The Changing NHS

Explicitly using the scenarios comes later in the year, via a second series of workshops where we help decision makers to:
a) test out the robustness of current and future strategic intentions and
b) help discover new strategic options for flourishing in the future

I don't have time (or client permission for that matter) to go into any detail about the workshop process and the shape of the scenarios that are beginning to emerge. The team should have something useful to share with the client in the Autumn and hopefully I'll be able to share some of this material at some point, but suffice to say some interesting stuff is already happening.
 
In particular, on a general level, I was struck by how, at the first scenario building workshop, the people present, (all senior NHS and Local Authority managers and clinicians), were very easily able to recognise that there are some big, important issues and questions that ought to exert significant influence on a set of plausible challenging scenarios. Questions about technological and pharmacological developments, societal attitudes to health and wellbeing and environmental sustainability, macro-economic pressures etc.  But, and its’ a big but, at the same time many of the same people also felt personally very uncomfortable when trying to contemplate working in these possible new worlds, mainly because the new worlds challenge conventional wisdom about:

i)   what managers and clinicians do; and 
ii)   the amount of power patients and citizens should hold and how they might exert it to get what they want.

Also, the scenarios depicted worlds that are, to quite a degree, very difficult ones for managers and clinicians working in today’s NHS to reconcile with their personal values. 
 
Perhaps this is an important aspect of what good scenarios should do? Namely, help decision makers contemplate how they might operate in futures that they otherwise would largely fail to entertain as plausible possibilities. But, even if this is true, I'm struck at how big a psychological barrier exists and unsure how we might help people begin to 'walk down the beach, put their toes in the water and then stay in there rather than running back straight away, screaming "the waters’ too cold".

How do we learn to face up to our demons? - Now that's a real challenge.