Innovations in health care - Making systems more resilient


Changes are taking place within society, which will become more pronounced in the coming decades. The need to have resilient systems in place, particularly in the field of health and health care, is critical.

On the second day of the Sciana 2018 cohort’s first meeting, members spent the majority of their time discussing how resilient health systems in the UK, Germany, and Switzerland were. The day’s programme began with a session titled, “How resilient are our country health systems in the face of demographic change?”

Members heard how health systems in Germany could cope in times of financial turbulence, but there were “hectic” discussions behind-the-scenes due to authorities’ concerns they would be less prepared for a catastrophic or pandemic event. Another member argued Germany was resilient because it was so difficult to change the system.

Focusing on Switzerland’s capacity, one member argued, as with many other countries, it would be difficult to predict how it would react to a sudden crisis. Members heard the health care system was quite resilient but the other systems involved and interlinked were slightly more rigid.

It can take a tremendous effort to convince others to make a small step forward, and there is an unknowingness as to whether it is a step in the right direction. One member suggested no one dares to take the lead in health care in Switzerland, and when they do, others tell them not to.

Demography doesn’t just concern ageing. Speaking about the birth rate in the UK, one member outlined the regional variation. He also raised the issue of the increasing number of single-occupant households over the next few decades and the potential effect it will have on loneliness.

The member argued, on one level, the NHS was resilient when responding to emergency incidents such as terrorist attacks. What it struggles with, however, is predictable shocks, such as the “winter crisis.”

Building on this “crisis” theme, another participant suggested crises in England grab the attention of others, including the media. This leads to insufficient space given to health leaders within the service to think about the system as a whole. This member described the NHS as something which becomes a “political football.”

Reflecting on all three systems, members drew out themes or similiarites they had noticed. One member said insufficiency appeared to exist in each context, stating that a better use of money would lead to a better standard of care.

Following a short break, members were asked to consider examples where they had shown leadership or signs of thinking differently. In groups of three, members considered what they had achieved and how they had brought others along on the journey with them.

One member discussed his experience of launching a new service. He expected controversy but anticipated the system would eventually adapt. He admitted the service was received badly by stakeholders and for a few years it was “hard-going.” Nevertheless, he and his colleagues persisted because they were confident they were providing a safe service, they were confident it would bear scrutiny, and it was well-received by its users.

Other themes to emerge in conversations included the power of stories, data, and relationships. Stories can work as a leverage tool in the UK, but in other contexts, it is not enough. They have to be backed up with good arguments and data. Before any of this can take place however, change can only start with dialogue between one another.

Members underlined the importance of alliances and creating enabling environments where innovation can happen and diverse views can be expressed.

Robert Kennedy, former US Attorney General, once said GDP measured everything “except that which makes life worthwhile.” Adding to this, a member said countries were beginning to come together to talk about the well-being economy.

Change can take place through relationships, trust and evidence of positive outcomes. It relies on the individual to persevere.

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