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Editor's blog Thursday 25 June 2009: Innovation, as seen from Burgundy

Good morning. This is being written from a break in rural France, where the weather has stopped doing the “I think it’s clearing up” thing and is doing the lovely summery sunshine thing. This is making me happy.

The latest Maynard Doctrine sees the irrepresssible Professor (who’d be silly enough to try to repress him?) get stuck into NICE rationing, and why more is needed in what David Nicholson refers to as “world-class decommissioning”.

Both Nicholson and Lord Darzi attended all of both days of the Innovation Expo last week at Excel. There were some interesting messages coming through the event. Policy-wise, if you get the NHS chief executive and the health minister responsible for NHS reform strategy at both days of an event, you have got a bit of a clue that innovation is the new buzz-word. I"Inoovation" will be up there alongside "quality" in a policy powerpoint presentation coming soon to a meeting near you.

Aside from the impressive kit on display at the Expo (much of the set-piece nature of which was, inevitably, acute-focused), it was heartening to hear the repeated message from both Nicholson and Darzi that innovation is not necessarily about shiny new kit, but more about using best practice, benchmarking and paying attention to variation. These things would indeed prove to be good innovations for many parts of the service.

There was also a repeated commitment on Nicholson’s part to accept that innovation involves risk and will also mean there will be failures. However trite it may sound, this is countercultural to much of what has been accepted practice in NHS management-land for some time, where unless your project is too big to fail (hello, NHS Connecting For Health) or you can successfully sweep it under the carpet, failure has been less an opportunity for learning and more a single to Siberia.

Nicholson has had the cojones to say that this should not be so if the NHS is serious about innovation. There are courageous words, and if they are followed by courageous action, the NHS may be in danger of doing something really quite clever – if possibly giving major hostages to fortune in the run-up to an election where health with be prominent. Not to mention the undoubtedly intelligent and mature reflection that much of the media will give to examples of failure.

Elsewhere online, the fine Dr Grumble links to this BBC File On Four programme on PFI, which being overseas, I can’t access. Hopefully, it is good.

The excellent E-Health Insider reveals that key elements of the national IT programme were red-lighted by the Office of Government Commerce ‘gateway’ reviews.

And the estimable Sally Gainsbury of Health Service Journal quotes an anonymous would-be FT hospital chief executive (email your guess as to who it is to editorial@healthpolicyinsight.com) that changes to Monitor’s prudential borrowing code limits introduced in April have “effectively cancelled” the rest of the PFI hospital-building pipeline. Which, depending on what you make of the File On Four programme linked above, might not be an entirely bad thing.

These are interesting times for Monitor. HSJ also revealed that plans are afoot to rid the DH of the trubluent Bil Moyes by splitting the job of executive chair. I will be seeking an interview with Mr Moyes about this and other issues soon.

Finally, Annette Sergeant of Hoggert and Bowers has produced an impressive new report on NHS chief executives’ tenure in post (or “short shelf-life”). Bold And Old does not tell you much you don’t already know, but it chimes with the messages from Innovation Expo in its conclusion that “the NHS needs to do more to explicitly encourage and demonstrate support for the unconventional, that is, for the bold CEOs who have the capability, drive and tenacityto initiate and inspire innovation”.