To mark the launch of PPR as a Nesta Enterprise we asked Director Dan Farag to reflect on our journey to date, the impact of the pandemic on our work, and what the future holds for us. This four-part series kicks off with a look at PPR’s experimental beginnings…
Earlier this month Nesta launched a new ambitious 10-year strategy. This new strategy will see Nesta be more focused and mission-driven, and concentrate its resources on addressing three defining societal challenges:
- how we can give every child a fairer start;
- how we can help people to live healthier lives; and
- how we can build a more sustainable economy.
As part of this new strategy the People Powered Results has been established as a Nesta owned enterprise. This means we will not only continue to support work focused on Nesta’s new missions, but we will also continue to work across the UK on issues that are broader than the focus of the Nesta strategy, and important to the public systems and communities that we partner with.
As we step into the next exciting chapter for the People Powered Results team, it also felt like a good moment to reflect on the journey and evolution of the team since 2015.
Renewed energy and optimism
The story of People Powered Results is a story of how connection and a shared human experience fuels positive change to develop better systems. From experimental beginnings, which combined a vision of people-powered health with practical methods and tools to bring it to life, People Powered Results grew rapidly across the UK…before Covid changed everything.
Like many teams and organisations over the last year we’ve had to adapt to Covid, which, when combined with an organisational change process, has at times felt like we’ve been through the washing machine. But we’ve emerged, and besides being slightly dizzy, we have a clean and fresh new look for 2021. With renewed energy and optimism to take on some of today’s biggest challenges, we find ourselves facing the future with curiosity and confidence.
Chapter 1: Experimental beginnings which combined a vision for People Powered Health with Rapid Results
2020 asked a lot of all of us. It asked us to respond to uncertainty with empathy and conviction in our values. And now, a year on from the start of the pandemic, we’re taking a moment to pause, look back, and ask ourselves… What have we learnt? What is the real work? For PPR, this takes us back to 2014.
Rosetta’s Philae had successfully landed on a comet, Gangnam Style reached 2 billion views on YouTube, the Ebola epidemic ripped through west Africa, and the world’s sceptical eyes were on Sochi for the winter Olympics…
Meanwhile, within the walls of Nesta, Halima Khan’s vision of a People Powered Health system was gaining traction. A core ethos emerged: that health and care is about much more than medicine. People are healthier and recover faster when their social health needs are met alongside their clinical needs. But this approach would also need new innovation methods to bring to life…
Here we introduce the work of Nadim Mattas and the Rapid Results Institute. They had developed a new method called the 100 Day Challenge that would act as a catalyst to make progress on some of society’s most entrenched social problems. A marriage of the two saw the birth of the People Powered Results team.
Our early partnership work in places like Essex gave us a glimpse of what was possible when you find ways to support public system leaders to build trust, share power, and collaborate in more meaningful ways with their frontline teams and communities. We saw and experienced the seemingly impossible results that could be achieved through creating the conditions which empower and mobilise the wisdom, knowledge and creativity of those closest to issues.
Multi-disciplinary ‘100 Day teams’ in Mid and West Essex achieved results like a 24% reduction in A&E attendances, 50% reduction in GP attendances for children and young people, and reduction of 12% in unplanned hospital admissions for the frail elderly.
We knew we didn’t have all the answers, but also knew that deep shifts in mindset, culture and behaviours in the systems we were working needed to happen alongside that tangible results. This approach would form a core part of the work that would need to be grown and cultivated to tackle the complexity of the issues being faced across public systems.
Looking to the future we found ourselves wondering… what could we achieve if we took this approach to the rest of the UK?
Chapter 2: Sparking change in public systems across the UK
From these early and experimental beginnings the 100 Day Challenge method rapidly spread, Sparking Change in Public Systems across the UK over the next 5 years. The team worked on a range of ambitious national and local programmes including focusing on improving children and young people’s mental health, supporting people with learning disabilities and autism to live meaningful lives, and improving outcomes around a host of health-based issues, ranging from frailty to diabetes.
The more we delivered the 100 Day Challenge, the more we learnt about the key ingredients for innovation in public systems. The areas we experimented with in the early days evolved into a wheel of core conditions that sat at the heart of every 100 Day Challenge and were key to creating the space for frontline teams and people with lived experience to experiment and learn so they could make real change in their systems.
PPR’s Conditions Wheel
We continued to see visible results in the systems we supported, in the form of new tools used, improved metrics and better outcomes for people, but, just as importantly, we have witnessed significant cultural and mindset shifts across the programmes we’ve delivered. Improved communication and collaboration, increased optimism and a greater sense of ownership for frontline staff are just a handful of the shifts we’ve seen and are what help sets this approach apart.
Throughout this period we have tried our best to “walk the walk” and put into practice the significant learning that emerged for us in nearly every programme we delivered – allowing us to grow and evolve our approach. For example, in the Essex 100 Day Challenge focusing on learning disabilities we learnt a huge amount about involving people with lived experience – placing their knowledge and experience front and centre.
Covid changed everything
As our confidence in the 100 Day Challenge method grew, we began to apply lessons learnt about the core conditions needed for systems change more broadly. Nationally, we worked alongside the NHS England Strategy Group to design and test the Elective Care Development Collaborative and worked with the Personalised Care Group to put into practice Integrated Personal Commissioning and shape the NHS Vision for Personalised Care at sites across England.
By 2019 the Nesta PPR team had grown in size and confidence, and we now had a presence in London, Wales, Scotland and Greater Manchester. We were excited about the path and direction of our work, and our craft was becoming more diverse, with the team experimenting with new tools and methods to support public systems to shape and co-create a more progressive future.
And then Covid changed everything for us and our partners.
Chapter 3: Into the washing machine, and out the other end with a fresh new look and offer
We used to start many of our 100 Day Challenge workshops with the metaphor that change is a marathon and a sprint…with the 100 Days representing a sprint which help to build the muscle and confidence for the system to tackle the marathon ahead….but the pressures that Covid put on our public institutions and communities felt like a series of marathons at sprint speed!
We knew standing still wasn’t an option for the team, and that it was important to find ways to nurture and support the power and resilience of the frontline and communities as they rose to meet the crisis of the pandemic. The team stepped into action finding ways to help our partners listen to the needs and experiences of the frontline through the initial Covid response, and identify areas where the pandemic had created an opportunity to reimagine future systems:
- We kicked off a sprint with arts and health professionals across Wales (HARP) to develop new creative activities that could help to mitigate some of the negative impacts of the pandemic on peoples’ health and wellbeing.
- We partnered with NHSX to listen and understand the changes and experiences of the frontline of rapid adoption of care technologies;
- We supported some of Nesta grantees to also adapt to the changing environment;
- We worked with Midlothian Council to help them gather the views of their frontline and communities and to co-create their future ways of working; and
- We partnered with Marie Curie, and St Christophers to explore the potential of reshaping the experiences of death, dying and bereavement as we emerge from the initial pressures of covid;
…plus many more which you read about here.
At the same time Nesta embarked on it’s own strategy review process, which inevitably brought about its own uncertainty as the organisation wrestled with its purpose and the impact it wanted to have. With so much going on and at sprint speed, it felt like we had been put through a washing machine – spinning as we did what we could to rapidly adapt to delivering in an online environment, whilst helping our partners make sense of the new world they were operating in.
It’s fair to say it has been a huge learning process for everyone…but as the spin cycle started to slow, and we began to make sense of our new environment, we’ve come out of the washing machine with a fresh new look, and cleaner, more diverse offer. Moving forwards, this will enable us to work with our partners to help navigate the challenges and opportunities in the years ahead.
Chapter 4: ….help us reimagine and co-create the future
Despite the challenges of 2020, the experience has only strengthened our team resolve and belief that shared human experience can fuel positive change and develop better systems.
As we relaunch the team as a Nesta Enterprise, our commitment to work in partnership with public institutions and communities across the UK to take on some of today’s biggest challenges and face the future with curiosity and confidence, remains our highest priority.
We’ve reflected on our learning from our work over the last 7 years, and thought carefully about the contribution we can make, and the range of ways we can support public systems over the coming decade to release the power of people closest to issues.
We’ve focused our support, and methods around the four themes:
- Curating Insights: our Listen & Learn programmes are shaping recommendations for the future by supporting systems to explore and understand the world through the perspectives of people delivering and experiencing services
- Shape new visions: we can support strategy development and implementation planning in ways that help systems reimagine the future, and design a path to get there.
- Make it real: our flagship people-centred 100 Day Challenge; sprints and prototyping methods can help to bring ideas to life and accelerate the pace and improve the experience of change in complex systems.
- Create space: we support organisations to create spaces where they can unpack some of today’s toughest challenges and learn new ways to achieve progress. We offer a range of services including leading through innovation, coaching, capacity building, events and workshops.
Alongside a fresh new look and website, we’ve also redefined our values and beliefs that will underpin how we work as a team and with our partners.
We believe in:
Everyday innovation: fresh ideas applied to everyday problems can achieve real change and anyone can be an innovator
Shifting perceptions of what is possible: challenging assumptions, taking risks and facing the future with optimism and hope
Collective Power: connecting and collaborating with others sparks energy and moves people into action around common goals
Putting all people at the heart of change: when unique perspectives are visible and diverse voices are heard, we create a world where new ideas can ignite change
Creativity making complex issues clearer: imagination and creativity are powerful tools for reaching beyond known solutions to solve problems
People should be at the heart of change
It is hard to comprehend the uncertainty that will be facing millions of people across the UK. People, communities, organisations and systems will continue to be deeply and fundamentally affected by the impact of Covid-19. The pandemic has entrenched inequality and exacerbated existing pressures and demands across the health and care system. There is no denying that recent events will define a generation.
But what this pandemic has taught us is the need to build on the everyday innovation that has emerged in response to the crisis – people have acted with ingenuity, communities have pulled together, organisations have redesigned services and delivered them remotely, and systems have enabled completely new ways of working.
At People Powered Results we believe that people should be at the heart of change. Place-based and people-focused approaches have too often been overlooked in systems-change efforts, a key reason why top-down reform alone often fails to achieve its potential. We are excited to work with local and national collaborators to create the conditions and cultures required to rapidly adopt new innovations and scale what works.