Not Signed-In
Which clippings match 'NHS' keyword pg.1 of 2
14 NOVEMBER 2014

NHS Innovation Diffusion: digital tools and social movements

"There is innovation inside the NHS. But innovations tend to stay local, failing to be adopted by other healthcare organisations or diffusing very slowly. This challenge is well recognised. But what's the problem? Given the assembled talents and good intentions of NHS staff, how can the systemic sum of innovation be so much less than its parts?

The NHS is sometimes described in terms of it's hierarchical structure. For my purposes it's useful to describe the current NHS using the language of philosopher–activists Deleuze & Guattari. In their terms, the NHS is a striated space marked by linear boundaries, restricted to a particular plane of activity in the space of all possible potentials[1]. For Deleuze & Guattari, like Foucault before them, power does not simply operate as a pyramid but in myriad multifaceted directions and relationships. Foucault said 'One doesn't have a power which is only in the hands of one person who exercises it alone... it is a machine in which everyone is caught, those who exercise power as much as those over whom it is exercised.. it becomes a machinery that noone owns'[2]. The overall effect is an institutional environment that acts to tame energies it is a social machine that produces conformity. As Deleuze & Guattari would say, the NHS is highly codified, where a code is a pattern of repeated acts. Of course, there are many situations where this is desirable–an ICU emergency needs a practiced response. But it doesn't make for a system that diffuses innovation.

Anyone who's returned from an innovation workshop and tried to applied new ideas in their NHS workplace has experienced this striation. It's the overlap in particular experience of all the dynamics that limit change: lack of autonomy in a hierarchical structure, the expectations of colleagues, the time it takes to deliver your daily targets, the lack of incentive, the lack of peer support, lack of sense of entitlement to change the way things are done all of which can combine to deliver an experiential straitjacket which is an impersonal affect, a pattern across the system and one that stifles diffusion as effectively as individual innovation.

The alternative is a system marked by flows, connections and zones of intensity. In the abstract terminology of Deleuze & Guattari, an innovative system would include smooth as well as striated spaces. Smooth space is occupied by intensities and events, by the continuous variation of free action. The characteristic experience of smooth space is short term, up close, with no fixed points of reference. I will try to show how the combination of social movements and digital technologies could blend smooth space with the more rigid boundaries and caste structures of the NHS in a way that aids the spread of innovation."

(Dan McQuillan, 2011)

[1] Deleuze, Gilles and Félix Guattari (1980). A Thousand Plateaus. Trans. Brian Massumi. London and New York:Continuum, 2004.
[2] Foucault, Michel (1975). Discipline and Punish: the Birth of the Prison, New York: Random House.

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2011 • a practiced response • an impersonal affect • change the way things are done • codified • conformityconnections • continuous variation • Dan McQuillan • diffusion • digital movements • digital technologiesevents • expectations of colleagues • experiential straitjacket • Felix Guattariflows • free action • Gilles Deleuze • healthcare organisations • hierarchical structure • ICU emergency • individual innovation • innovation diffusion • innovation workshop • innovative system • institutional environment • intensities • lack of autonomy • lack of incentive • limiting change • linear boundaries • local innovation • machinery • Michel Foucault • myriad multifaceted directions • myriad multifaceted relationships • NHS • no fixed points of reference • ownership • particular plane of activity • peer support • philosopher-activists • power • pyramid structure • sense of entitlement • short term • smooth spacesocial computing • social machine • social movements • spread innovation • striated space • striation • up close • zones of intensity

CONTRIBUTOR

Simon Perkins
24 SEPTEMBER 2013

Inside Out of Mind: ethnographic research catalyst for theatre project

"Based on extraordinary and extensive ethnographic research, Inside Out of Mind offers moving insight into the mysterious domain of dementia; a world of medical magical realism peopled with puppets and performers in pursuit of a lost man in pursuit of lost love. A darkly comic and empathic tale."

(Meeting Ground Theatre Company)

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Anna Mottram • arts and sciencesdementiadissemination through performanceethnographic researchethnographically informed study • Health Care Assistant (HCA) • healthcare • Holly-Robyn Harrison • hospital treatment • hospital wards • Inside Out of Mind (play) • Jarrod Cooke • Jim Findley • Joanna Macleod • Joanne Lloyd • Justine Schneider • Kezia Scales • Lakeside Arts Centre (Nottingham) • Lily Lowe-Myers • Maurice Roeves • Maxine Finch • medical research • Meeting Ground (theatre company) • NHS • no name • Nottinghamnursepatient carereality as processresearch disseminationresearch project • Sean Myatt • Simon Bailey • Tanya Myers • theatre • theatre company • theatre projectstheatrical performancetheatrical playtrauma • Ulrike Johannson

CONTRIBUTOR

Simon Perkins
29 JUNE 2013

The (UK) National Institute for Health Research

"The mission of the National Institute for Health Research (NIHR) is to maintain a health research system in which the NHS supports outstanding individuals, working in world class facilities, conducting leading edge research focused on the needs of patients and the public. ...

Since its establishment in April 2006, the NIHR has worked with key partners involved in the different elements of NHS research to transform research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy and developed and supported the people who conduct and contribute to applied health research."

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2006 • applied health research • basic science • clinical medicineclinical researchDepartment of Healthhealth • health research • leading edge research • medical practicemedical research • National Institute for Health Research • NHS • NIHR • patientpatient care • patient needs • primary careresearch • Research for Patient Benefit • research funding • RfPB • Sally Davies • tangible benefits • UK

CONTRIBUTOR

Simon Perkins
12 NOVEMBER 2012

One of A Kind: a childs guide to Radiotherapy

"Young cancer patients have told their stories in a cartoon that shows children and parents what it is like to have treatment. The six children, who received radiotherapy in Bristol, teamed up with the animation house Aardman for the production called One of a Kind! Their voices were recorded and given to the animated characters in the short film. It will be made available to hospitals all over the UK. The cartoon was the idea of Jancis Kinsman, advanced practice therapy radiographer at Bristol Haematology and Oncology Centre."
(15 June 2010, BBC News)

Fig.1 Emma Lazenby (2010). "One of a Kind" concept by Jancis Kinsman, directed by Emma Lazenby, produced by Aardman and ArthurCox, 6min.

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20102D animationAardman Studiosanimation • ArthurCox • Bristol • Bristol Haematology and Oncology Centre • cancer • cancer charities • cancer patients • cancer treatment • Charlie and Lola • childrencommunication tooldigital storytelling • Emma Lazenby • guide • guide for children • haematology • hospitalhospital treatment • Jancis Kinsman • naive illustrationNHS • oncology • One of a Kind (film) • paediatric radiography • personal narrativepublic health • radiography • radiotherapy • their storiestherapyUKvoicesyoung children

CONTRIBUTOR

Simon Perkins
01 NOVEMBER 2012

What is the Liverpool Care Pathway?

"The Liverpool Care Pathway (LCP) is a scheme that is intended to improve the quality of care in the final hours or days of a patient's life, and to ensure a peaceful and comfortable death. It aims to guide doctors, nurses and other health workers looking after someone who is dying on issues such as the appropriate time to remove tubes providing food and fluid, or when to stop medication.

However, its use for some has become controversial, with relatives reportedly claiming it has been used without consent, and some saying it is used inappropriately.

This criticism and the media emphasis on the supposed controversy is puzzling, as the LCP has been standard practice in most hospitals for a number of years. The LCP has also received recognition on both a national and international level as an example of good practice.

As a GP put it in the British Medical Journal, the LCP 'has transformed end of life care from an undignified, painful experience into a peaceful, dignified death at home'"

(NHS Choices, UK)

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1990s • advanced illness • British Medical Journal • care • comfortable death • consent • controversydeath • death pathway • diedignitydyingemotional needsend of life • end of life care • end-of-life careeuthanasiagood practiceGPguide • health workers • healthcare • hospice • hospital • LCP (acronym) • life • Liverpool Care Pathway • Marie Curie Palliative Care Institute • media criticism • medication • multidisciplinary approach • National Health Service • NHS • palliative care • patientpatient care • peaceful • physical needs • plan of care • prolonging life • public health • quality of care • relieve suffering • Royal Liverpool University Hospital • social needs • spiritual needs • suffering • terminally ill • UK • undignified

CONTRIBUTOR

Simon Perkins
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