People Powered Results

Front-line practitioners and people who use health and care services have unrivalled expertise in how the system operates, but often have little influence or ownership over change. Our approach empowers and connects those closest to delivery to drive change.

Empowering those on the front line not only brings a renewed energy and power for change across a system, but also brings a detailed level of insight into the real issues and challenges that are faced by a system to inform longer term strategic ambitions and plans. We think a place-based, people-focused, rapid approach to change has been a missing part of the jigsaw in complex system change, and a reason why top-down reform on its own often fails to achieve its potential.

The 100 Day Challenge is a structured innovation process, combined with coaching support. The approach enables frontline staff from across a system to collaborate and rapidly experiment with new ways of working, to achieve real results for people and communities.

The method complements traditional top-down approaches to change. The method works with leaders of a system to mobilise those closest to the action - driving change from the bottom up, in real time and at pace. 100 Day Challenges are intensive periods of action and collaboration that typically involve representatives from health, social care and voluntary organisations. System and organisational leaders are supported to break down longer-term strategies into challenges with measurable objectives. Frontline practitioners and citizens set ambitious goals, and develop and test creative solutions in real conditions.

The approach focuses on creating the conditions for change and innovation in complex systems, depicted below:

The 100 Day Challenge method works best on complex/wicked issues, which require collaboration across organisational and professionals boundaries, and a range of interventions to be tested simultaneously. Over the past few years we have been testing the applicability of the approach to tackle the following issues:

• Improving care and support within a community setting to reduce unplanned admissions
• Improving approaches to hospital discharge to reduce avoidable delays
• Supporting areas to develop proactive approaches for those at risk of developing long term conditions - such as diabetes
• Working nationally to reduce the rising demand for elective care - helping to make sure that people see the right person, in the right place, first time
• Supporting health systems to develop and scale person and community-centred approaches through place-based/neighbourhood working.

Check out our short animation and booklet for more information on the approach. You can also check out our full easy read booklet or the shorter version for more information.

Our work launched in 2014 with a pilot programme taking place across Essex. Since then, we have been working alongside the NHS England Strategy Group to support the Elective Care Development Collaborative and working with the Personalisation and Choice Directorate to support the scaling of person and community-centred approaches to care across the country. This includes work with the personalised care group in NHS England, supporting Integrated Personal Commissioning at sites across England, and regional work with the Greater Manchester Health and Social Care Partnership.

Our experiences of pathway redesign and whole systems transformation, which mobilises the front line and service users, provides rich insight into how health and care systems locally and nationally can transform at pace.