NHS Institute for Innovation and Improvement

The NHS Institute for Innovation and Improvement supports the NHS to transform healthcare for patients and the public. The way we work is inspired and based around service design approaches, shaping how our teams work and how they develop and deliver products and programs.

The Institute’s Innovation Practice team - an interdisciplinary mix of health experts, researchers and service designers - can be seen as the internal ‘guardian’ of the service design approach. It provides the NHS Institute and wider NHS support and expertise in innovation processes and in particular how design methods can be translated and used to support improvements in health. We’re passionate advocates of open innovation, building collaborative networks and promoting the value of health care innovation and service design. A big aspect of our work is to create thought pieces and ‘products’ to support health care innovation, including guides and capability building programs for leaders and front line staff to help them better innovate in their own context. We also contribute to wider policy to ensure that service design is included and spread to broad audiences and at policy level.

How do we use the service design approach for health care innovation?

We use service design to support the NHS Institute internally:
The NHS Institute uses design principles within its ‘Work Process’ - a formal process developed from our observations of innovative companies and used by all teams. We ensure teams invest sufficient time at the beginning of the process using anthropological observation techniques to better understand the challenges they are trying to solve. We also use a co-design approach to help identify real opportunities for change and to then take these design led findings as a criteria for business decisions.

We have continued to build internal expertise through learning and coaching sessions and through continued partnerships with a range of design organisations. In addition, we have built our own internal capacity by employing our first in-house Service Designer as part of the Innovation team, helping to ensure service design is an integral part of health care innovation.

We use service design to deliver change within health care:
At the NHS Institute we’re fully embracing service design methodologies having worked with service designers since our inception 4 years ago. We understand that in order to improve health care, we need to bring patients and staff together to share the role of re-designing our services.

A big - if not the most important - aspect in achieving long term change is the need to build capability to improve within the NHS itself and not having to rely entirely on external help. Front line staff, for instance, can be encouraged to use co-design techniques and methods in doing their every day job and to work with and for patients to deliver the improvements that are needed. For that we ‘translated’ a range of tools and techniques from the design industry that NHS staff can adapt for their own context, for example the ‘Observation toolkit’, ‘Thinking Differently’ and ‘The Experience Based Design Approach’.

While leading global companies have used similar approaches for years, the design approach and its tools are new for the NHS. Where we’ve used them in the health service, they have had amazing results - delivering the sort of care pathways that leave patients feeling safer, happier and more valued, and making staff feel more positive, rewarded and empowered.

Some of our Service Design-led programs:

Thinking Differently
A guide full of tools, examples and inspiration - demonstrating how thinking differently can help to fundamentally change the way care is delivered. It provides a range of practical approaches that NHS leaders and front line teams have already used to rethink pathways of care and service delivery. It includes references to the value of observation and co-design as critical factors for health care innovation.

http://www.institute.nhs.uk/building_capability/new_model_for_transformi...

Observation toolkit
One of the key tools that is being used to support effective improvement is observation. This is a technique that has been drawn from the worlds of design and ethnography and has proven to be an incredibly effective way of clearly understanding your current challenges. It enables front line staff to experience the power of observation and understand how they can use it as part of their work. The principles of observation are already incorporated into a number of our most popular products such as the Productive Ward and The ebd approach.

http://www.institute.nhs.uk/building_capability/thinking_differently/obs...

Experience Based Design (ebd)
Ebd describes an approach and way of thinking to redesigning services, putting patients and their experiences at the heard of the process. It suggests a range of tools which have been developed and tested in close collaboration with patients and NHS staff including a film about experience based design, a guide and tools book, ebd concepts and case studies (available September 2009) and a series of practical workshops some of which we co-deliver with designers.

http://www.institute.nhs.uk/quality_and_value/introduction/experience_ba...

Papers:

Maher, L. (2009) A bright future. Health Director. July 2009. p 4-5.

Maher, L. Baxter, H. (2009) Working in partnership with service users. British Journal of Health Care Management. Page 172-175, Vol 15, No 4.

Rogers, H. Maher, L. Plsek, P. (2008) New design rules for driving innovation for access to secondary care. British Medical Journal. 2008;337:a2321

Maher, L. (2008) Innovative Partnerships. Within ‘In View’ The Journal from the NHS Institute for Senior Leaders. Page 25-26, Issue 19, October 2008.

Maher, L (2008) How the NHS is thinking differently. In Innovation by design in public services.

Pickles, J. Hide, E. Maher, L. (2008) Working with patients: a practical method to support governance. Clinical Governance; International Journal. Vol 13. No 1. p 51-58.

Mugglestone, M. Maher, L. Manson, N. Baxter, H. (2008) Accelerating the Improvement Process. Clinical Governance: International Journal. Vol 13. No. 1. p 19-25.

Bevan, H., Bate, P., Robert, G., Maher, L,. Wells J. (2007) Using a Design Approach to Assist Large Scale Organisational Change. Journal of Applied Behavioural Science. Sage Publications

Case study- Maher, L (2007) How working together can transform public services; case study in: The Collaborative State, DEMOS, May 2007

Case Study-Maher, L. Szebeko, D. (2006) Experience Based Design: A Case Study: in Journey to the Interface: DEMOS, September 2006

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