‘Thinking Differently’

Our local health and care system has continually evolved over time:

• • 1950’s, we transformed our society when we created our health and care systems. We moved from a Dickensian world where most people died in their sixties, people often went hungry, untaught and untreated. Life spans lengthened, our health improved, we created free access to education and a safety net when things went wrong.
  • 1970’s, we thought differently about the increasing demand on our services and embedded the principles of public management, introducing competition, targets, audits and cost controls. It brought new assets and opportunities and new issues too.

Now in the 21st century we face new challenges

• • • People are living longer with chronic conditions. One–off interventions by experts are no longer enough and new solutions demand the participation of those we treat.
    • The health impact of complex social issues and are beyond our current 20th century health and care organisations alone.
    • Our system was designed to treat emergencies; it was not designed to help people thrive.

We have new opportunities and expectations through technology

• • • We now have instant access to information through the internet.
    • We can now connect to each other in different ways and have power and influence through our ability to share messages and opinions.
    • This has changed everyone’s opportunity to participate in our own health and care and that of our community – and our expectations that we should.

We now need a new way of thinking about our delivery of health and care that is:

• • Predictive – as we develop the capacity to embed population health intelligence.
  • Personalised – as we embed genomics and more targeted treatment.
  • Preventative – through more accurate scanning, more support to change lifestyles.
  • Participatory – engaging all of us to change our own health outcomes and those of our families, neighbours and communities.

We have identified our ‘Higher Ambitions’ that identify the causes of ill-health and distress and have committed to tackling these together as we integrate our health and care system.

We have started to build relationships and deliver support in ways we would not have imagined a few years ago. At our System Leaders conference on Friday 13 September 2019, we shared examples of where across our system we are already ‘Thinking Differently’, we looked at what had sparked the change and how we could embed this thinking into our whole system plan.

Highlights from the Thinking Differently Leaders Event

In his concluding remarks at the end of the day, observations from ICS Executive Lead, Dr. Ed Garratt were that:

1) There is a ‘sea change’ in the system. Whilst there are many challenges, there is a strong sense of mutual trust and optimism in the system. Transformation is happening in many places.

2) ‘It’s not just us, it’s the system’. Leaders are increasingly putting the population before narrow organisational interestes. We are recognising that ‘capacity comes from working together’. We are also spreading innovation across Alliance boundaries.

3) The ‘Power of Kindness’ was a theme that ran through all the presentations. There was also a relationship between kindness and technology.

4) We need to ‘Tackle the fear factor’ and have the moral courage to do the right thing for the population. As leaders we should role model courageous leadership and take risks on new innovations.

“Old power works like a currency. It is held by a few. Once gained, it is jealously guarded, and the powerful have a substantial store of it to spend. It is closed, inaccessible, and leader driven. It downloads and it captures. New power operates differently, like a current. It is made by many. It is open, participatory, and peer driven. It uploads and it distributes. Like water or electricity, it is most powerful when it surges. The goal with new power is not to hoard it but to channel it”
Timms & Heimans ‘New Power

“The most important reason people don’t trust institutions is that institutions don’t really trust people, … we need to dream up entirely new models that make us feel more powerful and more connected to one another in all our guises: as patients, taxpayers, consumers, neighbours, voters, students and parents”
Timms and Heimans ’New Power’, 2019

“To solve todays problems, we need collaboration, we need to be part of the change and we need systems that include all of us. We need to create systems that make participation easy, intuitive, natural and to do this, we need to start in people’s lives”
Hilary Cottam ‘Radical Change’, 2019.

“The relationship between citizens and the state, and also between citizens and civil society, is currently based on outdated and unhelpful models of ‘doing things to and for’ citizens, without recognising individual and community capacity to do things for themselves, albeit with the support and enablement of other agencies”
National Association for Voluntary and Community Action (NAVCA)

“Our welfare state might still catch us when we fall but it cannot help us take flight. It cannot support us to confront the challenges of the day to day and it cannot change the direction of our lives”
Hilary Cottam ‘Radical Change’, 2019.