Our origin story

Monday, April 15, 2019 |
BOB.health is building a free web-based service to help the NHS staff create, share and learn from the practice and experience of others. Where did this all spark from and why is it so important to fix practice sharing? Neil Crump explains...

I’ve been obsessed with the concept of sharing proven good practice and experience in the NHS for more than four years. This was originally sparked at a Healthcare Communications Association meeting where a commissioner from Manchester talked about innovation uptake. His presentation focused on the practical nuts and bolts of how a system makes this happen. He explained that people start a project with a blank sheet of paper to create the solution for their locality.

As he spoke a question came to mind: surely people must learn from someone that has done something similar before and not reinvent the wheel? As the Q&A session opened my hand shot up and I asked my (diplomatically rephrased) burning question. The response was that people try, mainly unsuccessfully, to find and learn from others but it’s a difficult challenge and most do start from scratch.

“That’s mad,” I thought and being a curious type I wanted to understand more. So, I bounded up to the speaker to ask for a meeting. He accepted my request and a few weeks later over a mug of tea and a round of fish and chips in Salford’s Tesco superstore cafe, this inspiring chap and I talked about his experiences on the topic of spreading innovation.

In one part of the country, out of view, an ‘improver’ and their colleagues can spread an innovation locally like wildfire – benefits are seen, often measured. That innovation, which is enhancing quality and safety, can receive a chilly reception elsewhere. As a result, little or no traction occurs, despite the potential to confer a host of benefits which might include:

delivering better patient outcomes, improving and saving lives 
saving time for both patients and NHS employees, making for a better experience 
creating efficiencies and potential savings to the system.

Interesting anecdotes were shared, beyond the obviously important human and cultural factors involved in the uptake of innovation and improver projects. What fuelled my obsession was that for more than 20 years I had certainly seen this happen with medicines. Innovative drugs, assessed to be cost-effective with the potential to transform patients’ lives, can sit on the pharmacy shelf or often never get on the shelf in the first place.

However, I was intrigued as we talked about how a service delivery or procedural changes, big or small, can equally fly or flounder when there isn’t a high-value medicine in the mix to be the ‘reason’ for lack of spread.

Now don’t think me too naive, I do get folk. We all know that people find it hard to change what they are doing, but surely if you can get it to work in one place, you must be able to learn from that. I pondered, “the system must be capable of making this happen?”. As the owner of a strategic communications agency specialised in healthcare, my obsession was set.

So, I’ve been on a quest to understand the sharing of ideas and practice. It became a key focus for me and my team. We did qualitative research, hosted a meeting at the Royal College of General Practitioners in 2015, and produced a report with a systems thinking lens to assess how we can create opportunities for patients to get access to innovation. Next an intern (the smart Freda Katunda) was hired to dig into the topic. We travelled all over the UK to meet people searching for the golden nugget of insight, that could then be spun across the system to fix the sharing conundrum.

You know what? That golden nugget was elusive. I met people, went to conferences, joined webinars, scoured the literature and finally, yes finally, the truth revealed itself. The truth is that there was no nugget to be found, not even a silver or bronze one.

End of the journey? 

All was not lost. Even though the system appeared more heterogeneous and complex with each expert I met, there was something that everyone agreed on: that the sharing of experience and practice works. That it is a good thing. It saves people time and money, brings quality and makes things more efficient.  I remember writing that on the whiteboard in my office with Freda – we wrote it up as a hypothesis – it was our Eureka moment… just make it happen because it works.

That is why it is so important that when the wildfire has caught in a specific location, that the ‘how?’ is shared and widely disseminated to help that innovation scale across the country. Rather than getting bogged down in why it’s hard to get sharing to work, we need to roll up our sleeves when we have great examples and crack on.

Introducing BOB.health
So that’s why, last month, we have officially set up a new organisation called BOB.health to focus our energy and try to fix this challenge. I have the role of Chief Partnership Officer and my fellow co-founder, Marc Southern, is Chief Executive Officer.  BOB.health is building a free web-based service to help NHS staff create, share and learn from the practice and experience of others. Exciting right!  

We have an advance concept on how we are going to tackle this which revolves around helping people to easily produce instructional ‘how-to’ case studies.  We have shown the great and the good what we plan to do (you know who you are) – they think we are on to something.  That has bolstered us to get on with it. It’s worth being obsessive about and to fan the flames of sharing and dissemination – through collaboration we can make this happen. 

Want to help make this happen?

The whole ethos of BOB.health is helping to make collaboration work. 

An amazing team at a NHS Foundation Trust want to collaborate and we are looking for other organisations and motivated individuals who might also like to get involved.  Let us know if you would like to collaborate via a simple form on our website.

As an individual in the NHS, we are always interested in talking to you to help us get a deeper understanding of the most important reasons that someone chooses to share their practice and experience. 

Reposted and modified from www.auroracomms.com/blog (posted 21 Jan 19) by the same author, Neil Crump. 

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