Is health and care transformation possible? And, if so, what is needed to make this happen?
We need to be more like an iPhone. This bold statement, made with the understanding that other forms of mobile communication device are available, was made at an event we held last week where we asked: “Is health and care transformation possible?”
One delegate suggested that the key to the iPhone’s success is its easy-to-use functionality and relatively affordable price; they went on to suggest that health and social care service re-design needs similar characteristics, in order to improve the user’s experience.
This was just one of the practical solutions on offer at the seminar, jointly organised by SCIE and the consultancy, PPL. The session was refreshingly challenging and provocative, attended by around 20 senior people across both health and social care sectors who operate at local, regional and national levels. Once we looked at whether transformation’s possible, we then discussed what that transformation might look like.
But let’s stick with the service user / patient for a moment. Our chair, Lord Michael Bichard, said at the event: “You see the stupidity when you step into the consumer’s shoes.” Michael was adamant that we have to believe that it is possible to transform health and care, and to identify and remove barriers which stop brilliant ideas becoming reality; in this respect I wonder if we have sometimes failed to excite and empower staff.
As organisational leaders, we can fall into the trap of operating on too much of a belief that we have all the answers. But we have to remember to inspire, to motivate - and to give room to - people who are well-placed to comment and who have good ideas. Quite frankly, I think we need to show more humility. Let’s not have a race to see who’s got more direct payments clients. Let’s look in the first instance at how direct payments may or may not be improving people’s lives in a particular area of the country. That’s perhaps how you really capture the spirit of self-directed care.
Let’s look at the way the world works in the private sector. It was suggested that the most vulnerable ‘clients’ of the NHS are those least able to exert pressure on the current system. In the private sector, however, this would probably lead to a collapse in demand and in turn it would most likely encourage the need for transformational change. All too often, in health and care, according to one delegate, we: “keep changing structures to make it look as if we’re doing something.”
Attempting transformational change in a time of crisis is accepted as being very hard to achieve, and it has probably prevented the success of some pilots and change programmes in the past. For example, where closing a hospital may be considered the most appropriate action for a system, it is politically dangerous for local MPs and councillors. So, how can we identify, and then share and absorb, the risks, as collaborators rather than competitors?
So, it was a stimulating and refreshing morning. The issues weren’t new, but there was a real sense of shared purpose that now’s the time to tackle a range of barriers in ways which really can make a difference. But – and it’s a big but – there’s a long way to go. However, let’s take Lord Bichard’s advice and do it in the consumers’ shoes. And that doesn’t mean we’ll always find the solution in an iPhone.
Tony Hunter is chief executive of the Social Care Institute for Excellence (SCIE)
• “Transforming outcomes for children and young people”, Wednesday afternoon, 9th December 2015
• “Delivering on mental health and wellbeing”, Wednesday afternoon, 2nd March 2016
SCIE – Improvement support for care providers
Paul Corrigan’s blog – (Event discussion facilitator, as chair of PPL’s senior advisory group)