NHS Citizen – thank you

This is a quick reflection on the NHSCitizen event this week – its really intended to capture the thoughts which are still circling in my mind and reflect my opinions rather than the team as a whole – hence it appearing here rather than the project blog. I find this quick bullet point format really helpful for making sure that I capture and reflect on something when there is so much going round in my head – any of these points could be a blogpost in their own right and may well be in the future. So – here we go:

About the event

• Firstly – it was amazing – there were so many fantastic people there and the way in which the whole concept and description of what we were trying to do shifted through the two days (and will continue to shift I expect) was exhilarating.
• This links to my second point – and is more personal.  I really enjoyed facilitating as part of a team and I really think this that the fact that the facilitation was organised collaboratively really supported the collaborative nature of the event
• Olivia and the team from NHS England were incredibly open to work with and speaking personally I am convinced that they are committed to whatever is built being something of genuine value – I have nothing but respect for this as its not easy to try and authentically create something that will hold you to account
• I thought the venue was great and the staff were hugely helpful which makes a big difference when you need the agenda to be responsive rather than fixed
• I think the way in which the online conversation was brought into the room really added to the event as it created a great sense of openness and audience – apart from the benefit of the actual contributions. There is a lot more that could be done on this and we will be mulling that over the next couple of weeks.
• I really like using open space techniques – I think they are more creative and also work in terms of shifting the power from the conveners to participants. However we have to think really hard about to make open space work for the people who are not comfortable taking the mic.
• I wonder if we can create a document drafting team that is capturing the work in progress – and link this too social media?
• I really hope my writing style becomes a little more penetrable once my viva is over
• Simon’s idea of a minutes reflection at the end was brilliant – I will definitely try and use that again (and of course fully credit him!)

What next?

• I was left with a sense that we could all see potential and an exciting opportunity in this work but no-one was clear on what it might be – we know there may be value in creating ‘it’ but we don’t know what ‘it’ is yet.
• There is a huge question as to how can we keep the question of what ‘it’ is open at the same time as making progress – I think the only way to do this is to experiment, test and refine ideas
• This is an uncertain place for people – while there was a big desire for change in the room as we debated ideas you could ‘feel’ us being dragged back to pointing out similarities with stuff that already exists – I think we have to keep the debate sharply in the arena of what is new and different and we have to help people be comfortable with that rather than consoling them with the idea that things won’t be that different
• If you want the outcome to be co-productive then you need to create it coproductively – however this creates real tensions between leadership, co-production and pace – how can we achieve something a the right pace to make a difference?
• Going forward I think it would be useful to think and perhaps define more clearly whether we are clear enough about the difference between consultation, engagement and democracy – I think the answer to question ‘what is different about this’ which kept getting asked lives somewhere in this discussion
• That being said – the mapping of different networks,groups and organisations involved is an absolute no-brainer – as long as we keep a place for the individual citizen or newly active individual to get involved without structures behind them I think that too often we talk about the wrong us/them – change makers exist inside and outside of the system and we must connect them together
• Agenda setting is going to be really crucial in making all this work – we need to spend a lot more time on this
• We have to be clear on the distinction between systems thinking and structure

Digital is central

• We really need to talk about digital – digital exclusion is a huge issue but it has to be attacked in such a way as to not hinder progress in using new tools that can open up access and opportunities for many people
• I think people need to take responsibility for their skills in this area to the full extent of their ability
• We need to link conversations about digital to support assisted living to discussion of quantified self to digital by default to social media and all to an ethics led conversation about big data – digital is much bigger than simply about using twitter to engage

Some ideas that struck me:

• The event was a microcosm of the system (thanks to Titus from Democracy Matters) – I agree – I think this is why its important that we ‘bank’ the progress made rather than seeking to recreate it
• The idea that we should title the whole endeavour as NHS citizen and leave out the reference to any specific mechanism (thanks to Andrew spong) – I really like that thought and I think it links the need to keep social and structural change in parallel
• The future is open (Tim Kelsey). I agree very strongly with this – but lets not limit it to data as it needs to encompass thinking and practice as well

And one final thought – I felt that so many people who participated were increasingly drawn to what might be achieved by really doing things differently but were held back by the need to ask if they can really trust this opportunity. There is no answer to this as trust is earned not given but perhaps if we can keep refining and understanding how can we make this different we can build the trust that is needed to make it work.

Thats it – comments, questions or challenge all very welcome – but the main thing is a huge thank you to everyone who participated – I can’t wait to see what happens next.