Why the social era represents the biggest challenge for the NHS?

  |   Thought Leadership

We want you to consider these 3 words.


“Connections Create Value”


In science, over the last 10 years a new understanding of life has emerged. It has seen us move away from seeing our world as a machine to understanding it as a network. The paradigm shift from machine to network is not only in science, but also in our society at large and through a newly emerging global culture. Today civil and technological networks are all important.


In global terms, we can identify three centres of power in today’s world. Government, Business and the network of NGOs that form a new global civil society. Networking is most widespread in civil society, less in business and least of all in government.


In recent months, as a start-up business we are a very committed part of the NGO network and we have sought out UK and Global relationships and networks to enhance client experience. Almost every minute in our network, we see a new policy idea emanating on the NHS. One of the features of the NHS is that no one is ever short of an idea, opinion or a diagnosis of what is going wrong and what could be done better.


This year’s new black is Integrated Care. There is a lot of “integration babble” in our network. One of the biggest issues facing integrated care is not the concept. It is how the NHS delivers it.


“And herein is the biggest issue facing our health system. Delivery.”


Delivering integrated care is reliant on connectivity. Manage connections to create value for patients, reduce costs and improve experience.


In the NHS this has to be done within a culture (a government department) with the least understanding, flexibility and agility to truly think and act as a civil network. In his recent (Jan2014) article on Integrated Care in the HSJ, Chris Ham refers to the progress made in 2013 on Integrated Care as good but its “premature to declare victory”.


“Many including Chris Ham see the delivery of integrated care through better contracting mechanisms, health and well-being boards, managing the regulators. This is a bureaucratic response.”


The key to delivering integrated care outside of user empowerment is organisations forming partnerships and networks. The problem for the NHS is that most organisations go into the network asking one question. “Who exerts the power in this network?” Since power is what many NHS organisations are more concerned about… “it is premature to declare victory”


  • The Bureaucratic response-“How do we contract for this?” (Alliance Contracts and Health & Well Being Boards presumably)
  • The network response, how do we connect, become better together and add value to our clients?


To understand how power works in civil networks, you can distinguish between two kinds of power: power as domination of others, and power as empowerment of others. The most effective organisation for power as domination is a traditional hierarchy. These are the ones that run through government and the NHS, and remain the biggest obstacle to empowerment.


In a civil network, people are empowered by being connected to the network. The success of this network depends on the success of individual members, whilst the success of each member depends on the success of the community as a whole.


In such an environment, the hubs with the richest connections are centres of power. They are sought out as centres of authority because they connect large numbers of individuals and organisations in the network.


They understand that connections create value and scale. Not necessarily size and their position in the hierarchy. These organisations would not advocate more bureaucracy, another Board Meeting or a new financial contract mechanism.


They would seek shared purpose, technological connectivity, open source data and knowledge. They wouldn’t be focused on power. They would be focused on value.


So when that happens in our health system, it really is worth declaring victory.