But my cat likes to sit in boxes…

Imogen Fuller, Engagement Manager
Centre of Excellence for Information Sharing

In a week where the future of the NHS has been in the headlines, I’ve found myself thinking about cats and boxes.  Stick with me and I’ll explain.

Jeremy Hunt declared in his speech this Thursday that he wants the NHS to be “powered by a culture of learning and continuous improvement”.  He is looking for ways to learn, not only from successful models here in the UK, but also from further afield, including the US – an approach which could be seen as ‘looking outside of the box’ for inspiration.

When deciding which five [1] hospital trusts the US health care corporation, Virginia Mason Institute in Seattle would be partnering with as part of “an international buddying programme”, a spokeswoman for the NHS Trust Development Authority (which will be managing the project) said the five trusts were selected because they had a workforce and board committed to making significant cultural change.

With a focus on the cultural and organisational factors that impact on information sharing, we often find ourselves highlighting the importance of similar factors (such as leadership, attitudes / readiness for change, and attitudes to learning) to successful information sharing as part of a transformation programme.

The vision of the NHS as a learning organisation also got me thinking about our work in the Centre of Excellence for Information Sharing, where capturing and sharing learning is central to what we do.  Like the plans to share and benefit from healthcare models from other countries, the Centre is often looking for ways to capture and share learning, not just from the obvious sources, but also from ‘outside of the box’.

One way we do this is to look across not just our work in different local places, but also across different policy areas.  We are starting to identify common information sharing challenges and transferable learning, because often, the issues being faced by health and social care pioneers (such as fear and a lack of confidence regarding sharing information) are same things being worked on by multi-agency partnerships for safeguarding, tackling gang and youth violence, and supporting families with complex problems.

But do we go far enough outside of our box when looking for learning?  It’s always hard to know what it is you don’t know, so when I found myself earlier this week listening to a radio programme comparing diagnosis and treatment for veterinary and NHS patients, I wondered if we should be exploring even further afield in our quest for learning?

The radio show looked at differences in the organisation of healthcare, compassion and end-of-life care for both human and animal patients. Whilst information sharing wasn’t explicitly mentioned, it got me the thinking about how the co-location of primary care and diagnostic services in a single building, which is common in veterinary practices, must have a significant impact on the ease of information sharing, when compared with GPs and hospital staff transferring patient results between different buildings and services within the NHS. Exploring further, it also struck me that by looking at how veterinary practices share information across practice groups, with emergency animal care providers and with private boarding kennels or charitable animal welfare organisations, we might also gain some valuable insight.

Apparently, I’m not alone in this thought. When GP Graham Easton (our guide for this journey looking at healthcare for people and pets) asked a representative from the Kings Fund if learning from studying veterinary practices could help support health and social care transformation, the answer was a resounding ‘yes’.  The Kings Fund did admit that it had not looked at veterinary medicine as a source of new ideas and learning before, but that they probably would do so from now on.

However, looking at how others do something, then learning from it and embedding the learning into a new way of working, is not easy.  It requires leadership, trust and a willingness to challenge yourself to step outside of your comfort zone or ‘box’: something which cats apparently don’t like to do (as evidenced by all those clips on the web), because for them, boxes are a comfort zone that provides them with insulation, stress-relief and a good place to sleep or hide!

[1] Shrewsbury and Telford Hospital Trust; Surrey and Sussex Healthcare Trust; Barking, Havering and Redbridge University Hospitals Trust; Leeds Teaching Hospitals; and University Hospitals Coventry and Warwickshire.