I read an interesting article in the newspaper today about curiosity, the psychological concept of ‘Need For Cognition’ and its role in fostering creativity and innovation.
The language of the NHS regularly uses the words ‘innovation’ and ‘transformation’ when discussing the ‘challenges’ of modern health care – but what does it mean in reality? and if we truly want to innovate to improve what we do how do we create a culture that actively encourages individual and collective curiosity?
IAPT is one of the biggest workforce transformation programmes mental health services have experienced in recent years. Pre-IAPT, whilst campaign groups for people living with cancer were challenging the NICE decision not to add expensive new treatments to existing clinical guidelines on the basis of cost effectiveness, people with mental health conditions like anxiety, depression and psychosis were being denied access just to the existing psychological treatments recommended by NICE. People all to frequently ended up loosing livelihoods, families, health and tragically sometimes their lives.
So make no mistake IAPT has achieved some remarkable things since it was launched in 2008, not least of which is the introduction of the waiting time standards, prevalence and recovery targets to drive service improvement. Targets are helpful, they give us some thing to aim for, the language of goals is woven through our clinical interactions and helps us measure how well things are progressing and what might need to be reviewed when things aren’t going so well.
Now, because of these achievements, IAPT has graduated to being ‘mainstreamed’, which means all commissioning, workforce planning and education provision is now part of routine NHS business.
A good thing you might say - but it's here that the journey really begins and the challenges grow. The upside of the sometimes frustratingly prescriptive and bullish approach taken by the national IAPT programme was that with strong leadership, a clearly defined model and measurable outcomes change actually happened at scale and pace. Commissioners, managers, clinical leaders, clinicians and universities came together to make it happen, we problem solved, shared successes and failures and as a consequence in the north west we trained around 800 new Therapists and Psychological Wellbeing Practitioners who now work in over 40 primary care mental health services.
However, in the longer term the potential impact of the methods used to achieve this quick (in the world of the NHS) success is that we created a purely target-focussed culture where clinicians are trained to do the job, but without encouragement or reward for taking time to be curious and ask the challenging questions that are needed to make IAPT services more sustainable and effective like “what do we need to stop doing to improve what we do?” and “how can we learn more by looking at what doesn’t work”
We heard last week at the IAPT NW Leadership and Innovation Forum about the Northern IAPT Practice Research Network a unique collaboration between universities and services in the North of England to foster a culture of practice based enquiry that puts the tools for improving IAPT in the hands of the clinicians, managers and commissioners who are now responsible for its implementation by getting curious as part of the every day business.
The PPN wants to support this culture in what ever way we can. By for example, forging relationships between universities and Special Interest Groups such as the Counsellors in the NHS and Salford University which has enabled them to use online participation for their events for busy clinicians; or exploring how we can promote curiosity in our colleagues in physical health care about the role of psychological approaches by using innovative means of communication like animation and social media.
So, if you are wondering how giving staff time to take part in PPN activities will benefit the service, or you are a clinician feeling too busy to get involved, it might be worth reflecting on the rejuvenating power of creating a culture of collective curiosity.