Shaping improvement labs to help tackle wicked problems in the health service

There is a sense of excitement and anticipation amongst the Q project team (perhaps mixed with a few drops of frantic final-touch organising!) as we prepare for the two Q community events on 4 and 13 May. Across the two days we are expecting more than 200 improvers to come together to share and connect with one another. Just thinking about how much expertise will be in the room across those two days is an inspiring thought.

It is particularly exciting for me as it will be the first time I get to meet Q members and prospective Q members. I started working at the Health Foundation two months ago and have primarily been spending my time working with the Q project team developing ideas and early plans to test with Q members and others about Q improvement labs.

Over this time many of my friends have asked me what I am working on in my new job. When I tell them that I am involved in a huge project to design improvement labs for the NHS they often look at me quizzically. I can almost see them imagining a laboratory – complete with petri dish and microscope – and wondering how my GSCEs in science qualify me to be part of this team. As I try to reassure them that I will not be let loose in a scientific laboratory, I have found myself trying to explain quite what this new brand of lab actually is! 

I have discovered that over the last few years there has been an explosion of interest in organisations and initiatives called labs. There is a growing need to find new processes to solve complex and intractable problems in a world where government resources are often precarious, and solutions need the input and support of many different people. Labs represent people and organisations across the world attempting to step up to this sort of challenge. 

The term 'lab' is applied to a plethora of processes and organisations, often with quite different goals employing distinct methods and approaches. There is no neat labs definition or typology. However, there does seem to be some defining features that set labs apart from other initiatives. The most succinct definition I have found so far has come from Frances Westley from the Waterloo Institute for Social Innovation and Resilience (WISR) who describes labs as:

‘Offer[ing] a place for creative, cross sector and cross disciplinary decision making and innovation. The process is supported by careful design and facilitation and is resourced by research geared to the decisions makers need. The focus is on those "wicked problems" that seem insoluble.’

It seems that now more than ever the NHS is grappling with so many of these ‘wicked problems’. Labs could offer an opportunity to pool knowledge and resources from experts working across sectors and across traditional boundaries, supported with high quality research, design and facilitation, to make progress on them. There will be a number of ways that these problems can be opened up and tackled, working at multiple levels. The exact shape of improvement labs is ours to refine and it genuinely feels like a once-in-a-lifetime opportunity. I can’t wait to kick off the discussion about how labs work in the health sector during the events in May, and continue those conversations over the coming months. 

Tracy Webb (@TracyWebb007) is a Senior Improvement Fellow at the Health Foundation