What are you laughing at?

Dr Jon Griffiths, Chair of NHS Vale Royal CCG and a GP at Swanlow Practice in Winsford, Cheshire, rues the fact that he will be missing Innovation Expo 2014:

The Health and Care Innovation Expo 2014 will be hosted by NHS England next month on March 3-4th and, as might be expected, the hope is that attendees will be inspired to bring about change, and to innovate.

Great. If I was not committed to seeing patients in surgery on both days, I would like to have been there.

Innovation has become a much-used word within the NHS in recent years, and I want to ask three questions. What is innovation, why do we want to innovate, and how do we innovate?

So, to the what? The dictionary definition is to ‘introduce changes and new ideas’. This sounds pretty straightforward, although I am very aware that the very concepts of ‘change’ and ‘new ideas’ are enough to give some people a minor panic attack. We don’t all like change. Some of us feel we are fine as we are, thank you very much. The NHS has just undergone enormous change, and many people are saying “Enough is enough. No more change thanks.”

So, how come we are being encouraged to flock to the Expo? Are we really up for more disruption?

I would like to argue that we are both up for it, and also that it is vitally important that we do.

As chair of NHS Vale Royal CCG I am proud to sign up to its four values: Quality, Patient Centred, Integrity and (you may have guessed) Innovation.

We developed these values a few years ago as a Practice Based Commissioning Group, and they have stood the test of time. We recognised even then that things need to change. The writing has been on the wall for the NHS for some time. Innovate or die. If we continue doing what we’ve always done, we’ll continue getting what we’ve always got. Not only can we no longer afford that, I would argue that we don’t want that. We want something new and better. We want transformation change across the NHS which will integrate across the organisational boundaries which exists both within the NHS and beyond.

Services need to appear seamless from a patient perspective, whether they are being provided from the GP, the hospital, the Local Authority or Age UK. The system is fast running out of money. Unless we do something we are going to fall off the burning platform and over the cliff edge (pick your favourite metaphor).

Innovation is about change. Innovation is about new ideas. We need both if we are serious about the ongoing sustainability of the NHS.

That was the why by the way.

Which just leaves us with the how?

This is the tricky one. Almost by definition innovation involves thinking of something new. There is no ‘off the shelf’ solution. True innovation is not copying someone else’s bright idea (they might have been innovative, you’re just an early adopter!), but coming up with something new and different.

How do you do that?

I would argue that we all are capable of this. We can all think ‘out of the box’, and come up with new ideas. I would also argue that we do this all the time. However, I think we also continually stamp on those ideas with our ‘yes, but’ approaches.

I once heard that Disney had a set process to go through when developing new ideas. Apparently they would have a team doing the ‘blue-sky thinking’. They would come up with all these great ideas, and would be enthusiastic and excited by them. They were given time to develop them, and they were not encouraged to think of the potential difficulties in turning their dreams into reality.

They would then introduce those ideas to another group who would work in a small, hot room (the ‘Sweat Box‘) whose job it was to think of every reason possible why these ideas would not work. They would feed this back to the first group, who would refine their ideas to overcome the problems identified before sending things back into the sweat box. This cycle would be repeated until a workable vision developed.

I fear that we don’t get past the first initial ‘blue-sky’ thought. Things tend to be immediately squashed by those of us much more at home in the sweat box. We have lost the ‘art of the possible’, and are often feeling so beleaguered with our day-to-day work that we cannot look up and see the opportunities that change may bring. We need to allow ourselves time to think. We need to allow ourselves time to notice the innovative ideas which get mentioned all the time, and then to talk about them, allowing the creative thinking, before we say why it can’t be done.

I remember once being told in a leadership seminar that the new, innovative ideas will often make us laugh. They are unexpected, surprising, and can seem crazy. Have you thought about looking out for the throw away comments made by others ‘as a joke’? It’s just possible that your next innovative idea has just been suggested. I wonder if NHS Change Day started like that? A suggestion, laughed at, not meant seriously. Until someone says “well, seriously, why not?”

And that is the beauty of movements like NHS Change Day. You don’t have to take them too seriously. They can be fun. All of the conversations I have had about Change Day have involved laughter.

But they have the potential to bring about great things, new ideas, learning and insights.

I’m sure there will be much laughter at Expo. I wish I was going to be there. Do me a favour, send me a tweet when you’re there. Tell me what you are laughing at. Use the hash tag #iamlaughingat. I’ll let you be the innovator, but I might want to be your First Follower.

Follow Jon on Twitter @DrJonGriffiths and at #iamlaughingat or blogging on the Vale Royal CCG website.

Dr Jonathan Griffiths is a GP at Swanlow Practice in Winsford, Cheshire, and Chair of NHS Vale Royal CCG.

He qualified from Manchester University in 1994 and worked as a junior doctor in the West Midlands, completing his GP training in South Birmingham.

He then worked as a GP for 7 years in South Staffordshire, where for a while he was involved as a member of the Professional Executive Committee for the local PCT.

In 2005 he moved to work at Swanlow Practice in Winsford.

Jon has been involved in commissioning in Vale Royal since Practice Based Commissioning (PBC) first developed a few years ago, and was Chair of Vale Royal PBC group before the NHS reforms led to the creation of Clinical Commissioning Groups.

He is a member on the board of the North West Leadership Academy.

Jon’s professional interests include GP commissioning and Clinical Leadership.

Outside of work he spends time with his wife and daughters, and enjoys being outside, particularly if that involves walking (or running) up a hill!.

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One comment

  1. David Pencheon says:

    Excellent blog. Much enjoyed reading it. Jon, I wonder if the drive for efficiency is sometimes the enemy of innovation in that the urge to improve efficiciency often drives one to continue doing what we traditionally do faster and faster rather than doing something truly difficult and that is to STOP doing something, and doing something quite different. Examples in teh business world include energy suppliers selling you warmth (whcih you want) ratther than energy (which your house may use badly. In such ways, incentives can be more claosey aligned. The equivalent in health care is e.g. rewarding prevention (which happens in some parts of the world from rural China [where I used to work with villlage doctors] to some US HMOs) and outcomes, rather than rewarding activity. So I guess innovation CAN be about doing the same things much more efficiently but it’s more likely to be transformational: getting the same outcomes but by radically different routes….