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How do we develop a culture of innovation by making it more convenient for staff to engage with the process?

What was the problem?

The NHS is committed to using technology and innovation to become more efficient and improve patient outcomes, and to build an innovation mindset amongst staff across the organisation. Within the NHS there are innovation teams at local, ICS and national levels, who try to understand problems faced by staff and patients and help them find solutions to improve things.

However, the programme director of an ICS Innovation Hub told us about a challenge they face:

In short, the people who know the problems best, and often have ideas to solve them, don’t have the capacity or opportunity to engage with innovation specialists who could help them to change things.

What could be the benefit of improving this

• Innovation teams would have better insights into the problems facing frontline staff, allowing them to better facilitate innovation within those teams
• Valuable ideas to improve services captured that may otherwise be missed
• Innovative changes and improvements are more likely to succeed if the people it affects are involved in their development (the Ikea effect)
• Frontline staff may feel more valued and that they have greater agency, helping with staff morale and retention
• A wider and more diverse range of staff could be involved in improvement and transformation

Our hypothesis

What did we do?

We carried out user research with members of frontline staff such as ambulance drivers, receptionists and porters who may have great insights into problems and ideas for solutions. We discovered that:

• Many staff feel like innovation is something done TO them, not WITH them
• Don’t have easy access to a work computer to fill in long corporate forms
• Are switched off by the language used by innovation teams
• Don’t have the time or opportunity to share innovation ideas
• Know what the problems are, but don’t want to be a “moaner”
• The direction of innovation/digital transformation programmes often ends up driven by a smaller group of more senior or more vocal staff
• Without an active “innovation culture” many don’t feel empowered or supported to initiate innovative ideas

What were the outcomes?

From these insights, we prototyped a WhatsApp based chatbot which would allow members of staff to submit problems and ideas using familiar technology from their own devices, without requiring corporate logins or lengthy forms. The question and answer format of an interactive chat allowed data to be gathered in a structured format suitable for innovation teams to ingest into their tracking systems. Correspondents could choose to remain anonymous if they wished.

We also experimented with adding a WhatsApp option to our own front-door submission form.

What did we learn?

Although chat-based input lowered the perceived barrier to the physical process of sending an idea by removing the requirement for access to a physical corporate device, it didn’t overcome some of the cultural and practical issues of engaging a wider range of staff members in the innovation process. For example, the headspace and time required to submit a suggestion; the reticence of adding to one’s workload by accidentally becoming involved in delivering your suggestion; or the cynicism that any action would result from it. These are wider institutional and cultural issues which also need to be tackled.

More information

If you would like to talk to us about this project, you can contact us at england.innovation.lab@nhs.net