Innovation or Novelty?

It’s a tough call commissioning new care processes.

Do you do the same as usual but faster? Do you do something different, by definition an untried process .

Doing something different is often described as an innovation, but is it really innovative?

A new contract to an existing supplier which is accomplished by the supplier in its current form is not innovation. It may have the novelty of newness, the frissant of freshness, but if the provider is just doing more of what it is set up to do, then there is no innovation. More of the same does not change the landscape and although novelty is amusing for  a while it soon fades and the system returns to normal.

Setting out to commission something which requires existing suppliers to change their processes and structures or which can only be fulfilled by a new provider is innovation. Beware that all existing pressures in our complex adaptive health system will attempt to force the new initiative into a shape that neuters the effect of innovation, so the emergent commissioning decision will need to be protected and steered to produce an innovation solution.

Why bother about innovation?

It is the nature of healthcare systems to be complex and adaptive. These systems want to revert to their current attractor state and the only way to move the system is a significant disruption. If you’re not ready to break it- and we’re not quite there yet with healthcare, the next best thing, possibly the best thing, is to innovate.

Go ahead, give it a try, but not as a novelty item.

Transforming the Horse and Cart

Part of the problem in healthcare is that we don’t actively seek transformational change. We focus on being better, being safer and just working darn harder to get results. Unfortunately building a better horse and cart has inherent limitations.

Sport illustrates this quite nicely, the high jump in the early days of the Olympics was a standing jump, which became a scissor jump after a run up. Of course performance increased, and thanks to occasional falls a mat was introduced to prevent injury.

Things went on for a while with slightly better results every four years but then, the straddle jump evolved and results improved dramatically. Now everybody did the straddle jump and things were slightly improving every four years, it seemed that the straddle jump was the best way of doing it, period-until Dick Fosbury came along that is.

Once again a transformation occurred which changed the game with a quantum leap.

Of course now the NHS faces a major pressure to survive, and surprise surprise we’re squeezing efficiency out of the current systems, getting that better horse and cart. Even the potentially transformative shift to Clinical Commissioning Groups looks like it will be focussed on better pathways, again that horse and cart.

So what should the transformation be? Who is the Dick Fosbury of our NHS. I don’t know, it could be you or me. The solution is not going to come to those of us who are equine focussed in mentality. The solution will come from people who are not afraid to question the status quo, and ask the question “why not?”