More learning about hope, inner journeys and positive safe team spaces

There was so much that I love about this article. Firstly its talks about inner journeys, this is something all of us should reflect on. When we are working in healthcare remembering why we do, how we can keep patients central and ways that we can keep on improving both as services and as individuals is so important. As the article said none of us can stay the same, why? Because, to create the best culture, best care, we must move on, keep evolving and listen to what patients need from us. Personal journeys can be hard, it may mean facing our doubts or fears, it may mean us being honest with ourselves about things that we need to change with-in us, perhaps attitudes or ways of working.


Our inner journey as the article points out, is linked to the teams we work in. Thinking about the questions in the article can help us re-focus and re-evaluate what we are doing as an individual, but also as a team.


What I love most about this article though are the thoughts around hopes and dreams. We all have hopes and dreams whether we are healthcare professionals or service users. Sometimes we have hopes and dreams but feel they may never become a reality. When we care for others, having hopes and dreams for our service helps us to aim for something, it gives us a common purpose and keeps us close, building respect. As the article says, thinking about where we fit in and the contribution we make, to those hopes and dreams can help us to always give our best and reach out for things that others may say are not possible. As service users we may have hopes and dreams for ways that we would like services we need to be. Bravely speaking up, telling our stories and reaching out to offer support can be a way of having those hopes realised. As a service user we have valuable insight and often we see ways that services can work better, this can be a gift we can offer that will not only benefit us but others too.


A wonderful article, by two inspiring people, who show true compassion and give us all much to think about.



The democratization of healthcare

Commentary by Anya DeIongh  


Anya works for the NHS in Dorset as a self-management coach in Dorset. She also works nationally as a patient leader, and her work has been recognized in the HSJ 2015 Rising Stars List, and the HSJ Patient Leaders list this year.

The Democratization of Healthcare

John Nosta’s interview is an interesting read – it certainly touches on all the buzz words in the digital health arena. It is refreshing to see someone acknowledge the multifaceted nature of the challenges we are facing in healthcare, but the solutions he has discussed are very narrow in their application.

Apps can be brilliant, but they require the users to have a certain degree of self-efficacy already. The people who perhaps most need support and to change their behaviors aren’t going to be able to access it. I certainly wouldn’t have been able to when I was at my worst.

It was interesting to note about the change in power dynamic. I agree with Nosta that access to information and increased understanding is a contributing factor in disrupting traditional power balances. Perhaps equally if not more so, the shift from clinical to holistic wellbeing also changes the balance. Focusing on the medical, psychological and social impact of a health condition in the context of some-ones’ day to day life (a more person-centered approach) can have a significant impact in sharing the power and knowledge as well.

Walking (and talking) mountains

Recent legislation The Care Act [2014] promotes the need for real personalisation to be the way of working in the social care sector. Whilst some in the sector are finding it easier to go back to business as normal, others are taking it up as an opportunity to embed real personalisation that understands and provides personalised care and support.

This blog provides an insight into the amount of time and resources that are deemed essential in order to develop and embed a way of working that incorporates everyone working together feeling valued and respected.

One point that stands out is that person centred care starts with person centred thinking. This is a culture change that needs to be taught and shaped using co-production.  As a carer I can relate to this way of working, as carers gain the skills to become personal commissioners in their own right. Formal and informal carers piece together services; we become the experts on how services work. Why are carers still not listened to?

Peers need to be supported and listened to if building community capacity is the way forward. Success will only come if we are all walking the mountain instead of just talking the mountain…

The future of social media will be built with positive psychology

Dave Hearn @DarziDave

Having only finally succumbed to social media ( #SoMe ) around a year ago I really identify with the 5 stages of a Twitter user: Denial, Curiosity, Aha!, Obsession, A Part of Life. There are many benefits to be gleaned from #SoMe. At a basic level it relieves boredom on the train but can also become an obsessive end in it’s own right – who’s retweeting my tweets, how many likes do I have, what big-hitters are following me. But always at the back of my mind is the nagging worry that I’ve become another one of a vain legion shouting into a packed room “Look at Me!”

This article asks the question – what is the point? #SoMe provides an amazing platform to connect, learn and influence, so what are you doing with it, what is the ‘social good’? If you want to answer this question for yourself it may be worth spending 5 minutes thinking about what your values are (in 3 sentences?!), how would you describe your ‘brand’, what would be your elevator pitch be? Then think – do all of my interactions on #SoMe match my values. Alternatively you could read this article and find out how to objectively measure your ‘social good’…

Holding a position of power does not make you a leader

This is a thought-provoking hard hitting article basically reinforcing the view with which I agree, that the title “leader” is not something that comes automatically with positional power but is about actions based on values and example.

I sense that the author Joel Peterson who graduated from business school in the 1970s has experienced the best and the worst of “leaders” – the latter being comprised of narcissists, bullies and power players whom he places in a box marked “jerk”. He rightly points out that many of the best leaders have no position in the official hierarchy at all such as community and faith leaders whom he describes as being characterised by the level with which they genuinely care about their “followers” and their capacity for honesty.

This is certainly my experience as a “patient leader” working for a long time with no real legitimacy in the system. I had to form my own notion of leadership to take into account that I had no real power or authority within the system and as such my “leadership” would have to be defined by how I conducted myself and by always bearing in mind the words of Lao Tzu “A leader is best when people barely know he exists, when his work is done, his aim fulfilled, they will say: we did it ourselves.”

Co-creation of news

A lot like health systems, journalism has, over the last few years, had to change and adapt to meet the changing demands of audiences: the internet has become the primary source of news, rather than newspapers and TV; audiences want their news now, live, as it happens; and news organisations who previously supported expensive investigative reporting, have had to slash budgets, so journalists are less able to follow stories for a long time. This means that for many media outlets, the detailed personal element of a story is being missed; which is a loss for audiences as it’s this personal, emphatic connection with a story that helps us to comprehend the impacts of events.

In addition to this, the rise of social media has led to audiences wanting greater interaction with their news. Usually this takes the forms of comments on a story. Traditionally, the audience are witnesses or by standers to events, interacting only after a story has been told. But what if we could co-create the news we are consuming, and actually be a part of the news-gathering process?

In this interesting podcast, Madalina Ciobanu of Journalism News talks to Jennifer Brandel, founder of WBEZ Chicago Curious City, Matt Danzico of BBC Pop Up, and Rob Edwards, founder of The Ferret – all of whom have introduced an element of crowd-sourcing to their news gathering and reporting.

These journalists, reporters and film makers have all developed ways in which the audience can be involved in every step of news gathering, bringing fresh ideas into the pipeline and opening up news gathering to diverse ideas and opinions, so that they can better represent the community they are serving and informing. Crowd-sourced, people-powered stories can direct journalists to questions that they may have not asked on their own, which can add context to local issues and allow the audience to have a greater connection with the story. These stories are a place for shared-understanding.

This is co-creation of news: the journalists provide the editorial judgement over what stories to cover, curate the stories being told, collect the information and write the news; but they are also the conduit through which the community can ask its own questions and share its own stories.

As an experienced journalist, I don’t think crowd-sourcing should be the only source of stories: often the role of journalists is to bring stories and issues to light, which the audience may not have been aware of; but I do believe that there is a role for people-powered news, and if we want to better connect with events, add context and understand their impact, then we need more engagement, and this can be done through co-creation. Via co-creation, we can ensure that limited news resources are investigating the issues that we the community want to know more about.

So, taking this into consideration, what questions would you like to ask? What topics would you like to be further investigated? Do you have a story that you want to share?

Commentary by Jen Clemo

Advanced measurement techniques in improvement work

An essential part of the change process is measuring the outcomes of any change that has been implemented. Outcome, process and balancing measures are all required to assess whether the changes are having the desired effect, being implemented correctly and whether there are any unintended consequences elsewhere in the healthcare system.

It can be tempting to concentrate assessment on specific areas such as interesting topics, areas of success without looking at the wider picture, or limiting data to a small timeframe. Falling into these traps will not provide useable assessments and so the following process should be adopted:

Develop an aim statement and improvement theory to be clear about what is to be accomplished and what factors need to be worked on to achieve this. Identify the outcome, process and balancing measures that will need to be analysed and a system that allows for the collection of all the necessary data. Analyse the data in the most comprehensive way possible and demonstrate the results in easy-to-understand form, complete with an interpretation of the results. Communicate the results, including failures as well as successes so that improvements can be made.

Improvement science alert

The improvement science alert is a great resource for health and care which highlights key reports, research papers and opinion pieces in succinct bibliographic style. It supplements The Edge and is equally well curated to bring you additional resources on leadership, large scale transformational change and improvement science. Content is layered and clearly identified in the following formats:-

  1. Open access for any online users.
  2. Athens resources from NICE which require separate sign in.
  3. Restricted access requiring payment to access a resource.

I would recommend that you sign up to the Alert and share with others in your health and care networks. Change is changing and this resource is handy to have in your innovation toolkit alongside The Edge.

Live webcast – building products that customers love


How can you make products that customers love? The webcast takes you through many of the ideas we covered in the issue 12 of The Edge on designing products and pathways. What I enjoyed within the webcast were the handy tips gained at each stage of the process which could be applied to innovation in health. First start with the problems and decide how you can develop a project that addresses these issues using the lean start up approach.

The lean start up approach is covered in more detail by Eric Ries and it is a fundamentally different way to achieve success with projects.   At The Edge we have spent a year beta testing the product – a knowledge hub for health and care change agents. Trying different ideas to see how it fits with the needs of the Edge community. Sometimes it worked, other times it did not, but what was important is that we learnt from that experience and what our community told us. We often quote in our Horizons presentation slide decks that we fail fast, learn and embed that learning. The Edge 1.0 has been an amazing lean start up experiment where we have tried agile approaches and apps, whilst working out loud.

We tested the science of intrapreneurship throughout the year whilst undertaking the various roles and designs that have led us to The Edge2.0 issue 13. The iterations will not stop and we want the community to work with us to develop the platform and use The Edge to support you to do good work.

The question we have now is not can we build a community change platform, but how can we work with our community to build an even better one! Change is changing and we want you to share your learning with us through the new more intuitive platform.

Why we should all hack medicine

This is a creative and inspiring TED talk which manages to take viewers through Lina’s own personal improvement journey – solving her own problems to that of solving others.

We learn more about why we should use a hackathon methodology to accelerate healthcare innovations. Hackathons allow us to:-

  1. Look at old problems in a new light
  2. Work across disciplines
  3. To solve our own problems

If we relate this thinking back to our teaching in the School for Health and Care Radicals I would suggest that the hackathon methodology allows us to:-

  • Create strong links from our weak ties
  • Challenge old power and move to new power change
  • Take problems to the edge of an organisation to be solved
  • To co-create change

Nottingham University Hospitals (NUH) ran their first clinical hack, focusing on health care for older people. It was an amazing day where over 30 NUH staff from a range of disciplines came together to tackle issues they face every day. After an introduction session, through a process of idea creation, the NUH staff identified four issues they wanted to focus on:

  • discharge planning
  • hearing issues for older people
  • keeping patients and staff happy
  • improving recruitment of staff into the older people service.

At the end of the day teams pitched their hacks to a panel that included the directors of Nursing, Communication and Service Improvement (Better for You) and the Chief Executive of the hospital charity. The hospital charity had made available some funding, and each team pitched for a slice of that money to help develop their idea further.

The final hacks were:

  • Creating a mobile app that had up-to-date information about discharge planning.
  • Installing hearing aid stores on older peoples’ wards, which would include stocks of batteries     and guides to help staff with patients with hearing impairments.
  • Purchasing an iPad for use by patients, to give them access to games, newspapers and Skype etc.
  • Developing a team hub and resource room and creating an education programme.

All the teams not only secured money for their ideas but a commitment from the senior leaders to help the teams put these ideas into practice.

Hacks are a new way of looking at healthcare issues. To showcase more of this approach we are going to be running additional hacks alongside the NHS Transformathon event in January. Each hack will link to the main event and highlight how change is changing.

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