Networks have never been more fashionable, and they can be an effective way of sharing information and learning. But is yours performing to its full potential? Richard Taunt suspects not
Sometimes you have to go a long way to realise a home truth.
When working at HM Treasury we had a colleague on loan from our Japanese counterpart, an organisation with blankets in the corners of offices and catchphrases including ”let’s leave while it’s still dark”.
It was through Kazuhisa that the Japanese Embassy called me up to ask how MPs ask written Parliamentary questions; I explained that once a question was given, a department then had 2-3 days to give an answer. ”Days?” was the response; the Japanese system was that their MPs could ask questions up until midnight for answer the following morning. Hence Japanese civil servants twiddling their thumbs all evening before springing into action at 1am. Suddenly their accepted ”that’s just the way it is” practice looked woefully inefficient and just a tad silly.
How many cases like this exist across the NHS? Initiatives such as the Atlas of variation, or Getting It Right First Time, are attempts to use data to expose such difference. But it’s our whole approach to collaboration, and in particular the use of networks, that has fascinated us at Kaleidoscope, and where the NHS has huge potential to learn and improve.
Common pitfalls
Networks – coordinated attempts to share, learn, and build capacity – are all the rage. NHS Improvement’s latest strategy included an aspiration to have “Effective networks thriv[ing] across the health and care system” within 1-3 years. We have Academic Health Science Networks, Strategic Clinical Networks, Community Education Provider Networks, to name but three contributions to the NHS’s attempt to out-acronym the world. Such proliferation of shared learning is a good thing: as the quality improvement guru John Toussaint has written, adult learning occurs best between peers, and networks can be an effective way of achieving this.
how many of these factors resonate: unclear purpose? Hard to work out whether it’s been worth the money? Over-reliance on the energy of a small number of people? Fizzling out when enthusiasm fades?
However, I’d suggest we still don’t have in the NHS a model of what a high-performing network really looks like. For all of those involved in networks past or present, let’s play network bingo – how many of these factors resonate: unclear purpose? Hard to work out whether it’s been worth the money? Over-reliance on the energy of a small number of people? Fizzling out when enthusiasm fades?
Let’s not tar all networks with the same brush, but it’s striking how common these factors appear to be across the NHS.
As such we’ve gone looking elsewhere, to other countries, and other sectors, for networks that don’t fall prey so easily to these pitfalls. From education leaders in London, to paediatricians in Ohio, to emergency care clinicians in Melbourne, there are examples of networks with the same aims as those within the NHS, but who appear able to meet them more effectively than we do.
As Jon Coles, the architect of the wildly successful programme to improve London secondary schools in the 2000s, puts it: “we’re not interested in cup-a-tea collaboration where we all talk but nothing happens. We want collaboration to have a bit of edge, pace, and a focus on outcomes.”
It’s the practical tips, tricks and tactics of high-performing networks that we’re going to be getting into in Networkfest, a week long digital event running from 25-29 September. All free; do join us.
Three ways to a better network
Yet beyond the detail, three over-arching factors stand out:
First is having a method, and sticking to it. The highest performing networks we’ve encountered have a clear, codified method describing what they do and why. For example, Johns Hopkins in the US run highly successful ‘clinical community’ networks based on the work of Mary Dixon-Woods. In contrast a study of the early work of AHSNs found a general lack of frameworks underpinning how they were trying share knowledge.
Second is being ruthless about purpose. We’ve all been there: the temptation of adding yet another priority to a project like a bauble to an already laden Christmas tree. Yet network resource – whether time or dosh – is always finite, and expecting to cope with more than 2 or 3 areas of focus is probably unrealistic. So important is this initial scoping phase to help determine purpose, that Cincinnati Children’s Hospital often spend up to a year getting it right.
Networks are not training courses; they’re focused on learning between peers rather than from a teacher
Third is about learning. Networks are not training courses; they’re focused on learning between peers rather than from a teacher. However, thinking rigorously about what is required for learning to most likely happen, is key. Jon Coles’ work with schools unashamedly sends headteachers on training courses to gain the skills needed to support others’ improvement. Contrast this with a recent conversation with an NHS Chief Executive despairing about how the simple act of running meetings to time is a skill beyond the reach of many.
Network success is never guaranteed. But, like the Japanese Ministry of Finance, opening ourselves up to new ways of doing things has significant opportunity to help make our network dreams a reality.
Richard Taunt works at Kaleidoscope Health & Care, a social enterprise focused on bringing people together to improve health and care. Networkfest runs from 25-29 September
Richard Taunt is part of Kaleidoscope Health & Care.
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