From bureaucratic to human: What real change looks like in practice

For years it's been known that bureaucratic services are bad at supporting people with complex conditions. It’s also been known what a better and more human approach looks like. What hasn’t been widely understood is how to get reliably from bureaucratic to human, escaping the sticky bonds of inertia. As a result, many thought leaders and some policy makers, with the best of intentions, have exhorted services to be more human, but without creating the capabilities, incentives, capacity or conditions needed to enable this transformation to take place . 

At Innovation Unit, we’ve  developed, after many years of practice, what James Plunkett at Kinship Works calls a process of metamorphosis - a reliable way to transform a bureaucratic service into one that’s more human (holistic, person-centred, tailored, and strengths-based). This process starts with building a chrysalis - a safe space in which leaders, practitioners and communities can dissolve the bonds of bureaucracy, and form a more liquid state, full of possibility. Then, helping them to design - and practice - a more human way of doing things. 

Living Well 

Living Well is a programme of system transformation for people with complex mental health that we have supported through this approach over the past decade, with partners in London, Greater Manchester, Derbyshire, York and Edinburgh. Evaluations show that it works, with Living Well systems delivering better outcomes and reducing pressure on services, at a cost that falls within NICE guidelines. 

James has used Living Well as a case study in his article Disassembling bureaucracy, exploring how this process actually makes the changes that are needed for this metamorphosis to succeed. 

“Over several years this process has been refined into a way of disassembling a bureaucratic service, and reassembling a more coordinated offer that treats people as humans. It does this in a comprehensive way, covering all aspects of metamorphosis - disassembly, re-imagination, reassembly, and even the survival of the new service/organism. It works with people who have complex conditions, learning from their experience. And the process is sufficiently systematic and well-documented that it can be reliably and affordably repeated.”

We’re delighted to see our work - and the work of local leaders, practitioners and people, who have embraced and sustained the work of Living Well so passionately  profiled in this way.  

Read the full article and find out more about our approach to neighbourhood health.