Digital innovation has the opportunity to transform public services to meet the needs of our changing population, deliver efficiencies and improve performance. Public sector organisations are striving to fulfil the government’s Digital by Default standard and, in doing so, provide a better service for millions of people. However, as compared with private sector technological innovation, the public sector is seen as a laggard.
There are several hypotheses as to why the public sector is slower to utilise technological innovation. In the private sector, the most innovative companies devote large amounts of time and resource to understanding their competition and evaluating their performance in all areas relative to other organisations in the industry. Public sector organisations (for example the NHS) aren’t competing for customers or clients in the same way that private sector organisations are. Therefore, it is suggested that they lack the motivation to adapt and learn from others. [1]
Further, in contrast with the public sector, companies in the private sector which embrace technological innovation as key to strategy will provide ample opportunity for both management and design/delivery teams to work together and communicate seamlessly and effectively. In this way the product or service is explicitly linked to organisational goals and objectives, and digital technology is used to maximise its effectiveness.
This helps to facilitate an innovative mind-set which is key to private sector companies maintaining a competitive advantage. In The Innovator’s DNA, (Dyer, Gregerson, Christensen) authors suggest that the most innovative companies are also the most experimenting. The process of experimenting is key to gaining new insights in addition to the research, observation and networking needed to increase the chances of success.[2] Public sector industries which are governed by time-restrictive schedules and targets have very little redundant capacity to devote significant amounts of time to technological innovation – it is therefore not viewed as business critical.
Public sector technological experimentation is happening however. The London Borough of Hillingdon for example have saved £750,000 a year through moving to Google Apps in delivering cloud-based IT infrastructure. In healthcare, The Leeds Care Record is digitising care records for citizens in collaboration with partner organisations such as NHS Trusts and GP Practices. It seeks to create one record per person which is never duplicated or cross-referenced when moving through different elements of the care pathway. 107 out of 107 GP Practices across Leeds are taking part in Leeds Care Record.
To date, the health and social care system has only begun to exploit the potential of using data and technology at a national and local level. Despite the fact that developments in clinical technology have been revolutionary, the same innovation has not occurred in the domains of digital technology and digital data. Across the public service spectrum, transformations in the use of digital technology have the capacity to create significant efficiency savings and performance gains. However, for this to happen, new infrastructure and innovative mind-sets must be developed and embraced. Motivation and opportunity to innovate in the public sector is crucial and this motivation is necessary in spite of fears surrounding reputational damage of failed experimentation. This is a difficult dilemma for the Health and Social Care arena in particular and for most Public Service organisations that find themselves judged in the Law courts and the ‘court of public opinion’, for their failure to protect against risk. In this sense the risk/benefit continuum is challenging tight – rope to walk for all those involved in trying to Improve services and outcomes. Public sector organisations need help to negotiate this challenging environment and foster “ahead-of-the-curve” thinking – and the first challenge lies in how to provide such help in a way that mobilises public and private sector knowledge, skills and resources. However, the challenges don’t start there. Whilst primary research, problem solving and invention are all exciting starting points to be engaged with its not the discovery aspect of Innovation that prevents organisations from accelerating along the curve. The failure to adopt or translate and spread what is already known is a much greater challenge in the mindset of organisations and the behaviour of teams. This is particularly so in the case of the Digital revolution and not so much for the introduction of technologies like ‘wearable devices’, but for the change in the behaviour of society that such catalysts can bring. Whether we welcome it or resist it, we cannot afford to ignore it.
In their editorial Kohane and Mandl[3] cite the issue of Electronic Health Records (EHR) as a concept that has struggled to ‘gain traction’ for a host of reasons. The problem has come in making that data portable across multiple organisations with the and involving the patient in contributing to the content of the record. Data security, patient confidentiality, commercial sensitivities etc are all reasons that are given as to why a ‘good idea’ has so far failed to realise the intended benefits. They argue that had the meaningful use policy criteria been set at enabling Patient Held Health Records (PHR’s) and Physicians incentivised to enable and contribute to such records, far more would have been achieved in realising the vision. They point to the opportunity of the fact that two thirds of USA population own smart phones with access to local and cloud storage. Patients needing to access several facilities and specialists could be providing clinical teams with their own up to date record where patients and clinicians share the responsibility of contributing to the content and providing a much more comprehensive view of what is going on in the patients’ life.
Why is this an important lesson for us to learn from? The law of unintended consequences is prevalent in practically any state of progression. Its important to Plan, Do, Study the consequences and Act to make modifications (PDSA). Whether its policy makers, clinicians, scientists, engineers or whoever, this rule applies. However, we must manage and monitor the human instinct toward determinism and with it the belief that we are incapable of affecting the outcome of events. A key element of accelerated leadership development is learning how to unlearn deep seated cultural norms that were really important to success in the past in order to lay down new mindsets and techniques that equip our leaders well for the digital future. Our young people will not need the unlearning but they will need guiding by our experienced leaders without inhibiting their potential to break new ground. As Einstein reportedly said you can’t solve today’s problems with yesterday’s thinking.
The public sector is showing a real interest now in the development of Innovation Hubs and Networks as catalysts to technological advance. We need to ensure that the Leadership community at policy and operational level understand how best to support that enterprise when things fail as much as when they succeed.
[1] Darrell M. West, Jenny Lu, Comparing Technology Innovation in the Private and Public Sectors, 2009
[2] J Dyer, H Gregerson, C.M Christensen, The Innovator’s DNA: Mastering the Five Skills of Disruptive Innovators, Harvard Business Review Press, Boston, 2011
[3] Mandl K.D. & Kohane I.S. N.Engl J Med 2016: 374;205-208
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Tony Bell OBE
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