FRED has been shortlisted for a NHS innovation award. A lot of thanks for this goes to South London and Maudesley (SLaM) who are our partners on the project, and who have helped give our ideas a home. We were invited along to a one day workshop for all the shortlisted candidates a couple of Mondays ago (it’s taken me that long to have an interesting thought on the day!

The purpose of the day was to help the candidates improve the quality of their final submissions. There were a few things I picked up.

First, it’s not a given in the NHS that innovation is a good thing. It still felt like the people in the room had to persuade ‘them upstairs’ that innovation was going to help us out of this financial mess we’re in.

Second, innovation in the NHS was a much more gentle thing. Everyone was sharing their ideas in an open way, which was really refreshing. However, there was a terrible politeness about it all too. Everyone being very nice and all that. I wonder – aloud – if that lack of competition means losing a bit of edge.

And finally, that the big problem isn’t a lack of ideas but a) the way they are shared (or diffused in NHS speak) across the health service and b) getting rid of the existing bad ideas.

And that was the thing that really stood out. De-commissioning is what it’s called. Basically, it means stopping providing one thing, in order to do another new thing. And the problem, it seems has been, that in the last decade or so of ‘plenty’ in the NHS, whenever someone came up with a new idea, service, technology, whatever, it was pretty much layered on top of the existing not-so-good service. Because there was money to do both.

Now that there isn’t even the money to sustain existing services, life will become more crunchy. Hard decisions will have to be made. It won’t be ‘oh, that’s a good idea, let’s do it’ but ‘oh, that’s interesting, what do we have to stop to make this happen’.

And that’s the difficult bit. In the business world, it’s called portfolio management. And really, who cares if some faceless corporation stops making another brand of chocolate. But stopping a service, in favour of a less proven innovation, that does get sticky. Especially when lives are public health are involved.

Fascinating stuff. I think we’ll stick to coming up with the ideas.