Liberating Ideas: the award-winning projects that could truly liberate the NHS

Take three award-winning projects to improve the NHS, some of the most senior and experienced people in the health sector, and an environment designed to encourage creative thinking and problem solving and what do you get?

The hope is rapid spread of good ideas and practice across the NHS – and that was the principle behind the Capgemini/HSJ Liberating Ideas Award. Three category winners were invited to present their schemes to a group of judges at Capgemini’s Advanced Solutions Environment in London.

The Advanced Solutions Environment – think huge whiteboards, creative artists, enabling technology and the occasional teddy bear – is designed to allow ideas to flourish, be developed and challenged in a collaborative way, and be refined so that final implementation time is reduced.

The aim was to identify the scheme which had the greatest potential to be spread across the NHS – ideally reaching 100 trusts within the next year. That did not mean that the other category winners did not have the potential to also transform care – and the judges were clear that they did – but more that their impact could be longer term or they needed additional time to develop their ideas.

The winners from the three categories of prevention, primary and secondary care, had the support of their chief executives and the commitment of judges to work with the winning team, using their contacts and experience to help push the projects forward. Capgemini also offered a package of support for the overall winner over the next year.

Capgemini head of healthcare Brendan Farmer said the day was “an opportunity to pick the brains of the judges and your colleagues from other organisations”. Judges could help to “cut through the treacle” of the NHS, he added.

And the three teams took this on board, explicitly saying what they wanted out of the judges in terms of advice, help and access, and responding to some very challenging questions.

Making the case

The day started with the three very different projects being presented to the panel of judges and their competitors.

Each team had 25 minutes to talk about their projects – helped by videos and poster displays – and answer initial questions. All three projects were developed by staff who had seen a gap in services or an opportunity for improvement which would both benefit patients and offer cost savings for their organisation or the NHS as a whole.

All had some evidence that this was happening, and, crucially given the current financial climate in the NHS, all were either implemented out of existing resources or had cost relatively little to put into place.

But from then the ideas were subject to detailed scrutiny by the judges. This was not with the aim of demolishing them, but to examine areas which needed further development and to provide useful input and suggestions which could refine the ideas and identify and overcome potential obstacles.  

Judges examined each scheme in three sessions looking at the business case for the reform and its state of readiness, how the solutions could be scaled up, and how to make it happen. This provided some of the most challenging points of the day with judges asking teams to identify obstacles and how they would convince the sceptics. Often the teams were having to think across whole health economies rather than just their own organisations and to identify key stakeholders. Their assumptions about who their projects would be aimed at and who would pay were tested.

Some of the questions asked had profound implications for the NHS. How do you fund a scheme which improves care in residential homes and reduces emergency admissions? Where do the benefits lie in the system, and how can the “winners” be persuaded to pay? How do you persuade orthopaedic surgeons to get behind a scheme to improve rehabilitation for their patients without making them feel their care is being criticised? Can a scheme to identify women with a long term condition considering pregnancy be used as a way of reaching women with other conditions?

The winner is…

So what was the outcome? Colchester University Hospital Foundation Trust was the overall winner. It impressed the judges with the simplicity of its offer, its potential scope, and its ability to save the NHS £90m a year if it were fully adopted.

It has already been rolled out from the original target group – patients with fractured neck of femur – to include elective orthopaedic patients, and could benefit other surgical patients. And it is addressing an issue which is common to most hospitals in the country: how to reduce length of stay and better rehabilitate patients for independent living. It could also be implemented quickly – the initial scheme in Colchester had been put in place in four weeks.

HSJ editor and judge Alastair McLellan, said it had been a difficult decision but “the judges were unanimous that this was a project which had clear and real benefits and was ready for rapid spread”. And it was an idea which was right for the challenges the NHS faces in the next 12 months.

Mr Farmer of Capgemini explained the process which the project would now go through – development to make it easy for other locations to implement it, adapting to the judges’ input and, importantly, the need for commitment from the trust itself to carve out time for the staff to work on it.

“It’s always amazing to see what the NHS is capable of,” said Richard Stubbs, project director for NHS Innovation Challenge Prizes at the NHS Institute. “There is no doubt that the three teams all have ideas and solutions which are vital for the NHS. The real thing is how do we take this and get support and enthusiasm.”

South Essex Partnership University Foundation Trust chief executive Patrick Geoghegan praised the process that the three teams had been put through. “We had an opportunity not only to read the documentation before we came but to meet the people and to probe with questions and challenges, and to be allowed to give some advice and input, a bit like being a mentor.

“These are very experienced judges which can help them take it to the next level – and that’s unique.”