Lesson 5: Be comfortable with inconsistency
Across much of the civil service, leaders are understandably concerned about the risks of the so-called ‘postcode lottery’, where the services an individual receives are determined by the location of the individual. This concern has created a culture of creating rules and regulations in order to attempt to achieve consistency.
It is important that minimum standards are put in place to, for example, ensure there are checks and controls to deter criminal activity and safeguard the vulnerable. But too many regulations risk stifling innovation, as leaders are unable to try different approaches and are forced to follow an overly prescriptive approach.
Paul has been inspired by the platform economy model, which sets minimum standards and then creates open spaces for innovation and creativity to flourish. These models enable collaboration as organisations and individuals have a clear framework to work together and the freedom to try new ideas.
This approach is quite counter-cultural to many in the civil service where officials are used to creating rules to govern and manage. Throughout his time working on the programme Paul often felt the need to make the case for as few rules and regulations as possible and try to shift the balance towards a less prescriptive approach to enable innovation.
Lesson for NHS
Despite the obvious need for regulation, the health and care sector has too many rules. Across the sector, effective organisations and systems should be given increased autonomy as recommended by the recent Hewitt Review of integrated care systems to enable them to increase their focus on improvement and innovation. Furthermore, the NHS should encourage colleagues to question the rules and regulations they are expected to adhere to and to develop and support initiatives that aim to reduce these.