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economists and logicians call ‘mutual knowledge’, which they distinguish from ‘individual knowledge’”. (Pinker, 2011) ‘Mutual knowledge’ is where both parties know what they know, they also know what the other party knows, they also know what the other party knows they know and so on... To conclude what may seem like a slightly irrelevant point; the message that I am communicating on behalf of the service, will need to be explicitly reciprocal in intent, ie. in basic terms; this is what you contribute, and this is what you receive. Disruptive innovation within healthcare: Professor Daniel Steenstra has written a paper, entitled ‘Innovating the NHS - Now or Never’. Within this, he argues that the service needs to innovate, rather than simply increase productivity whilst cutting costs. Describing the aspects needed to deliver innovation; ‘developing new, more effective services will drive the use of new technologies and products but also change the attitudes of employees, organisational structure and leadership.’ (2010) Daniel explains that in the past, any initiative to encourage innovation was hampered because of the isolation of one of these elements. Steenstra continues to blame the top-down hierarchy and target setting approaches adopted by the organisation. ‘Measures such as awarding Foundation Trust status to financially sound organisation; outsourcing services to the private sector and PCT commissioning has actually led to competition...good practice or mistakes are not shared.’ (2010)
the passivity of the patient role as the reason for this. ‘Something changes in people when they become patients. As consumers they are informed and empowered and can easily assert their choice by shopping elsewhere, buying other products or changing service providers. Somehow when they get a diagnosis of a disease there is a change in their behaviour. They seem to readily accept inefficient services and ineffective products; they are not up to date with the latest developments in their condition and with new products that could support them better... Patients are reluctant in engaging with market research; they feel that they are owed the best medication, products and services but do not want to support their development. This makes it difficult for the companies to develop better products and services.’ (2010) With an increase in demand, reduction in funding and a complete political shift, Daniel states that the NHS is left in ‘...desperate need of innovative service and products on a scale not seen before and established industry and academia that are unlikely to satisfy that demand.’ (2010) However, a glimmer of hope comes in the form of the opportunities created through the removal of SHA’s. ‘There is a window of opportunity to lead the way in a new model of innovation and collaboration. This has to: be internally driven and focus on news services, integrated with new products and organisational change.’ (2010)
Essentially, he establishes a strong argument that the NHS is not well equipped to innovate; ‘The NHS doesn’t have a history or capability to innovate; it never had to be innovative - just to provide patient care. So far it has only considered innovation to be product related.’ (2010)
Jason Hwang, based on ideas and research by Professor Clayton Christensen, is critical of the knee-jerk reaction of cutting costs; ‘The problem is the solution shop activities of hospitals and of diagnostic work is inherently expensive and complex...and to make sure that they continue delivering value to the healthcare system, cutting reimbursement rates to those people and those technologies is not the right solution...what we need to do is find ways to get that technology into the right business models that can use them in a cost-effective manner in the marketplace.’ (2009)
Discussing in particular, the ways in which patients cannot drive innovation, in the same way that consumers can; Daniel attributes
The ‘solution shop’ activities that Hwang is referring to, describe the business model of general hospitals who are working to find out
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