Business leaders, senior managers and even politicians all say they want it. In the NHS its role is officially described as – and I quote – “to ramp up the pace and scale of change and deliver better outcomes for patients”.
Noble stuff, to be sure, but do we really appreciate what innovation means, why we strive for it and, perhaps most significantly, how it comes about?
As a researcher in this field, I’m not so sure we do.
For a start, how should we define innovation? Maybe the neatest answer is to view it as the successful exploitation of new ideas or as a means of bringing value by doing things differently. It’s a process that carries concepts into actions – irrespective of whether those concepts take the form of services, technologies, businesses, means of organising or even ways of thinking.
Why do we strive for it? Generally speaking, the reasons fall into two fairly distinct categories: external and internal. External drivers might include competition, booms and busts, new technologies and emerging trends. Internal drivers might include growth, a desire to maintain a competitive edge or a need to combat business fade. You may think some or all of the above relate to the NHS with suspicious neatness. You could well be right. Regardless, this brings us to the third and final question, which is supreme relevance:
How does innovation come about? The notion of “idea producers” and “idea consumers” was first proposed by scientist Paul Lutus, who designed equipment for NASA missions before writing some of the most important programs in the annals of personal computing. According to Lutus, “idea producers” can be identified by their unshakable belief that novel concepts are invariably the work of others. Accordingly, the more we cultivate “idea producers” – and, by extension, the less we encourage the proliferation of “idea consumers” – the more likely we are to achieve success through innovation.
This is a vital lesson for any organisation, the NHS included.
Case in point: a little over a year ago Nottingham University Business School hosted a creative problem-solving session for managers and staff from a major NHS trust. The best pitch came from a podiatrist who proposed increasing the scope for giving renal patients in-clinic care by treating them during dialysis. This was a radical suggestion. Among other hurdles, there was the ever-vexed issue of cross-site working: community providers would have to attend patients in a secondary care unit with no funding from the hospital. Nonetheless, senior managers present at the session agreed it was feasible and vowed to support it through commissioning routes. The scheme was up and running within months and has since proved itself unusually capable of satisfying the “triple burden” of a patient-centred, cost-effective, high-quality service. It’s now attracting interest from elsewhere.
But how should other trusts actually respond? That’s what we need to look at next. Of course, any idea that engenders a transition from acute to preventive treatment deserves to find favour everywhere within the NHS. Yet it’s vital to understand that mere imitation of the podiatry initiative discussed in my previous posting would completely miss the point, which is that the ultimate value lies in moving away from an organisational culture rooted in the misguided conviction that innovation must always be the stuff of visionaries, of outsiders, of “them”.
The reality is that the engine of change is in plain sight and awaiting a turn of the key. The story of our podiatrist shows what can happen when an organisation is willing to solicit the input of its own staff and to tolerate the uncertainty that the unfamiliar inevitably brings. The fact is that many of the people best placed to save the NHS through innovation are already working in it.
They just need the encouragement and the freedom to demonstrate as much. Anyone who doubts the validity of this claim may want to consider the following simple illustration. Imagine a business has a staff of a thousand but allows only 50 of them to contribute to its innovation activity – say, by sitting on the board or working in the R&D department. That means 95% of the workforce contributes nothing. This is both self-defeating and incredibly wasteful. In a large organisation 95% of the workforce could easily run into the thousands.
In the NHS we would be dismissing the insights of more than 1.5 million people. The point is that anyone might hit on a would-be “game-changer”; yet what he or she probably dreads more than anything is apathy – or even fear – from those higher up the chain of command. In other words, everyone has ideas, but not everyone has a voice.
If anything like the creative potential that lurks within the NHS is to be realised – and if innovation is to be more than a passing buzzword – time must be found to nurture an environment in which all employees can be confident they’ll be listened to, supported and, when appropriate, backed from the top.
In short, what’s required is a genuinely participative culture – one that recognises the unavoidable and extraordinarily useful truth that all of us know more than one of us.
Paul Kirkham is a researcher in the field of entrepreneurial creativity with Nottingham University Business School and co-deviser of the Ingenuity problem-solving process taught to students at its Haydn Green Institute for Innovation and Entrepreneurship (HGIIE).