One for the road

Lars Sundstrom, our Director of Innovation and Growth, who retires on 28 March, reflects on how much the West of England AHSN has achieved, and how we might fail better.

Clearing out my desk today deep down in the bottom of a drawer I found one of the first drafts of a strategy paper which Liz Dymond and I produced over 5 years ago. It was about wealth creation. Originally people thought AHSNs should be largely about that, before they became more synonymous with adoption of existing stuff into the NHS.

Rather amazingly we more or less did everything we set out to do and pretty much stuck to our original strategy for the first 5 year license, so I guess it wasn’t a bad plan.

I could look back and chalk that one down as a success and claim it was all plain sailing, but for some reason my thoughts focus much more on the difficult times we had along the way

So as a final blog I thought I’d pick up on one of my favourite topics – ‘failure’. This is not because of some sense of self-pity, but because throughout my life it has been one of the most important drivers for why I chose the paths that I ended up on.

Looking back at all that has happened in my working life I guess I can honestly say that I’ve taken some big risks. As a result I found myself in a few interesting places, like being chased by a pack of hungry wolves in the Canadian wilderness (it’s in BBC documentary If you don’t believe me). Maybe I’ll tell you about that one another time if you buy me a beer.

Curiously, my most vivid memories in reality are the failures, the times when it didn’t work out so well.   I don’t really remember the successes like selling my first start up business when I was in my twenties or having the highest cited scientific paper in my research field in my thirties (I didn’t even know until someone recently pointed that out).  I don’t remember what I learned from any of that. However, the really tough times are etched in brain forever, like laying off all the staff in one of my companies that didn’t go so well, that memory still hurts today and I never want to go through that again.

I played a video for some of the staff a couple of weeks back which made the point that failure is not the opposite of success, it is a stepping stone on the way to success and it is more our failures that shape us and make us learn hard lessons rather than the easy wins. Just look at Steve Jobs at Apple, one of the greatest innovators of our century, clearly spectacular at both failing and succeeding. Eventually his innovations changed the world forever.

Failure and taking risks is essential if you want to succeed in innovation, or rather the permission to fail is essential if you want to innovate. If we can’t try new things, we can’t innovate and without innovation we don’t progress as fast as we need to.

So let’s look now at healthcare and particularly the NHS. Being honest, it’s not the easiest place to do innovation. It has everything going for it though, so it and should be the best place in the world to innovate, but it isn’t and it generally follows others. It lags way behind other sectors, why is that?

There are many reasons, but I believe a major one is the NHS’s low tolerance to risk and it’s fear of failing. It seems to me that the fear of a few bad news headlines has a greater impact with people than celebrating the successes that happen in the NHS every day.

In a way that’s not a bad thing. After all people’s lives could be at risk, so treatment has to be safe. I wouldn’t want doctors or nurses trying things out on me for the first time unless it was a well-controlled trial.

Nevertheless, the point is that innovation also saves lives. If we are afraid to innovate, and instead stick to the old ways of doing things, in the long run we will actually do more harm than good. Do no harm does not mean don’t do anything different for fear of doing harm.

I don’t have all the answers to this conundrum. It seems to me a big part of the problem is a risk averse culture and a system which seek to improve by punishing failure rather than rewarding those trying to succeed. An answer must be to create a place where we can innovate and fail safely in the NHS and it seems to me that’s what AHSN should really be about rather than just a distribution channel for existing products into the NHS.

There are 2 things I know we can do:

1) Create an effective and safe test bed system where we can try new things in the full understanding that they may not always work out. Let’s encourage people to think of new ways of doing things and stop penalising them for trying, even if they don’t succeed at first.

2) Have a more open and honest dialogue with the public and bring them on the innovation journey with us. They should understand why we might not always succeed at first and why we need to keep trying.

Above all we need to be brave enough and ambitious enough to be the best we can and that means being bold enough to try things we have never done before.

I was recently told that there are more people alive today than have ever died, so if that is true, we can’t simply improve on what we already have, we need a step change in the way we deliver care. We can only do that through innovation and it will be disruptive by definition.

So my hope for AHSNs is that they retain the ambition to be brave enough to take risks and become the home of innovation in the NHS, rather than just measuring the number of new products which are taken up and used by the NHS.

If you have read my previous blogs you will know that I am one prone to mock politicians (particularly US ones). Who wouldn’t, given their current inability to govern on either side of the Atlantic? Occasionally, however, the Americans do turn out a few great ones, usually when times are tough.

So I’ll end by paraphrasing JFK : ‘We choose to send people to the moon, not because its easy, but because its hard; because that challenge is one that we are willing to accept, one we are unwilling to postpone, and one we intend to win

Below is a short film reflecting on the change in attitude he has seen towards the role of companies and innovators in healthcare:

Posted on March 26, 2019 by Lars Sundstrom, Director of Innovation and Growth

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