Another insightful blog from Professor Becky Malby on how to create the right conditions for innovation in health and social care.

She points out that we tend to know what the future needs to look like – less hierarchy and top-down control and people and communities themselves working in genuine co-production with professionals, yet there seems to be at times to be a yawning chasm between where we are and where we know we should be.

She describes well the tension between a system based on judgement and choice (hierarchy) and one based on innovation and change (networks). This divide is often indicated by, she states, the dismissal of “innovation” as “soft” and acceptance of performance management as ‘trustworthy’.

I believe that what is really behind much of this tension this is a reluctance to cede power and this is often fear-based. We can see the value of empowered communities exercising self-determination but can be reluctant when it looks like this might mean ceding hard-won personal/professional territory.