Innovation: scaling is in the air
By Janet Grauberg, Organisational Strategy and Learning Consultant
Three Reports on scaling innovation
You wait years for a report on scaling up innovation, and then three come along at once. A report by SCIE and partners on health, social care and support, plus publications on the NHS by The King’s Fund and Innovation Unit and Health Foundation were all published in January 2018.
- SCIE: Growing innovative models of health, care and support for adults
- King's Fund: Innovation in the NHS
- Health Foundation: Successfully scaling innovation in the NHS
They take a similar approach – identifying case studies where innovation has been followed by attempts to scale or spread, and drawing out the threads of what has helped and hindered. They also bring different perspectives. SCIE’s report stresses the importance of co-production, which sees users and carers as central to the design, delivery and evaluation of innovative care and support services. This principle should underpin both the generation of new approaches, and the way in which they are spread to new contexts.
The King’s Fund paper, developed in partnership with the academic health science networks (AHSNs), highlights the value of “boots on the ground” for spread to happen, and the importance of both senior clinician support and project team resourcing. The IU/HF paper adds a reflection on the state of the academic research about spreading innovation, and pulls out key insights for organisations wishing to innovate, and for system leaders and funders.
So far, so good, so what next?
The three reports make a strong case for investment in scaling. But they prompt two further questions. Firstly: where is the system leadership to provide such investment? The AHSNs, the various “What Works Centres”, and the three “think tanks” who produced the report all have a role to play. But as the King’s Fund report says, while the NHS only sets aside 0.1% of available resources for the adoption and spread of innovation, progress will be slow.
Secondly, what are the practical activities that funders, leaders, and organisations could undertake in order to accelerate the spread of innovation?
A recent paper on spreading innovation in children’s services identified the '4S' characteristics of engagement activities that were likely to be effective in spreading innovation:
- Social engagement – ie people connecting face-to-face to uncover tacit, as well as explicit knowledge
- Situated engagement – enough information to be able to understand the source organisation, and to reflect on the context of the recipient organisation
- Sustained engagement – to enable reflection on action and to build trust
- Start with the question of the learner – led by those who want to adopt
So what can we do?
There are plenty of activities that have these “4S” features, including joint practice development, job swaps, journal clubs and communities of practice (See Further Reading below).
In my work I’ve been developing Action Learning approaches that mix information, input and the chance to visit and ask questions of the innovator, with the structured and supported process of action learning, characterised by voluntary participation, peer support, reflection on action and contextual sensitivity. This enables a small group to ‘get under the skin’ of the core features of the innovation, work through how to apply what they have learnt in their own places, and come back together at regular intervals to share progress, ask further questions, and be supported to work around any barriers they may be encountering.
It’s early days, but I’m hopeful it will become a practical approach to help bring the scaling of innovations out of the air, and onto the ground.
Fielding, M., Bragg, S., Craig, J., Cunningham, I.A.N., Eraut, M., Gillinson, S., Horne, M., Robinson, C. and Thorp, J., 2005. Factors influencing the transfer of good practice.
Sharples, J. & Sheard, M. (2015) Developing an evidence-informed support service for schools–reflections on a UK model. Evidence & Policy: A Journal of Research, Debate and Practice, 11(4), 577-587
Sims, S., Moss, G. & Marshall, E. (2017) Teacher journal clubs: How do they work and can they increase evidence-based practice? Vol. 1, No. 1. Chartered College of Teaching. Impact, 1(1).
Revans, R. (2011) ABC of Action Learning. Oxford: Gower Publishing, Ltd.