by Sue Brown, CEO ARMA
I was reminded the other day of the three horizons model and thought how well this expresses the tensions we face in MSK. There is wide recognition that how we do things now doesn’t work for a whole host of reasons. It was this realisation that led Sussex MSK Partnership to try to do something radically different. They came up with community assessment days, which have excited a lot of people. While they experiment with this, they have had to continue delivering the service as it is currently arranged.
How can we transform services to work better when we also need to deal with the huge numbers of people needing diagnosis, treatment and support right now?
Horizon 1 – business as usual. Managers are trying to keep the show on the road as it becomes increasingly obvious that business as usual isn’t working.
Horizon 3 – visionary. Those who can see how things should be. ARMA’s vision is that the MSK health of the population is promoted throughout life and everyone with MSK conditions receives appropriate, high quality interventions to promote their health and well-being in a timely manner. Increasingly I think we realise that we can’t get there by making the current system work a bit better.
Horizon 2 – innovation. Entrepreneurs come up with ideas to disrupt the status quo. Unlike horizon 3, this is about immediate action. Putting in place innovative ideas that may (or may not) work. Horizon 2 can deliver activity which moves us towards the visionary future we want.
Community assessment days were intended as a different way of thinking about community MSK services. One unanticipated outcome was that they shortened community waiting lists. A lot of people emphasised this aspect and look to implement them with this as the main purpose. If we do that, the innovation becomes another sticking plaster to keep the status quo going, rather than a move towards the vision.
The key message of the three horizons model is that we need all three. Three voices – manager, entrepreneur and visionary. Most people are wedded to one of the three and tend to react negatively to the other perspectives.
- We need the horizon one managers, working to keep the current system on the rails. Too many people are already waiting too long for services.
- We need the horizon two entrepreneurs innovating, experimenting, trying to take things in a different direction. Without this we can never transform services.
- We need the horizon three visionaries challenging us to think bigger, to see the vision and not to accept anything less. Without them we will remain stuck with a status quo that lets everyone down.
We all need to listen to each other and recognise the value of all three perspectives.
Which voice do you represent? And how do you value the perspective of the others?