Think differently: Nine ways to adopt good ideas for NHS change

“When you don’t have to ask for permission innovation thrives,” said Steven Johnson in Where Good Ideas Come From: The Natural History of Innovation.

‘It was “thinking differently” that led to the creation of the NHS nearly 70 years ago’

At the heart of the Challenge Top-Down Change, set up by HSJ, Nursing Times and NHS Improving Quality, is the quest for new ideas; the opportunity to “think differently” about how we can make change happen in the health and care system.

It was “thinking differently” that led to the creation of the NHS nearly 70 years ago.

Since that time, people who care passionately for the ideals of the NHS have consistently seen the need for new thinking to meet the challenges of an environment that is ever changing. That need for good ideas about change is probably greater now than at any previous point in NHS history.

Outstanding response

The initial response in the first 10 days of the Change Challenge has been outstanding.

Hundreds of frontline staff, leaders and partners of the NHS have contributed their ideas, opinions and comments about what we need to do to deliver change in and beyond the NHS, far outweighing our expectations when we conceived the idea of the challenge.

‘If we don’t have new ideas, the NHS storyline won’t change’

This got me thinking: how come so many people are demonstrating creativity, energy and effort in responding to an ideas generation challenge in HSJ and Nursing Times when there is a deficit of new ideas coming through about change inside NHS organisations?

If we don’t have new ideas, the NHS storyline won’t change and we won’t get the future we need.

How to adopt good ideas

So, in the spirit of role modelling a process, here are my nine ideas on tactics that leaders and activists can adopt to get more good ideas about change in the NHS:

1. Use a structured process for generating and evaluating ideas and the quantity and quality of your ideas will snowball.

The free “Thinking Differently” toolkit is a treasure trove of methods for producing breakthrough thinking in health and care.

2. Bring together different groups of people who would not normally connect with each other and generate ideas on a multidisciplinary, multi-experience basis.

Give a voice to those who don’t often have one, such as patients, families and support staff. Value and encourage diversity of thought and dissent. The evidence shows that highly diverse groups of non-experts consistently outperform small groups of experts when it comes to the quality of new ideas and decision making.

3. Create ways for people to interact with each other and connect beyond organisational silos.

I’m a big fan of “randomised coffee trials”, as developed by Nesta. The process of innovation, from ideas generation, to getting buy-in, to implementing new ways of working is an intensely social activity. To quote Jorge Barba, what kills most innovation isn’t a lack of ideas; it’s a lack of relationships.

4. Make the time to listen to peoples’ stories about their real life situations so we understand a diverse range of perspectives, become aware of unique standpoints and generate ideas.

To paraphrase a famous saying, the real voyage of innovation is not in seeking new horizons but seeing the horizon in a new light.

5. Often what people do is different to what they say they do.

Invest time in observing what is really going on to see the situation through fresh eyes and get new ideas about a situation.

‘Invest time in observing what’s really going on to see the situation through fresh eyes’

Observation gives us the chance to connect issues and ideas that at first seem unrelated.

6. Make the “ideas generation” stage an earlier phase than the “idea evaluation” stage so that we don’t shut down creative thinking prematurely by judging the ideas.

We need lots and lots of ideas.

Across multiple industries, the ratio of ideas generated to innovations implemented is around 100:1. As the Nobel Prize winning chemist, Linus Pauling famously said: “The best way to have a good idea is to have a lot of ideas.”

7. Practice “honourable creative theft”.

There are very few original ideas. Most ideas build on previous ideas, adding a different context or perspective.

Make opportunities to take ideas from others in health and care, but also look outside your own field and to other industries for ideas you can adapt and test.

8. Be a role model for good ideas.

To what extent are you learning, thinking, questioning, observing, exploring, experimenting, failing, connecting, joining up and intersecting ideas every day?

Are you making idea creation and innovation part of your regular work routine so that you are continuously engaged in idea development, rather than waiting for other people to bring ideas to you?

9. As senior leaders, we should consider the relationship between control and freedom.

In our current, challenging operating environment we need control; to ensure that quality, activity, patient experience and income goals are met and to mitigate risk.

At the same time, freedom is a prerequisite for creativity and innovation.

How can we create an environment where people are encouraged to share ideas, take risks, experiment and challenge the status quo without fear of reprisal?

Just the beginning

Of course, generating good ideas is only the very start of the innovation process.

To get from good ideas to practical changes that really make a difference for patients and public is a long road and we will model that in our Change Challenge.

‘The best way to have a good idea is to have a lot of ideas’

However, history tells us if we get things right at the beginning, generating big number of ideas from diverse sources, building relationships and intersections as we go, we create the strongest foundations for future change and improvement.

If you haven’t contributed your ideas yet, there is still time. Contribute to the crowdsourcing platform.

Helen Bevan is chief transformation officer of NHS Improving Quality. Follow her on Twitter @HelenBevan