about
Performance
Knowledge
about
process and
results
Consumers
Purchasers
Regulators
Contractors
Citizens
Care delivery
organisations, Care
delivery teams,
Professional practitioners.
inform
Enable
Adapted from Berwick, DM, James, BC and Coye, M. The connections between quality measurement and
improvement. Medical Care 2003; 41(1) 30-39 (Jan)
51. 3. Loss of Public Sector Values
Picture from Newsweek
60. What is known about innovation
spread
• You need to be frustrated enough with the
status quo
• You have to have the capacity to adapt
• You have to diversify who is involved
• You have to give up power at the top
61. Health Systems Innovation Lab:
The Next Generation
• Data supported understanding
• Generating a possible picture of the Future
• Catalysing the conditions for system to change
• Connecting to innovators
• Enabling translation
• Prototyping and adopting
62. Our role here in higher
education
• Challenge the ideology
• Offer ideas and clarify what works
• Show you what’s possible
• Help you have courage
• Hold your hands in the fog of
implementation
• Help it stick
63. The Next Generation NHS
• Data, for Understanding, Rapid
prototyping, Citizen action
• Services delivered through networks
• Less reliance on institutions
• Has to learn
• With citizens as active partners and
leaders
64.
65. What is the one thing you heard
that made you think?
Is it possible to predict the number of people coming to A&E with a fractured hip every week, by time of day?
https://www.polleverywhere.com/multiple_choice_polls/Yc7tdKH27VKCMSc
Who is the best GP?
https://www.polleverywhere.com/multiple_choice_polls/tu2l41YZ7wTHQjt
Kretzmann, John P. and John L. McKnight. Building Communities from the Inside Out: A Path Towards Finding and Mobilising a Community's Assets. ACTA Publications, Chicago, IL. 1993.
A Data Model for Social Innovation in Place
William Gibson The Economist, December 4, 2003 William
What helps innovation happen? Choose the most important.
https://www.polleverywhere.com/multiple_choice_polls/c96QOLYd8OvH33u
From forthcoming book Malby R, Anderson –Wallace M, 2016. Networks in Healthcare – Managing Complex Relationships
Adapted from Berwick, DM, James, BC and Coye, M. The connections between quality measurement and improvement. Medical Care 2003; 41(1) 30-39 (Jan)
Jones K, Warren A, Davies A. 2005. Mind the Gap. Exploring the needs of early career nurses and midwives in the workplace. NHS Health Education England, May.
https://www.hee.nhs.uk/sites/default/files/documents/Mind%20the%20Gap%20Report_0.pdf
Adapted from The Innovation Unit http://www.innovationunit.org/our-projects/projects/what-really-works-scaling-innovation