Ensuring innovation works - across a portfolio
The Situation
Client was an alliance of public sector organisations (a health economy) with combined turnover of over £1 billion, and with an innovation portfolio of £60million per year. They had no way of finding out whether the innovation actually did any good – and they suspected it didn’t.
The Task
I led a team of 4 consultants. Our task was to create a system of measuring and reporting on their innovation projects so they could decide how to prioritise, invest or disinvest, and generally get the best return on their investment. We termed it building a Benefits Framework.
The Action / Approach
We divided the whole of health and care into 10 workstreams, streams like “Public Health”, “Planned Care”, “Refugees and Migrants”. Each stream went through a series of 3 workshops, 10 weeks apart, with coaching and support in between the workshops. Workshops included Board Members, Senior Managers, Team Leaders and Front Line Staff, and crossed boundaries between health (PCT, Hospital, Region) and social care (local authority adult, families; charities and independent providers).
*First workshop* got them to explain where they were now. What were the innovations, the new projects/ initiatives in their stream? Compare this with the strategic objectives of the whole health economy. Understand if there were any conflicts/ duplication and what were the real gaps. It included instructions for working towards Second workshop.
Second workshop developed measures – not what’s easy, but what’s useful. This engaged everyone in what they were trying to achieve. It also developed the baseline against which performance could be judged.
Third workshop got the initial measures from the initiatives – ie what had changed in 10 weeks. Yes – a lot had changed and improvement was already obvious.
The Result
Staff from all providers were surprised and pleased to be involved in deciding on priorities. They said that they didn’t know what the strategic objectives were, and once we explained how strategic objectives related to their specific stream, and to their specific team, they were excited. There was a brief moment of concern “so if my project isn’t useful, will I lose my job?” to which i replied “would you rather know now, and change and do something useful, or find out in two years’ time that what you were doing was useless and that you could have found out two years ago?” – instant motivation!
In general, health and care professionals don’t like measuring because it makes them feel like hourly paid workers. With carefully designed, relevant, measures, they were very engaged – one nurse told me “for the last 15 years I’ve turned up at 8am, seen a bunch of sick people, and gone home at 4pm. Now I can tell my grandchildren ‘I did a good job this week’ ” – and the stop smoking team said “we want to be measured on smoking prevalence across the population, not just how many people we saw each January, as they are probably the same people”
We didn’t get an estimate on how much difference we actually saved, but 5 years later, the Chief Executive of the tPCT was still giving talks at conferences about how successful it was.
