Keep calm and bring it on

December 2, 2009 at 8:52 am 1 comment

By Sarah Gillinson

Narayana Hrudalaya (NH) cardiac hospital is proud to offer a service that confounds expectations – they conduct eight times as many open heart surgeries as comparable Indian hospitals. Operating theatres allowing multiple simultaneous operations have enabled NH to combine the precision of heart surgery with the efficiency of the production line. Founded in 2001 by renowned cardiac surgeon, Dr. Devi Shetty, NH also works to prevent critical cases by actively connecting with ‘hard to reach’ rural populations. Technology from the Indian Space Research Organization links heart specialists with local GPs to support diagnosis. Today, 99% of people are treated locally and only the 1% of patients that need surgery is sent to NH. The quality of the hospital’s service is higher than could ever have been imagined a decade ago, and its costs lower.

Unlikely as it may sound, thousands of miles away in Norfolk public servants are getting to know that Narayana feeling. Police, local government officials, health officers and others are working together to re-think public services. They have been told to think big and think differently. They are working with users to develop a deeper understanding of the challenges they share – like how to stop dropping the ball when children move from primary to secondary school. They are using these new insights to find both savings for Norfolk’s hard-pressed politicians and service improvements for Norfolk’s citizens.

Politicians of all parties may be talking ‘cuts, cuts, cuts’ but Norfolk’s local leaders are talking about ‘lead, engage, aspire’. The quality of their work means they have the chance to achieve both.

Narayana and Norfolk are both working to achieve radical efficiency: different, better and cheaper public services. Neither organisation starts with a cost-cutting guillotine. They both start with a fresh perspective on the challenges faced by those they serve and a determination to develop creative solutions. They demonstrate that public services really can ‘have it all’ – achieve better outcomes and lower costs through innovation.

The Innovation Unit’s research into radical efficiency has uncovered hundreds of examples of innovation that generates different, better and cheaper public services. And we believe that the lessons these examples contain can form the basis of a new type of response to the financial crisis. Some public services will respond by providing ‘less for less’, simply cutting budgets and offering less to the public. Others will seek to provide ‘the same for less’, finding operational efficiencies within existing approaches. Radical efficiency focuses on the challenge of providing ‘more for less’ by fundamentally re-shaping services to be both cheaper and better.  You can read the interim report from this work here.

That demand of ‘more for less’ might seem like the final straw for people already working at breaking point to hold services together. It’s actually about setting them free, to be honest about the restrictions in existing approaches and work together to resolve them. And that is vital not just because of short-term economic problems but long-term social change. Demand on public services is inexorably growing – an ageing population, climate change and chronic disease mean that, in the long-term, business as usual is not an option.

So radical efficiency is important for today and tomorrow. But success relies on aspiration, not desperation; on quality outcomes, not cost-cutting. We can have it all: different, better and cheaper public services today and in the future. But only if we think radically – and positively – about what people really need.  We need a no fear approach to public services.


Entry filed under: Public Services. Tags: , .

Getting Engaged Is learning in school ‘Meaningful Work?’ (taking cues from Malcolm Gladwell)

1 Comment Add your own

  • 1. Disciplined Innovation  |  January 8, 2010 at 6:05 pm

    […] of this blog will remember our early December post about the ‘radical efficiency’ research being undertaken for Nesta.  Radical efficiency focuses […]


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