Keeping the A in AHSN

Lars Sundstrom, our Innovation and Growth Director reflects on the role of academia in encouraging innovation and experimentation, and the importance of this to AHSNs.

Last month we had our first get together as an AHSN Network. Around 200 fellow AHSNers, most of them considerably younger and much more energetic than me, got together to celebrate how fast and far we have come in our first five years. Bright eyed, bushy tailed and ready for the next challenge, how can an old-timer like me not be inspired by the next generation and their appetite for the future?

When I was a university professor, I always felt the best antidote to feeling blue or if things got a bit bogged down was to find some students and talk to them. You quickly realised that the world is driven by hope and belief in the art of the possible, but that over the years you accumulate fear and restraint to the extent that you focus more on the art of the impossible.

Anyway, at the AHSN gathering I felt like a milestone had been achieved, not just because we entered another five year licence, but because it completes a personal journey from invention to innovation that I have been on for the past 30 or so years.

Bench to bedside

As you have probably guessed, the path that led me into the AHSN was not via the NHS but through academia. I spent most of my career in translational medicine doing drug discovery and development both in universities and in industry. I tell the youngsters in the team that back in them olden days when I was young we didn’t have a word for translational medicine, and we didn’t even know how to do it. I tell them we didn’t have phase one, phase two and phase three clinical trials; we just gave people pills or injected them with stuff and saw what happened.

“No way man – how could you do something like that? That can’t have been safe!” Well it wasn’t, I say, but what else could we do? Somebody had to be brave enough to be the first!

Translational medicine was the buzz word at that time and the term ‘bench to bedside’ is often used to describe it. So what brought me to the AHSN was the next logical phase – to  scale up. Perhaps we could say bedside to bedsides. I was also attracted by a new buzz word ‘innovation’, which I believe is probably the most important word to ever impact the NHS, and I’ll explain why shortly.

So back to the AHSN conference. After reminding people how AHSNs came into being five or six years ago, the speaker asked, “Hands up how many of you were around when it all started?” Apart from me, a few hands went up. She described the amazing progress made and we looked into the future and it felt great – except a bit of me felt that as the endeavour grows, that original pioneering spirit of adventure was slowly slipping away a little; that leap into the dark, that fear of the unknown. It all felt a little too safe, a bit too much like the NHS.

In the coffee break I bumped into my colleague and friend Tony. “What did you think of that then?” I asked. “It was great”, he said, “but I guess I’m still trying to figure out when it was that I joined the NHS?” “Yeah,” I said, “it feels a bit more like we’re in the NHSN rather than the AHSN.”

The conference concluded with a fabulous talk by Michael Seres, a patient entrepreneur and someone I have admired for many years. We once ran a conference on what it’s like to be an entrepreneur and inventor developing products for your own health issues – a ‘chief patient officer’ as Michael describes it. His message to us was clear: “Dare to be brave.” What’s  great about people who have come to this journey by misfortune in life is their spirit of adventure. It feels like they have nothing to lose and everything to gain, so they just hurl themselves into the unknown with unswerving devotion and energy.

People like Michael, Kevin Mashford, David Constantine are amazing – people who dare to be brave and innovate against all odds are the ones who will change the world.

What is innovation?

So back to innovation, this new buzz word. What is it? Well, like translational medicine in the olden days, we actually don’t really know how to do it healthcare. In 10-20 years’ time I will be able to tell you. I can tell you what it isn’t though. It isn’t about continuous improvement; it is about doing something that hasn’t been done before. Therefore it is also not 100% safe. I could write a blog on just that but in the meantime have a look at this excellent blog post by Alex Ryan and Jerry Koh on the subject.

I strongly believe, as I have said many times before, without innovation the NHS will not transform and will not be sustainable and it won’t survive. But like translational medicine back in the day, if we don’t try and we don’t fail, we will never learn and it will never be safe. So my message to the young AHSNers is: dare to be brave, learn from failures and then improve it, and it will become safe.

In the questions and answer section, I asked the chief officers where they would like us to be in five years’ time. Charlie Davie, Managing Director of UCL Partners, gave a great answer. He said, “I want the NHS to be known for being the best place in the world to do innovation, and in future the Americans come over here to learn, instead of us going over there to learn how to do improvement.”

As an academic, I know that all improvement and impact starts with experimentation. So I say, let’s keep the A in AHSN – where it stands for Adventurous, Ambitious and Audacious. If we see ourselves just as a safe distribution channel for innovation into the NHS we will have become NHSNs, and from there it is a small step to becoming the NHS and we will have failed to change anything.

So let’s dare to be brave, keep the academic mentality in the AHSN, and keep in mind the words of George Bernard Shaw:

“There are those that look at things the way they are, and ask why? I dream of things that never were, and ask why not?”

The answers are out there

Natasha Swinscoe, Interim Managing Director, explores some of the issues raised by the recent Nuffield Trust  paper ‘Falling Short: why the NHS is still struggling to make the most of new innovations’.

Many of the NHS staff I’ve worked with seem to be cut from the same piece of cloth. If you show them a problem needing a solution, they’ll either find the solution or work out how to. These people are proactive problem solvers, so if the thing they need isn’t on the market, they may well make one ‘Heath Robinson’ style.

At a recent conference I listened to clinicians from one of our local trusts outline some of the systems and solutions they’d been putting into practice to fix their problems. These ranged from different training methods to a sponge being used in an innovative way to stem internal bleeding. I was struck by their creativity and innovation. The question in my head was how we harness this creativity, recognise and celebrate it, and then spread the solutions to others in different hospitals to use. Professional networks often provide an adoption route, but even these don’t offer comprehensive coverage.

Shortly afterwards I read the Nuffield Trust briefing paper ‘Falling Short: why the NHS is still struggling to make the most of new innovations’. I knew it resonated with my experience when I kept underlining sentences in red, with a number of exclamation marks! Here are a few…

  • Innovation in the NHS relies on pushing products first and hoping people take them up!
  • Identifying problems and looking for solutions isn’t built into everyone’s day job!
  • Innovation needs Senior Exec level oversight and support!
  • Too often short term savings drive the need for innovation rather than transforming pathways!

These are all important points. We know clinical and non-clinical staff will always find solutions. What we can’t rely on is the culture within the NHS supporting innovation. If the culture doesn’t foster or support innovation then new solutions or ways of working will falter, stay hidden from others, or at worst fail to solve the problem.  A ‘let’s try’ environment is crucial.

In my role as a manager of Acute Services, I lost count of the number of times I had clinicians turn up at my door or stop me in the corridor with an ‘idea’ they wanted to try – frequently for little or no cost.  We often pursued these ideas with a positive ‘Ok, let’s give it a go’.  Out of this came some fascinating service and pathway changes benefiting patients and staff, and saving time or money that we could then re-invest.  There were many  win-win results,  but they relied on a team culture that encouraged and shared  ideas, kicked them around, and then had a go, without being sure if they’d be successful or not.

From April we’ll be working with Office for Life Sciences to support this innovation pathway ‘end to end process’. We will be looking for ways to strengthen and support trusts and commissioners to adopt tried and tested ‘oven ready’ innovations. We will be looking for ways to capture ideas from front line NHS staff to match with business sector innovators.

The answers are out there. The people working in the NHS every day, the ones facing the situations that need solving, embody a wealth of creativity. We should be asking them what they need to make their working lives easier, what they need to make services slicker, safer and cheaper. They know what’s needed. If we support them and pair them with innovators and creators in the commercial and business sector they will create the changes we need. Let’s all start by looking for our innovators, listening to them, and supporting them to give it a go.

Goodbye 2017, hello 2018!

Drawing on lessons from our Patient Safety team’s recent away day, Nathalie Delaney shares a few creative and collaborative ideas to review what you’ve achieved as a team in the past year and how this might inform your plans for the coming year.

At the end of the year, it can be a good time to reflect on the achievements and learning of the past year and make intentional plans for a successful year ahead.

The West of England AHSN’s Patient Safety team met at the end of 2017 to do this together, and I thought I’d share our process here as you may want to reflect on this yourself or with your own team.

Goodbye 2017

As an icebreaker, we looked at the strengths of our team using the 16 personality types. Who’s in your team? What are your strengths? Then we looked back to celebrate the past year and asked ourselves:

  • What were our successes and achievements in the past 12 months?
  • What have we learned about ourselves and our members this year?
  • What were our biggest lessons this year?
  • Was there anything that surprised us?

If you are doing this as an individual, you may want to start by reviewing your calendar for the past year to identify key milestones and achievements. Alternatively you could create a shared timeline as a team. The Sign Up to Safety Kitchen Table Scribble Sheet has some other prompts that may help you do a freeform download of what’s on your mind.

Based on this we made a list of: what might we change or maintain in our work in 2018?

Looking ahead

We then had a presentation from our Managing Director, Deborah Evans, and Chief Operating Officer, Tasha Swinscoe, on the ‘big picture’ for the year ahead, both nationally and locally. From these, we identified what opportunities and challenges might arise in the year ahead?

Each member of the team was asked to nominate their theme song before the workshop. We held a short quiz to try to guess which song belongs to each team member, based on 20-second snippets from Spotify. As a team, we were surprisingly bad at this and it was a good way to find out something new about colleagues we work with. In case you’re interested, mine was ELO’s Mr Blue Sky.

Hello 2018!

The afternoon was spent creating a shared vision for 2018. We split this into aspects about how we, the team worked, and also our projects.

For our team we asked:

  • What should we stop this year?
  • What should we continue this year?
  • What should we start this year?

You can download a template to use with your team or consider the questions individually.

After a quick cake break, we discussed our projects and objectives, using the MoSCoW framework to identify our key aspirations and the impact we wanted to see:

  • Must do
  • Should do
  • Could do
  • Won’t do.

Our next steps are to identify what results we want to see and break these down into our large goals and smaller steps as driver diagrams using Quality Improvement methodology. As a team, we are moving to using Verto to manage our programme in the New Year. If you prefer paper to digital, you can print out our handy calendar for 2018 and add in your own goals and actions.

Over to you…

How can we in the West of England AHSN help you reach your goals in 2018? There are plenty of opportunities for support whatever your aspirations.

If your goal is to learn more about Quality Improvement, why not sign up to study the Quality Improvement in Healthcare MOOC starting in February 2018. This is a free six week course delivered online. You can also sign up for a free account for LifeQI which is a web-based platform designed to assist frontline staff running Quality and Safety improvement. The LifeQI system has recently been majorly upgraded and is free to access for West of England AHSN members.

Opportunities to join the Q community, an initiative connecting people with improvement expertise across the UK will re-open in 2018. Register your interest to be notified when applications are open.

If you are working in primary care, recruitment will open soon for Cohort Three of our successful primary care collaborative. Find out more and register your interest.

If your goal is to share learning from an innovative, measurable solution to a patient safety issue then why not enter the National Patient Safety and Quality Improvement Poster competition. Enter online by 16 March 2018. Short-listed entries will be invited to present a poster at the Bristol Patient Safety Conference on 16 May 2018.

If you are working in business check out our business support video which includes an introduction to our work with businesses and innovators and sign up for our newsletters including our funding finder which provides regular up-to-date funding opportunities for health innovators. This includes opportunities from Innovate UK, Department of Business, Innovation & Skills, Horizon 2020, The National Institute for Health Research and NHS England.

If you want to meet and share ideas with others who share your passion about improving and innovating healthcare, then you need to sign up for hyvr, our new social network for citizens, innovators, healthcare professionals – and well anyone really!

And if you would like to know more about evidence and evaluation or involving public contributors we have a range of toolkits to help you with practical steps in your day-to-day work. NIHR CLAHRC West provide a range of excellent training courses aimed at developing of skills in understanding, using and producing evidence for the health, public health and commissioning workforce, and patients and members of the public. You can also join our evaluation online network, a virtual peer to peer support group for all things evaluation related.

Evidence Works – an evidence-informed commissioning toolkit

Evaluation Works – a service evaluation toolkit.

Working Together – A toolkit for health professionals on how to involve the public

All the best wishes for a fantastic 2018!

The industrial strategy, right on man!

The government’s green paper on Building our Industrial Strategy was published in January. Our enterprise director, Lars Sundstrom says it’s about time…

Last month the government published its long awaited industrial strategy. “Frankly, my dear, I don’t give a darn,” I hear you say. Well, you should. When I read it, I thought to myself, “Finally. They’ve actually got it right this time. Absolutely spot on,” as you Brits would say!

The UK lags far behind other European countries like France and Germany in terms productivity, a trend which is now worsening quite rapidly.  So while our French neighbours enjoy a glass of wine having finished work while we are still toiling away with the longest working hours in Europe for lower output (and hence less money to buy decent French wine), one has to ask, what makes them so much smarter than us?

The science base in the UK is the best in the world. The UK, per capita, has the strongest academic sector by far, especially in terms of scientific output. It outperform its nearest rival the (United Stated) by almost three to one. In other words, the papers written by British boffins are more highly cited than anyone else. The UK has six universities ranked in the top 50, with three in the top 10 (Oxford holding the coveted number one spot), while Germany has only one and France has none.

So although the UK has the best science, its ability to translate that into economic growth seems to be lacking.

Some years before I joined the West of England AHSN I worked in biotechnology and spent a considerable amount of time in South San Francisco, which is where this new industry was born – only around 30 years ago. Biotechnology grew out of genetic engineering and cell biology, both of which owe their foundations to British scientific genius. Yet I remember, as I used to drive down Highway 101 in my open top Mustang, just how many British scientists I met who had brought their technology with them to develop it over there, and how frustrated they were that they couldn’t do that back home.

The industrial strategy is seeking to redress this and it has done two things that, in my view, are absolutely right on:

1) Invest heavily in translational science and infrastructure for applied research, and reward those that do it;

2) Not doing it at the expense of basic science but maintaining fundamental research budgets.

The secret to France and Germany’s comparative success in productivity is their ability to provide the right incentives and infrastructure for applied research and product development/testing, as well as a well-developed industry-university interface. In particular, success comes from the valorisation of people who want to do applied and industrial research and who are not considered inferior to university academics, far from it. The pinnacle is to work for a top company: Vorsprung durch Technik!

I am really pleased to see the recognition in the strategy that AHSNs will play an important role acting as catalysts for the conversion of innovation into new healthcare products and services through our involvement with the SBRI Healthcare programmes, test beds and the new accelerated access partnerships and innovation exchanges.

So I for one welcome this strategy. The government is absolutely on the right track, but it’s going to take a long time; in Germany it took over 25 years of continuous investment. But just imagine what the UK would be like now if that investment had been made 20-30 years ago and the UK had been the home of biotechnology!

Britain started it all with the first industrial revolution, it largely missed the second and third through lack of investment but. as we now enter the dawn of the fourth industrial revolution, it looks to me like the UK is now on the right track. See here if you are wondering what the fourth revolution is about.

California’s GDP is now around $2.5 trillion just behind the UK at $2.8 trillion, with biotech contributing about $200 billion, so I have to say thank you Britain for sending over all your scientists and the huge role you have played in building our local economy – I was born in California in case you hadn’t guessed. We will never forget what you’ve done for us, and have a nice day!

Read the NHS Confederation’s briefing on the Industrial Strategy.

Why the AHSN is like a honeycomb helmet

In follow up to her last cycling-meets-leadership blog post, Deborah Evans reflects on the beauty of a new cycling innovation and draws comparisons with how we work here at the West of England AHSN…

Talking of cycling, I was fascinated to read an interview with a woman who had invented a cycling helmet made of paper. In a classic case of design mimicking nature, it used a honeycomb structure.

I’m not sure whether I’ll wear one until someone else has tested it (not just a dummy) and definitely not until it’s been waterproofed.

But I’m enthusiastic about the concept nonetheless, because like cycling itself, paper is very eco-friendly and makes for happiness.

It made me reflect on the similarities and differences with the innovation processes we use here in the AHSN.

Firstly, it’s a great example of ‘innovation pull’.  In this case the unmet need was a lack of helmets to go with the ‘Boris bikes’ which we can pick up on the streets of London and ride at will.

Our equivalent in the AHSN is that we ask clinicians what problems they would like to solve. Sometimes we work with them to identify innovations that are already on the market, having been tested and are ready for use. And sometimes we issue challenges for innovations that are still in the developmental stage. Our favourite, perhaps, is the Small Business Research Initiative (known as SBRI) which is nationally funded. Our latest initiative in this programme was called General Practice of the Future and we called for innovations responding to demand management in primary care; self care and diagnostics and earlier triage.

Another similarity is that we like to invite people who use services to help us design innovative products and services – such as our crowd sourcing project Design Together, Live Better, which in its first phase famously resulted in a prototype child  car seat which you can fasten with one hand.

As far as I could tell from the newspaper article, the honeycomb helmet results from the inspiration of a lone inventor, and we have plenty of those in health – especially clinicians. But Lars Sundstrom, our Director of Enterprise and my innovation muse, tells me that the future for innovation is largely about collaboration and open source activity. This seems to be most effective (many minds are better than one) and quicker. This is a feature of our Diabetes Digital Coach test bed project, where we have a hearty collaboration between a number of small and larger companies and the support of Diabetes UK to create an online service hosting a range of digital self management tools for people with diabetes.

Another reason to love the honeycomb helmet of course is that it’s cheap, and surely that’s what the NHS needs. Effective, cheap and recyclable innovations.

Get folding that paper!


Donald Trump to save the NHS!

In his latest blog post, our Enterprise Director Lars Sundstrom reflects on leadership in times of change.

So have I finally gone insane or is there is any substance to this statement? Of course not. But then again, not much of what Trump has promised will materialise: he just said it to win votes, and you can quote me on that.

Being an American, I am saddened by the lack of ability of many of my fellow citizens to distinguish reality from a reality show. But I guess, as that great voice of the nation Homer Simpson said: “I don’t believe in facts. You can make them say anything.”

Now that I have your attention though, I’d like to keep you here to talk about the importance of leadership in times of change.

Last Thursday, David Constantine received his honorary doctorate from the University of Bath and gave the 48th Annual Designability Lecture. What an extraordinary life he has made for himself and so many others despite being wheelchair bound, having broken his neck in an accident at the age of 21. Not only has he over the years been at the forefront of designing mobility equipment for those with disabilities but has managed to travel the developing world and set up local wheelchair factories that continue to make lives better for hundreds of thousands every year who have more to complain about than we do.  And just to cap it off helped set up the charity Motivation to implement new financial sustainability models that employ locals to do it.

You are a truly inspirational leader, Dr Constantine, even though you apparently don’t seem to accept it was anything special.

And then to other inspirational leaders. On Friday night, our MD Deborah Evans received the NHS South West Leadership award for Leading System Transformation; another well deserved accolade to someone who doesn’t think they deserve it. All I can say is that Deborah is one of the most inspirational leaders I have ever met and have had the pleasure of working with.

It’s a beautiful autumn day as I write this blog post, but we are now bracing ourselves for what will probably be a harsh winter in more ways than one: pressure on healthcare to deliver more for less resource has probably never been greater.

Even the most hard-nosed Brexiteer accepts that the economy will initially suffer as we exit the EU and public finances will be tightly squeezed. It’s hard to feel optimistic at times, when some use deception to triumph over reality and make things worse for those of us left to cope with the real world. However, I really believe it’s in hard times that true leaders and true innovation arises.

We will of course cope. The US and the UK have given mankind many of the greatest inventions and lead the world in innovation. In fact, many of the great American reforms and indeed the NHS itself were born out of severe austerity. So this is the time for great leaders to emerge and take the stage. Next week I am teaching a leadership course for university academics and I will be telling them to expect and embrace change. Don’t suffer it. Lead it!

So Trump is not the kind of leader we need right now, and he won’t care much about equality or healthcare. He won’t save the NHS, but I do remember a certain Mr Farage a little while ago…

Digital health recognised as regional strength in Science and Innovation Audit

A recent audit into the science and innovation strengths of the South West and South East Wales has highlighted both health and life science and digital health.

The South West England and South East Wales Science and Innovation Audit (SWW–SIA) has been undertaken by a consortium of key organisations and businesses from across the region, including AHSNs, businesses, Local Enterprise Partnerships (LEPs) and higher education institutions.

Lars Sundstrom, Enterprise Director at the West of England AHSN, said: “I am really pleased that the Science and Innovation Audit has been able to underscore our local strengths in health and life science, and particularly our strengths in digital health.

“We look forward to working with our colleagues in South West England and South East Wales to continue our efforts towards making it one of the best environments to develop health care products in the world. We also look forward to fulfilling our new role as innovation exchanges with a role for supporting digital health as recommended by the Accelerated Access Review.”

“An opportunity for catalysing the region’s hi-tech SME cluster and the broader entrepreneurial community to respond to clearly defined challenges in the health system identified through the increased investment into health research”

The audit report refers to the region’s strength in leading the development of integrated care systems and suggests this presents an opportunity to “catalyse innovation, including attracting businesses to research, pilot and test innovations in the region, alongside catalysing the region’s hi-tech SME cluster and the broader entrepreneurial community to respond to clearly defined challenges in the health system identified through the increased investment into health research.”

The “exceptional capability” in population health research within our region is recognised in the report as providing companies with access to “world-leading expertise in evaluating the performance of digital technologies in improving population and individual health in the region. When combined with underpinning world leading capabilities in fields such as designing and evaluating complex health interventions wireless and optical communications technologies, data security and encryption and other major projects that are integrating data across, for example, primary, secondary and social care this provides a unique proposition to SMEs and larger corporations and will attract them to develop and grow in our region.”

The report welcomes the active support of the two Academic Health Science Networks NHS England in the region (West of England and South West) in supporting the development of the digital health sector and linking it into the NHS – the primary customer for digital interventions – and into the local authorities who now have responsibility for public health in England.

Our Healthcare Innovation Programme, which we run in partnership with SETsquared, Europe’s leading university business incubator is given a specific mention. This is our popular development programme, created to support healthcare innovators in the West of England, focusing on those with a clear business proposition or an innovative application in the healthcare sector. These are frequently in the Digital Health field.

The report also credits our involvement in both the development of local innovation hubs and the South West Interactive Healthcare Programme, a joint initiative between the West of England and South West AHSNs and SETsquared, financed by Creative England’s regional growth fund, to improve cross-sector collaborations and innovation, while opening up exciting practical opportunities for creative professionals to work with business clusters in the healthcare sector.

The Government has thanked the SWW-SIA consortium for its submission and is expected to make an announcement about its Industrial Strategy in the upcoming Autumn Statement.

Visit to read the full audit report. The summary report is available here, while the Digital Living annex report is available here.

Lost in translation

In his latest blog post, our Enterprise Director Lars Sundstrom reflects on the need for AHSNs to be multilingual.

When I first joined the AHSN three and a half years ago from my previous job at the University of Bristol, one of my esteemed colleagues at the time said I was crazy.

“Don’t go there,” he said. “I’m warning you as friend. People in NHS land speak a different language. They aren’t like us. You really won’t like it there, trust me.”

After being there a week I understood that he was probably right. I had no idea what my colleagues were on about in meetings and they soon got very fed up of me asking the same question, “Why are you doing it like that?”

I had to undergo an induction the following week. I had visions of magnets and coils but instead I was introduced to the patient safety lead.

“What’s patient safety?” I asked. “Is that something to do with making hospitals safe?” She smiled at me and said,  “Well it can be but it’s really about reducing variability across service providers.” I was none the wiser.

Then I was introduced to the improvement lead. “Hi, what do you do then?” I asked.

“Well,” she said, “We apply quality improvement support working in the local workforce to ensure they have appropriate skills to spread best practice.”  “Geez, sounds complicated,” was the only thing I could think of to say.

I feel like I’ve landed on Mars among a bunch of aliens! I have no clue what you guys are talking about in our team meetings.

After my first month our MD called me into her office for a chat. “How are you finding it?” she asked.

“Well, I feel like I’ve landed on Mars among a bunch of aliens! I have no clue what you guys are talking about in our team meetings.” “Don’t worry,” she said, “You’ll soon pick it up.”

I wasn’t so sure. However I was clearly amongst a new tribe of very bright and talented individuals with a passion for what they were doing, so I thought to myself, “Wow, this is great. I have so much to learn.”

“So, tell me about your plans for the wealth creation remit of our AHSN license,” our MD asked. Now, this I understood so I launched into my thoughts about translational medicine and the importance of building trusted partnerships to achieve effective co-creation in an open innovation environment, while encouraging horizontal innovation from multiple sectors and especially the importance of achieving joint value creation rather than operating merely in transactional mode with the private sector.

“Interesting,” she replied, looking at me with an air somewhere between bemusement and intrigue. “So what exactly does that mean then?”

Last week we had our third annual conference on the topic of innovation for sustainability and transformation. This morning I was having breakfast with one of our newest recruits; a bright young chap from a corporate finance background.

“So James, what did you think of the event last week?” I asked.

“Well,” he said tucking into a bacon sandwich, “Honestly, I was totally lost most of the time, didn’t understand what was going on. It’s a different world, clearly.”

“Don’t worry,” I said, “You’ll soon pick it up.”

Between bites he then added, “Well actually, the only bit I really got was when our MD spoke about how adopting open innovation and co-creating value leads to cost savings and the importance of partnerships across multiple stakeholders. What’s all this sustainability and transformation stuff all about anyway?”

“Well,” I said, “It’s the local road maps for delivery of the five year forward view.”

“Hmmm,” he said, and I could see from his expression he was none the wiser.

We are what you might call an eclectic mix and what I am looking for most is people who can bring their own perspective on what we do and are not afraid to question what we are doing.

So I realised that our AHSN has now become truly multilingual. I understand NHS speak, though my accent is apparently still a bit rough, and my colleagues now also speak a very different language too.

I have always tried as far as I can to hire people to our team that are as different to me as I can possibly find. We have people from many backgrounds: education, finance, health and government.  We are what you might call an eclectic mix and what I am looking for most is people who can bring their own perspective on what we do and are not afraid to question what we are doing.

The point is diversity of thought; the ability to see things in a different way. Feeling empowered to question the status quo and feeling empowered to do something about it is what really matters if you want to achieve truly sustainable transformation.

As a famous person once said, “We will not solve the problems we have by applying the same thinking that created them in the first place.”

How to make stuff happen…

Today something interesting happened as I was cleaning out two filing cabinets that I had manage to completely fill with paper over the past seven to eight years.

I put everything into two piles, one to keep and one to shred and get rid of. The pile for shredding was pretty big, but so was the keep pile. After a vigorous bout of shredding and filling I sat down with a cup of tea and peering at the two mountains of paper sill left on the floor I wondered to myself, why on earth had I kept so many useless papers?

What was the difference between the stuff I was discarding and the stuff I wasn’t?  I realised that the stuff I was throwing away had been kept because at the time it felt like it was really important, or at least at that time was equally valuable to the stuff I’m still keeping.

Being a bit simple minded I thought, wow that’s amazing, I now have a pile of stuff that has become useless and a pile of stuff that has become valuable.

This obviously holds the secret of all success; all I had to do is see which ideas worked out and which ones didn’t and could learn how to make more ideas work out more often.

So picking up the first folder from the reject pile I mused to myself, yeah well that was a pretty crazy idea, no wonder that didn’t work out. OK, let’s see what’s on top of my success pile. Hmm… actually that’s also a pretty zany idea but that was great success. So I picked another folder off the success pile: absolute no brainer, obvious why that idea worked out. Next, I picked one from the reject pile. OK, so why didn’t that one work out? It was an even better idea than the one I just looked at.

Astonishingly, I had to admit that with hindsight there was no difference between the two piles except that some things had worked out and some hadn’t!

Now this really bothered me  because it means I can’t control it and I can’t use any of the knowledge, but in the back of my mind was a nagging feeling that I had been here before.

In a former life I used to teach a course explaining entrepreneurship to scientists and the one thing they all had a real hard time grasping was the fact that success is not an equation, and it’s not exactly reproducible. You can take the same ingredients in a business proposition that worked last year and try and do it again the next year with the same people and it could fail.

If you think about it, were it to be exactly reproducible we’d all be rich and famous, but in reality stuff happens that we don’t control. One business I was involved with went out to raise funds the week before the markets crashed in 2008. We couldn’t have controlled that.

So the same is true of my two piles, the difference is that other stuff happened and got in the way of things so some ideas worked out and others didn’t. So what is this magical stuff that decides what works and what doesn’t. The things we just don’t control, well I guess it’s just Life.

I’d like to think I am getting better at spotting good ideas from bad ones but i’m still left with the rather stark conclusion that fundamentally the only way to make more successful stuff happen is actually to do more stuff.

But then again I guess I also want to have a life!