‘Maverick Mindsets’ are needed to transform public services, says new report

Today (Wednesday 7 September), the RSA (The royal society for arts, manufactures and commerce) and NHS Lothian have published ‘A Rough Guide to being a public entrepreneur in practice: Learning from NHS Lothian’.

While an entrepreneur in a more typical sense focuses on profit, an entrepreneur in the public sector context is dedicated to improving services and inciting systemic change.

Ian Burbidge, former Head of Innovation and Change at the RSA and Jamie Cooke, Head of RSA Scotland, said: “Change in our health and care systems has failed to keep pace with the rapid transformation of our societies. The recent Covid-19 pandemic has pushed our healthcare systems and our key workers to their limit and shone a light the vast inequities and the deep challenges that persist in the sector.”

“This practical guide draws on the insights of the NHS Lothian staff to offer different tools and approaches that can be used to disrupt the status quo and drive change and innovation in our public service bodies so that they can meet the needs of today and the future.”

Rebecca Miller, Head of Strategy Development, NHS Lothian, added: “It might seem unusual to talk about the need for a ‘maverick mindset’ when it comes to publicly funded services, but we need some more entrepreneurial thinking if we are going maximise our resources in the future. We sometimes ‘muddle through’ with the resources and approaches we have. Given the pace of change and long-term trends and challenges on the horizon this is no longer sufficient.”

“The Covid-19 pandemic has meant that changes in how society operates that previously may have taken years have happened in days and weeks, and we have delivered services in very different ways. We have also seen performance in some elements of care deteriorate, and a widening of inequalities. This report shows that creative thinking and demand to do things differently among staff is essential. It’s vital that we start to generate ideas, inspire creative thinking, and spark conversations about how we can overcome challenges and support efforts to drive change.”

The guide includes 15 core lessons learned on how to widen and support innovative practice in the form of an ‘NHS Lothian Entrepreneur’s Manifesto’. The guide offers insights, tools, and approaches to help navigate change which could be used beyond the NHS to benefit other public services such as education, housing, and transport.

The document contains fresh insights from inside the NHS from both staff and leaders, including:

• “A lot of the time it’s about taking leaps of faith, trust staff and the process.”
• “[…] strategic work often gets pushed aside (in favour of patient time), and when you […] cobble everything together that is when you come up with a quick fix.”
• “Being reminded of important goals and/or missions (ie helping people!) gets us beyond a simple focus on hitting targets. When you remember why you work for the NHS you realise how important the need to change is.”
• “We need to make sure that there is the space and energy to be fun, creative, innovative, entrepreneurial, and embracing of change.”
• The Manifesto’s 15 core insights are: develop trust and support; hold a safe space to think; have a maverick mindset; be adaptable and flexible; see different perspectives; see the system; find the energy for change; disrupt the status quo; learn from the journey; small changes into something bigger; don’t fixate on the answer; identify new forms of value; balance short-term pressure with long-term challenges; tell stories; and harness the power of the collective.