46 Suffolk and North East Essex ICS | ‘Our Journey Together’ 5.7 Enable change and transformation to evolve Evolution rather than revolution There has undoubtedly been a strong appetite for change and transformation in Suffolk and North East Essex ICS throughout the last decade. There is some learning from this journey not just from where we have been successful in achieving transformation but also, and arguably more importantly, from where we have not. Stakeholders talked about how whilst always focusing on a vision for high quality health and care for all, we need to take a gradual approach to transformation, of evolution rather than revolution. The ‘Three Horizons’xlii model for change has been a useful tool to consider this issue in the ICS. This recognises that the current state of the system (Horizon 1) has strengths but also elements that are not working and should be stopped. The model requires us to set out our vision for the future (Horizon 3) and then what more we will do (Horizon 2) to achieve it. Understanding the process of change and transformation The vision in the Suffolk and North East Essex ICS has been to radically ‘reimagine’ the way that health and care is delivered but stakeholders have often felt frustrated about what feels like a lack of progress towards achieving that vision. Our learning is that successful system innovation is unlikely to occur as a binary process where we move directly from a current state of business as usual to a future state where radically different ways of working have been implemented. Instead the process of transformation from a current state to a future state is likely to take place as a more gradual process over time following a reliable pattern of specific process stages. The updated ICS Integrated Care Strategy ‘Future Shift’xliii (December 2024) offered a simple framework to evaluate our progress and maintain momentum beginning with building the right foundations before doing things smarter then progressing to doing more innovative smarter things and then building on this in time to genuinely reimagine health and care. Prevalence Time Three Horizons Framework H1 H2 H3 • Horizon 1 (H1) is the currently dominant but failing system that declines over time as it loses its fit with a changing environment. However, H1 will not disappear completely, as some aspects will remain valuable in the desired future. • Horizon 3 (H3) is the envisioned desired future that is aligned to the changing environment. • Horizon 2 (H2) is a turbulent intermediate space of innovations, some of which are ‘captured’ by H1, prop it up and extend its lifespan (so-called ‘H2-’ innovations), and some of which are genuinely disruptive and create space for a radically different kind of system to emerge (‘H2+’ innovations). The framework also shows how some people and systems will already be working in radical ways that already embody H3 values, described as ‘pockets of the future in the present’. Innovation A progression framework for innovation and transformation 2016 2024 2032 2040 1. Building the Foundations 2. “Doing Things Smarter” 3. “Doing Smarter Things” 4. Reimagining Health and Care Picture – progression framework for system transformation & innovation – Future Shift, 2024
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