Patients and staff can both promote innovation

When I worked as a political adviser in Whitehall people would regularly come to see me with a gizmo they said would save the NHS.

‘The more power you pile into the instruction, the less likely innovation is to happen’

Sometimes it was private companies, sometimes NHS staff. What they wanted to know was: who was the person they needed to go and see who would be able to tell the whole NHS to implement their innovation, and could I introduce them? They had already tried seeing X and Y, but they didn’t seem to have the power to make this happen.

The paradox in this request is at the heart of the problem about spreading innovation throughout the NHS. Innovators know − because this has been their personal journey − innovation needs space, anti-authoritarian people and the opportunity to try things out. Their bright idea was created in the teeth of their bosses telling them to get on with what they had always done.

The people who came to see me were hoping there would be a single person that would tell the NHS − with its million public consultations every 36 hours − what to do. As imaginative innovators, they were desperate for the NHS to be a Stalinist organisation that would tell everyone to carry out their very new innovation.

In December 2011 the government published Innovation, Health and Wealth and many of those who wanted innovation enforced from the top perked up. This was after all the prime minister arguing for innovation to be spread in the NHS and linking the successful spread of innovation, not only to improved health but also future growth in the economy.

Scanning the horizon

A year later, a progress report echoed the Stalinist structure that some yearned for. As with Soviet analyses of progress in the five-year plan, this report ended with 21 boxes being ticked, and none not delivered. But if everything was going so well, why was it still so difficult to spread innovation?

The main way in which people want to spread innovation is through pushing it into the NHS. When that doesn’t work, they want a more powerful push, and when that doesn’t work, more and more pushing.

You can make an organisation do one or two things this way, but you can’t make it innovate. The more power you pile into the instruction, the less likely innovation is to happen.

‘The more patients have the chance to exercise choice over services, the better innovation will spread in the NHS’

In other industries the main way innovation is spread is the pull of innovation into every corner of the industry. The main mechanisms for pulling the spread of innovation are staff and customers.

In these industries, senior staff bring the new idea into their organisation. They think: “If we don’t keep up and exceed the speed in which other organisations are pulling innovation into them, then we will fail.” Staff are constantly scanning the horizon for new ideas for their organisations and the better they scan, the better the organisation does.

Patient power

This is why a powerful failure regime for NHS organisations is an integral part of the faster spread of innovation. Thriving as an organisation means that we have to be early adopters of the best ideas and if we don’t then we will be in danger of failing.

‘Publish which practices are not complying and give the public the right to quickly and easily move to those that are’

Alongside this is the power of customers − or patients in the NHS. Whole industries move forward in an innovative way because customers demand it. They go to X because they provide a more up to date service than Y. The more that patients have the chance to exercise choice over services, the better innovation will spread in the NHS.

Some GP practices are much more up to date with carrying out National Institute of Health and Clinical Excellence guidance than others. If patients knew which these were, they could chose to move to them. The practices that lagged behind would have fewer patients; NICE-backed innovations would spread to more patients more quickly.

A patient’s right to NICE-approved treatments is enshrined in an NHS constitution backed by law, but at the moment this is failing to push NICE guidance across the NHS.

Let’s learn from others and publish which practices are not complying and give the public the right to quickly and easily move to those that are. Patient groups would provide some of the power of pull to make this happen.

Paul Corrigan is a management consultant and executive coach