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Blue Sky Thinking

by Lisa Carr

Professor Martin Green, CEO, Care England

Social care has always struggled with innovation and developing new approaches. Partly this is because the foundation of our services is the relationships established between the people who use services and those who support them. Understandably, sometimes people are frightened of new developments because they fear losing the service altogether. However, there is a real need to think creatively about developing new ways of doing things in the future.

When we consider innovations, the priority must be to improve the quality of life and outcomes for the people who use services. We must never lose sight of the fundamental purpose of a social care service. That said, there is a myriad of ways to embrace innovation and technology and deliver better outcomes and deliver more efficiencies. If we’re going to develop new ways of doing things, every bit of the system needs to change and facilitate, rather than impede innovation

Over many years we have seen what might be described as a symbiotic relationship of lazy commissioning, which has driven lazy provision. There has not been any space for innovation and creativity in our current system because nobody would commission it. For this blockage to be removed, I believe the Government should set up an innovation fund to develop new ways of doing things and share the risk across the system. One of our challenges is that in the current system if a care provider seeks to develop a new and innovative way of doing things, there is no guarantee that it will be accepted by either commissioners or regulators, and that puts the entire financial and reputational risk of development firmly in the hands of the provider. An innovation fund would also include some opportunities to research the efficacy of new approaches to have clear evidence if we want to roll this out across the entire system. There are currently ways in which this is being funded in the NHS, but despite all the discussions about an integrated system, this is not happening across health and social care.

We also need some change from the regulator because we need a regulatory system that facilitates innovation rather than stifles it. Regulators are particularly bad at embracing new ways of doing things. Often, if there is no previous track record of how things are done, the regulator will look upon new developments negatively. Partly this is because the regulator is also concerned about their own reputational risk. If they endorse something that subsequently fails, this will impact their reputation and that of the care provider.

If we are going to get good innovation in the sector, we will also need to develop an appetite for risk because there is no approach to innovation that does not involve some risk of it going wrong. We need a way of mitigating risk and a way of ensuring that if innovation does not work in the way we expect it to, this does not destroy the reputation of either the care provider, the commissioner, or the regulator.

The Covid-19 pandemic marked a moment in time, and many things that we had regarded as impossible were delivered because we were managing a global emergency. I sincerely hope we will use the experience of how we delivered some very swift changes to the way things were done because of Covid-19, and we learn how to accelerate innovation and development and not be derailed by endless processes.

The demographics are clear. In the coming years, we will need a lot more health and social care services, and we simply do not have the people or the financial resources to continue to deliver services in the same way that we currently do. Innovation is no longer something that is nice to have, it is imperative that we find ways to do things better and more efficiently.

@ProfMartinGreen, @CareEngland

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