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A place to think

Professor Terry Young, Associate Dean, Health Partnerships at Brunel University London, explains the work of the Cumberland Initiative, its new CumberLAB facility and its quest to untangle the trickiest healthcare problems.

In editing her father’s letters (‘Don’t you have time to think?’, 2005, Penguin), Michelle Feynman presents a portrait of the 1965 Nobel Laureate for Physics. Against the brash public image, this collage of communications reveals someone who prizes time to think, who turns thoughtfully to each correspondent, and who has many strategies to avoid anything he sees as a distraction, whether it be bureaucracy, furnishing references, delivering lectures or showing up at high-profile events.

His ability to get to the heart of a problem was famously demonstrated at the enquiry into the Challenger disaster when he used a rubber O-ring and a glass of ice-water to show how the seals lost their resilience one cold night on the launch pad. On another occasion, Feynman was asking a lot of questions at a seminar well outside his research field, which a colleague wrote off as showboating. Later, someone discovered 50 pages of pertinent equations in Richard’s notebook.

Most of us long to be that well-prepared and would give anything for that behind-the-scenes reflection, chasing down the dead-ends or refining a line of theory. For most of us it represents a level of luxury we can only dream about. And most of us go on longing while we put out fires and fill in forms. Most of us lack the job security to walk away from all that administration and think. Moreover, we know that even a month in a monastery would not solve our problems, because they cannot be solved in isolation.

The trouble is, really effective people do manage to carve out that sort of time – as Stephen Sondheim put it – somehow, someday, somewhere.

Imagine a space to do just that: where you could work with others at scale to probe the problems and plan for better days. We are just about there with a facility in Slough that offers space for systems thinking – computer-based, discussion-based, games-based or even action-based at scale in the large space behind the offices: the CumberLAB.

At the Cumberland Initiative, we have always believed that the people to untangle the trickiest healthcare problems are the people with the experience and expertise to recognise what an appropriate solution would even look like. They are, of course, the people who spend their lives there, as patients or professionals. What we can add are some methods, some tools and the space.

As I write, the collaborative working and seminar spaces are just about to come online, after which we will turn our attention to the jewel in the crown: somewhere to model, to game, to run provider-commissioner trading floors or to mock up the front end of a hospital or a suite of operating theatres. This is not about the ergonomics of particular healthcare environments, but about the end-to-end flow of patients and staff within the wider ecosystem of demand and care. So how do you design such a space? We don’t know, yet, but we hope to have fun finding out.

The illustration above is an Architect’s view – by Ewa Moskwiak of D4B Studio – of how our 450m² of space might be used to support simulation scenarios.

Time to think. The shuttle disaster pitched a highly regarded scientist into the harsh glare of a public enquiry, with the attendant political tensions and the crushing demand for answers, preferably acceptable answers. His ability to create the time to think enabled him to focus a set of analytical skills, developed over a lifetime, upon a national problem.

In many ways, the cross-currents of demands and proposed solutions represent a hazardous environment for leadership and management in the NHS. They exert intense pressure on those at all levels of service providing organisations, pressure that cannot continue to build forever. The best way forward is to find better ways to deploy the human resources and technology at our disposal in more effective ways, ways that reduce the wear and tear and improve the experience all around. Other sectors have innovation spaces. Now healthcare in the UK does, too.

FOR MORE INFORMATION

www.cumberland-initiative.org

^{(Above: Professor Terry Young)}