Conversation #6 — Michelle Hawkins, Head of Futures, Virgin Care
This was a great conversation — I met Michelle by chance at an event hosted by the lovely people at Boundless (ask them about their Discovery sessions, they’re brilliant), and got talking about innovation straight away.
I love the story of how Michelle came to her current role with Virgin Care, and her interest in happiness as something worth measuring and striving to deliver. I touched on this a while ago in a blog post, and it’s heartening to see it gaining traction (apparently there’s an algorithm for happiness, according to Mo Gawdat of Google. Is there nothing an algorithm can’t do? 😀 )
So Michelle, what’s your remit as Head of Futures?
In a nutshell, creating value by helping the organisation do things differently. While my team does deliver and lead on innovation projects, much more time is spent supporting our colleagues to do it.
How do you start?
One of the first things we do is to map our marketplace (healthcare) and our organisation’s priorities to identify innovation hotspots. You can’t innovate everywhere all at once and we only have a small innovation team, so we need to find the areas where there are the biggest gaps or challenges in the system.
We start with desk research, looking at the vast amount of public health data to examine the system as a whole and identify gaps: where are the biggest challenge areas in terms of how much they cost the NHS, how many people are affected, how preventable they are and how many healthy years of life are lost as a result. Many of these are clinical hotspots, but some are non-clinical, for example reducing the use of agency staff, or improving access to services so people can find and attend appointments more easily and quickly.
Then we look at our organisation to see how it matches: are we similar to the overall marketplace, are there differences? We then streamline our list to come up with priority hotspots and go through another insight gathering stage. We speak to experts in each area to help us understand the issue in depth, identify people in the business that we can work with on the problem (including the service design team to help design new models of care), and scout for existing innovations that could be implemented quickly.
Then we get our champions involved, pilot top solutions identified or developed and roll it out. Although we tend not to talk about pilots any more, because once we have an evidence base and have done an options appraisal, we should be pretty confident that what we’re doing is more about refining the implementation.
Was there someone in the role before you, or did you have to start from scratch?
I started it from scratch which is my perfect way of starting a role! Originally, my team sat in the commercial directorate but we’re now part of the transformation directorate.
We sit in the “Change” part of the organisation. Innovation is great for growth, but what creates value is delivering it and getting it rolled out. This means my team is responsible not just for scouting and finding new ideas but also getting them embedded into the business, and benchmarking and evaluating them.
It’s a big remit and we are a tiny team, but we have an extended network of innovation champions across each service and in different head office functions who might each be leading on a pilot and linking into us for support on how to embed it.
You’ve got a very interesting career background including sales and marketing and tourism — how did you come into this role?
I guess the common link between all my roles is an interest in why people behave the way they do. When you are in a sales and marketing role, it’s all about people’s behaviour and how you can influence it.
When I was in Africa working in hotels, I realised that traditional marketing wasn’t having an impact on my bottom line or bringing guests into the hotel. What was making a difference was word of mouth — for example people on TripAdvisor saying that they’d had an amazing experience.
So I started looking at the evidence for how you design experiences, and then by chance (or fate!) I met the gross national happiness team from the government of Bhutan, who were staying in the hotel.
I was on lobby duty, going round talking to the guests, and a gentleman handed me his card which read something like “head of the national happiness bureau”. I said, “That sounds like the most brilliant job, what do you do?” And he said, “Well in the essence, Michelle, everything you are doing here is geared towards making me happy so I want to come back again and again because I leave happier than when I arrived. Happiness has to come from within, but you can create the conditions for it to be more likely.”
I thought this was genius: that’s what it actually comes down to, and you must be able to break down happiness by design.
Happiness by design sounds good — tell me more?
I looked at how you designed a physical space and how people interact in social spaces, and focused in on four factors which I found to be common themes in creating the conditions for happiness.
The first was relieving Pain, which meant going around the hotel and identifying things like where it smelled bad — e.g. smells from the kitchen coming through, or the pain of not being acknowledged by the front desk when you were queuing. So I looked at pain from a physical and psychological perspective.
Then I looked at Pleasures and realised that you adapt to pleasure very quickly — so if we did the same thing every time someone came to the hotel, they would assume it was just hotel policy and quickly get used to it. Whereas if every time they came there was a different thoughtful gift or someone remembered something about them from my last stay, that would be a pleasurable surprise each time. So we tried to build in spontaneous pleasures. One of our staff, for example, realised one of the long term guests loved to cook for himself. He would often buy ugali, which is a local carbohydrate dish in Tanzania. We bought some ugali for his stay and he was absolutely delighted. Now that only cost us a couple of pounds but truly delighted the guest.
The third aspect was around Connectedness: when guests came to stay some wanted to be connected to their families, but others wanted to meet people. So we looked at how we could facilitate connections, such as hosting free drinks for our guests in the members’ lounge at a certain time every week .
The fourth aspect was around Purpose and that was probably the hardest thing to crack. We started to look at some of the softer areas such as how we recruit people from the local area rather than bringing in outside experts to manage the hotel, and at our environment and sustainability approach so that when guests came to stay they felt good about putting their money into the hotel.
And then what happened?
Well, my grandmother was very ill at the time. She was going into homes, but not the most appropriate ones because she needed specialist support for dementia and psychosis. And I started thinking that everything I was doing around designing positive experiences in hotels could be done in healthcare. I started looking at happiness in the ageing brain and older people generally, and my search terms triggered an advert for the job at Virgin Care. I hadn’t planned this route at all but when I went to meet them, I was so sold by the vision and the opportunity to make a difference with all the understanding I’d built up that I stayed.
So how much of your role is about innovation and how much is about incremental tweaks — or are they in fact the same thing?
I don’t tend to look at the difference between improvement and innovation so much as what value you’re creating. One small tweak can have a massive amount of value. For example, the difference that it makes if you go into your GP’s office and the receptionist is smiling and welcoming, tells you how long the wait is, shows you where to sit down, and so on creates enormous value. Is it innovation to run a customer service training course? No. Does it create a huge amount of value as a service improvement? Yes. It’s usually easier to implement an improvement than an innovation, but both can be equally valuable.
There’s been some articles in the press recently about hospitals and hotels learning from each other — it sounds like that’s something you would agree with?
Absolutely. There’s a book by Fred Lee called If Disney Ran Your Hospital, about how to apply the Disney principles to healthcare. Think about the last time you went to the doctor or another healthcare environment, and about how different this experience is from the last time you stayed in a hotel. In the healthcare environment, quite often you don’t know where you’re going, you don’t necessarily get a welcome, people don’t remember your name and you don’t know how long you’ll have to wait.
The porters in the hotel were often overlooked but they were the first point of contact guests have with the hotel, so they should be seen as key people. It’s the same in healthcare services, it’s often people who are overlooked who make the difference. I was reading through some feedback from an in-patient in one of our community hospitals and the person said: ‘There’s a person that comes in every morning, and she always gives me a beaming smile that makes my day’. That person happened to be a cleaner.
Patients don’t necessarily differentiate whether you are a cleaner, a receptionist or a clinician. You are just part of the hospital team.
So coming back to your innovation hotspots — once you’ve identified them, are there any techniques or models that you use to get ideas?
Yes there are, we have an innovation scouting process which swings into action once we have a brief. Often the challenges come from one of our services, for example how can we improve self-management of people newly diagnosed with diabetes. So the first step is to go and meet the team and understand the problem as thoroughly as possible.
We’re spending quite a lot of time on this element now, working out how to frame the problem statements and keeping them as focused as possible. It’s hard to stop people coming up with solutions at this stage. When you’re discussing the root causes people just want to come up with their ideas, and it’s so hard to stop them and say, “Hold that idea, just wait a moment.”
But, when we’ve finally got our problem statement, we do some intensive innovation scouting. We look at quick wins that have got a really good evidence base, that we could easily implement. Alongside that we look at innovations that are slightly more radical, that push people a bit further. Even if you don’t adopt them, having more radical ideas in the mix can put other ideas into perspective!
Where do you look for innovations?
There are certain economies in the world we know are good for different things. Israel is leading the way in healthcare technology and systems integration. Because of the private payment model of healthcare, America is getting innovations through a lot quicker, while for social innovation we look at Australia and the Scandinavian countries. There’s also some amazing work being done in emerging markets, especially around doing more with less, so we place equal importance on looking at Africa, Brazil, India and China.
We create a shortlist of these innovations and then run a workshop with the people that submitted the problem to us. In that workshop we often have interactive stations round the room where people can test things out, and at the end, people have to stand by their favourite innovation and pitch to the room why they think we should go for that one. We often ask people to go round in pairs, which means you get different perspectives — for example pairing a clinician with a service manager.
When we’re down to one or two solutions, we work with suppliers to get more information and negotiate pricing. Then if the team are willing to take this innovation forward we support them with the application to the innovation fund.
And how do you get everyone involved in innovation? Is it difficult to engage some people?
We pick the people that are engaged. Not everyone is going to be enthusiastic and not everyone is going to be in the right mindset. At the start of my career I would have been very naive in thinking that we should get everyone on board, but then I quickly realised that some people would need to be carried by others.
So instead we’ve spent quite a long time identifying innovation nodes or champions. We have an innovation champions network that we’re developing so hopefully that will help a lot with spreading innovation and capturing good ideas.
Do you think everyone can be creative, though?
Yes — but not everyone knows they can be creative. I recently listened to a TED talk on AI about how we should be really worried about AI in the future because we are creating an intelligence that will far go beyond human intelligence, and then what happens? I was thinking at that point, what do we have to offer? What’s going to be different about us? Creativity and empathy or the ability to form relationships will be the key skills that differentiate humans.
So do you mean that AI won’t be able to handle the emotional side of relationships?
Yes — although having said that, there’s an interesting innovation in the US called Sim Sensei that uses an avatar and a webcam to detect body language and work out how stressed you are. It’s in the early stages and is doing well in trials so far.
At this point I had to let Michelle go before we got embroiled in a long discussion about AI — I suspect we could have gone on chatting all day!