Change that sticks

2. Change that sticks Innovation, experimentation and adaptation

3. What’s embedded in the word? invention change innovation progress improvement

4. An Innovation in public services • (NB not the same as public sector) • needs to be more than a policy idea……. • about implementation and does not need to be successful • more than continuous improvement - a step change • durable enough to affect the operations or character of an organisation • service innovations are intangible because they are not based on • products but on changes in relationships e.g patients and clinicians • may be invisible except to those directly engaged in the activities • is only recognised as an innovation if it perceived as new • by a several of key stakeholders • From • Innovation and its contribution to improvement. A review for policy makers, • Advisors, Managers and Researchers Jean Hartley May 2006 • Dept of Communities and Local Government www.communities.gov.uk

5. Dimensions of innovation (Jean Hartley) Product innovation e.g. new instrumentation/equipment Service innovation - e.g. Assertive outreach in mental health services, Hospices, intermediate care, patients booking hospital appointments on line Process innovation – e.g. admin reorganisation, mapping leading to new approaches e.g. pre-op assessments, computer links Position/location innovation – e.g. new contexts or customers e.g. own homes, independent treatment centres, polyclinics Strategic innovation - new goals or purposes e.g. new social contract with citizens, co-production, pluralism in providers Governance innovation - e.g. Community Panels, Board of governors in Foundation Trusts, City Academies Rhetorical innovation - new language or concepts e.g. carbon tax, food miles, contestability, WCC, leading place.

6. Lots of new and radical ideas, what makes them unsticky? ‘I’ve been working with a client trying to radically change itself. There is no shortage of good, new, radical ideas. People say, “Yes!” and grab them and put them back into old processes old relationships old information flows. They take up the new and put it into the formats, processes and systems of the current culture, turning it back into the very thing it’s trying to change!’. Myron Rogers 2008 Implications- we have to innovate relationships or social relations

7. Incubating & prototyping Generating possibilities Replication & scaling up Analysing & learning A rough-and-ready framework for thinking and action on innovation in public services an iterative, not linear process Albury & Mulgan, October 2003

8. Generating possibilities • conditions and circumstances • which foster the production of innovative ideas • (more later in ‘self-improving organisations’) • Incubating and prototyping • Pilots, pathfinders, beacons, demonstration sites • modelling and simulations • Analysing and learning • routine evaluation of policies, programmes and initiatives • generally not enough on why and in what circumstances • something works (or doesn’t) • Replication still slower diffusion in the public sector • obsession with ‘best practice’ • when diversity fertilises innovation • over-focus on top performers • though innovation more common among strivers • and under-performers Albury and Mulgan 2003

9. Mayo clinic: SPARC Lablast 10 years

10. Mayo Clinic SPARK labCumulative value creation

11. Some questions we are asking at CIHM (giving attention to both wholes and parts) ‘What makes it possible for people to find solutions that stick ?’ ‘ What supports the capacity of systems to innovate?’ (‘What supports self organisation?’)

12. In living systems Evolution is the • process within which adaptation occurs. • It involves • the generation of diversity, possibilities • Selection forces applied to these • Amplification or reward

14. What about complex social systems which do not operate as markets (or maybe quasi markets? In your table groups work on the following questions • How do possibilities get generated?

15. What about complex social systems which do not operate as markets (or maybe quasi markets? 2. What are our distinctive ways of amplifying in the public sector?

16. What about complex social systems which do not operate as markets (or maybe quasi markets? 3. What are the selection forces in the public sector if organisational exit (death) is inappropriate as a selection force?

17. Self-improving system: required characteristics for a system which fosters innovation and its diffusion • leadership: clarity of vision and desired outcomes (and relaxed on process) • funding regime which rewards improvement in (not absolute levels of) performance • source of venture capital (loans not grants) • users and providers have easy access to robust, comparative performance information • contestable: enables replacement of under-performing or failing organisations by more successful • sufficient diversity for adaptability and experimentation • sufficient concentration to exploit economies and benefits of scale Albury and Mulgan 2003

18. Our working assumptionsfrom a complex system perspective. • You can trust resourcefulness of the system - the problem is not the • shortage of ideas and innovation can arise anywhere in the system • 2. There may be a problem of learned helplessness in systems. The • attribution of cause to individual rather than systemic factors) • ’they won’t let me’ or ‘I do it in spite of the system’ • 3. Finding solutions to service users problems never ends.- It is not a signal • of having got things wrong but of the constant adaptation needed to get • personal services ‘to work’ • 4. Requisite variety is necessary for evolution/adaptation or innovation. • 5. We use conversations to work with both tacit and implicit knowledge • -face to face engagement and relationship building • 6. It is unlikely to stick if one part of the system tries to innovate alone. • Multiple perspectives are always in operation and can increase • possibilities at both the invention and the implementation levels. • 7. It is not a linear process so how do we work with non-linear dynamic • processes • 8. You can’t predict which offerings/efforts will succeed - you may not know • till the end of the process

19. What busy managers could pay attention to: • Way tell stories • Clarify constaints • Generate possibilities: create space, multiple perspectives, recombination, time to explore • Amplify/ Select: pattern recognition, new relationships, new roles (anthropologists, T people), access to info, reward adopters

20. Most happens at the front line - the top of the organisation can give space for experimentation. (Albury) 30-80% of innovations fail (private sector data) and that is an under recording Think of an example of something you tried to innovate but failed to get the outcome you wanted

21. The problem of ‘failure’ Innovating? What fails- the event not the process? Experimenting? bad experiments but not bad results Evolving ‘Failure’ is essential

22. Thinking about experimentation……. • The scientific community is self organising. • There is no ‘corporate structure nor one boss. • Act as if your theory is right only in as much as it • hasn’t been found to be wrong yet. • Good experiments are not failures • Behavioural Rules • formulate testable hypotheses • design reproducible experiments • make findings available to public examination

23. Experimenting to find things that stick Some key findings about what is missing: Innovations abound but what is lacking is the focus and no co-ordinated capacity to evaluate which innovations are worthwhile More networks and face-to-face exchange (formalised informality) will build inter organisational and interpersonal relational capacity to grease the wheels of innovation dissemination The adoption of proven innovation depends on the local application of effective change management processes Formalised informality: an action plan to spread health innovations A position paper prepared for the Ministry of Health New Zealand by Jonathan Lomas 2008