This is turning out to be a fine example of cynefin dynamics and of ‘safe to fail’ experiments.
I initially facilitated the foundation workshop looking at ways to reduce the pressure on the accident and emergency dept at Coventry Hospital. Using Participatory Narrative Inquiry methods I held open a space with no constraints. Many ideas emerged, some were more enthusiastically owned, story-boarded and supported than others.
A while later, one idea, named RIPPLE started to deliver, a self organised local community group, informal, educational as well as entertaining but most importantly social. Demonstrating a prime principle of complex adaptive systems it started to deliver more than the sum of its parts in ways that had not been predicted but could now be explained in hindsight.
One such hindsight insight was that they were reducing isolation (in TRIZ terms a known harm in every social system) and if you watch this video you will see it highlighted as one of the programmes initial aims.
Personal happiness seems to be the biggest benefit to be observed and amplified. I love the (much later) insight that the staff are getting a boost from this approach as well.
As the months passed the patterns began to form. Beneficial patterns were amplified, harmful patterns dampened. Slowly the system could be moved from complex to complicated where it could be exploited as it now had governing constraints that would encourage and allow the NHS to run six more franchisee experiments, copying the patterns but not the blueprint of RIPPLE.
Each different local area encountered different problems, different people and adapted accordingly to meet local context.
What I like most is that the structure, ethos and lessons learned (shared regularly, face to face and in a knowledge base) grew into enabling constraints, just enough structure to work within but creating the conditions for local quirks and genuine innovation.
I have mentioned this quote before but Jules Pretty in his book Agri-Culture in a much more ecological environment, said:
When people are organised in groups, and their knowledge is sought, incorporated and built upon during planning and implementation, then they are more likely to sustain activities after project completion
…long term sustainability was only guaranteed when local institutions were strong…
…projects failed when there had been no focus on institutional development and local participation”
In the initial and subsequent idea generating workshops we made the invite as wide ranging as possible to include patients, third sector, specialists, local GPs, chaplain, NHS staff, University etc. If you watch for the ownership in the eyes of everyone participating in this video you get an idea of just what might be possible.