Guest blog: Health and Social Care Innovation – are we really learning our lessons?

Hazel Harper, Programme Manager, Health & Care, at Innovate UK has kindly offered readers this guest blog (which is also available on the Innovate UK website).

Delivering Assisted Living Lifestyles at Scale (dallas) is the largest innovation programme in Health and Care to date. With an ambitious target of touching the lives of over 160,000 people, just exactly what can we learn from this ambitious programme?

 It was no mean feat. With no blueprint combined with delivering business as usual and only 3 years to deliver there are plenty of lessons but the question is how many of them will we really learn or will our incessant need to do things our way or no way remain the longest running barrier to progress we’ve known in this space?

lessons learnt

Insight in to some of the lessons learnt (in no particular order)

Treat it like a quiz – see how many you recognise. Of course there are more and new lessons to be learnt, applicable to the whole sector but there’s just not enough room here!

  1. Project initiation always takes far longer than anticipated and three years is not long enough for a programme of this complexity and ambition. Five years is the suggested minimum period with the greatest benefits realisation around 2 years later.
  1. Establishing and maintaining large heterogeneous multi-agency partnerships to deliver new models of care is challenging and requires robust management, excellent communication and time to achieve coherence and influence care models and approaches. Resource the project properly and actively facilitate collaboration.
  1. Flexibility and adaptability and an iterative approach to both development of systems and the implementation strategy are key facilitators.
  1. Building trust across a variety of partners in a competitive environment requires time, understanding of each other’s objectives and continued validation of purpose.
  1. Identify and manage the different risk appetites. Sometimes you have to stop debating IF it’s the right thing to do and just try it! Risk empowerment of all partners, especially NHS ones, along with managed risks and a willingness to fail is key.
  1. Seek and take advice. Don’t re-invent wheels. Yes, that old chestnut.
  1. There is an inherent tension between embracing innovative co-design and achieving delivery at pace and at scale.
  1. Co-design is the new consultation. But beware you can do too much and ROI on invested resources may not materialise to the level expected. Consider engagement touch points before rolling out products and what tools/offer do you have at that time to connect to the project user. Be agile and flexible.
  1. Walled gardens versus the internet. Individuals who drive things forward, still want to ‘personalise’ the products which puts it in a walled garden for one with 200 people…. You need individuals who are personally committed but it is crucial to have the partner who can get buy in and make decisions.
  1. Use SME 3rd party app developers who can work within your structure. If you are an SME offer value add to current service offers.
  1. Quality Adjusted Life Years (QALYs) are unlikely to be the most appropriate outcome for assessing the benefits achieved from deployment of digital consumer wellness products. It’s important to examine new ways to define, measure and cost “wellness” and/or “wellbeing” as currently there are no adequate methodological tools.
  1. There is a need to explore new ethical and consent models to bridge the gap between consumer and research approaches. Current R&D and ethical arrangements are not “fit for purpose” to address the ethical issues raised by the evaluation of innovative and evolving service delivery programmes such as dallas.
  1. The effects of branding and marketing issues in consumer healthcare settings are of crucial importance. Awareness, awareness and awareness!

Other skills and attributes:

  • Resilience in bucket-fulls to survive the ever shifting sands of health and care and other continually changing external environments.
  • The ability to navigate complex socio-technical change against challenging uncertainty.
  • Court the champion engage them, and secure by-in. Close the gap between top level commitment and the budget holders.
  • Think like you are dating but behave like you are married. Working with a mix of partners from industry, statutory and other sectors brought new perspectives, collaboration and delivered learning. But tensions and external influences in stakeholder groups forced changes in direction. Living it Up had 30 partners .…. they say it was like being married, rows and disagreements but eventually compromise.
  • Don’t be short sighted. Consent and data sharing it is sooo hard but it’s not a time to be short sighted or take the easy option, think long term.

So, don’t reinvent wheels, visit the dallas resource site at DHACA (Digital Health And Care Alliance).  Because this is a mammoth task we’re still pulling together the resources but you will find plenty to keep you going for now.

More diving coming soon …………. what will surface next?

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  1. James Barlow

    All are horribly familiar to those involved in this area going back 15 years or more, but what are the actual lessons, ie on outcomes from the individual to the system levels?

  2. Hello James

    Yes, they are all too familiar and there lies the point. Unless we actually address these reoccurring themes we simply won’t make the necessary progress to unearth the true and sustainable benefits to the system and individuals or create demand and the necessary infrastructure for a much needed consumer offer.

    Innovate UK commissioned two evaluations:

    The University of Glasgow looked at:
    (1) Benefits for the individual, their family and carers and
    (2) Benefits to systems.

    Databuild Research Solutions Ltd looked at Wealth creation benefits for the UK.

    Both these reports will be published and available on the Digital Health and Care (DHACA) website in the next couple of months.