I have always believed that we are learning every day. I take the opportunity to make small changes to my own practice if I notice something that we should be doing differently. I also encourage my teams to do the same.

This requires us to be open to the concept that the world is not black and white, or that there is a right or wrong way to do things. We often place a defensive wall around ourselves if we do not adopt a flexible mindset as we often confuse disagreement with rejection.

By being open forms the foundation stones for change.

We can all be change agents, champions and influencers of new thinking.

A wicked problem is an entrepreneurial opportunity.

They are a problem that’s difficult to solve, normally because of its complex and interconnected nature. Wicked problems lack clarity in both their aims and solutions and are subject to real-world constraints which hinder risk-free attempts to find a solution.

What are wicked problems in healthcare?

• Environmental challenges with a need for regenerative design
• Radicalisation and extreme perspectives from part of social communication
• Complicated technology and integration including artificial intelligence
• Consumer led health and social care solutions with limited resources
• Poverty and Health Inequity
• Knowledge management in a rapidly evolving world
• Personalised medicine
• Patient and human subjects’ privacy and protection
• How to build trust in our health and social care systems
• How to have a workforce that is competent, confident and happy

In the beginning of my career, expert opinion and consensus view led the evidence base. We now analyse our data, initially retrospectively to make changes and create evidence based medicine and solutions nut now have moved to real time data to visualise today in real time. This gives us lots to think about but rarely builds creative thinking or generates new solutions.

In our complex worlds, multiple stakeholders have different opinions, have different values and priorities and work within different organisational structures. Although we all want to be more collaborative, our systems are not designed to be integrated.

This is where the entrepreneur can try something new and experiment.

My own unique talent is to be able to look at new service design recognising that skills can be taught and develop governance systems and shared values to ensure safety and effectiveness. This can lead to an improving service where resources can be used more effectively but with improvement of quality.

In the 90’s, I was part of the advanced practice movement sharing the burden of diagnosis and treatment with new models of service design with a sider professional group able to assess patients.

In the 00’s, I continued to identify models in healthcare moving from doctors towards a wider multidisciplinary team with improvements in capacity but ensuring that they were caring, trauma informed and met high quality standards.

In the teens, I founded my own company based on these principles in forensic healthcare which grew to be one of the largest providers of forensic services in England.

What next? We need to turn our attention to the workforce shortages and the experience of distress. Those who use our services have complexity of needs and we have limited resources. Mental health and understanding of our behaviour are all wicked problems.

So which wicked problem?

New opportunities include:

Being able to make a difference to those who experience disadvantage and create a new workforce of those with lived experience harnessing their power and ambition to pull together the existing infrastructure to meet their goals – so The Maslow Foundation was born.

Being able to make a difference to health and social care and the crisis of staffing, with a model of psychological safety, ensuring safe spaces to nurture our talent and build confidence and competence in forensic healthcare, investigations and clinical reviews, expert opinion and wider healthcare – hence Nurture Health and Care Ltd was born.

Other organisations; Urban Nest Housing Solutions and Centre for Artificial Intelligence Interaction Ltd have formed out of the need to support The Maslow Foundation and Nurture Health and Care Ltd.

In these organisations we can:

• Frame the problem without worrying about the systems
• Bring together diversity of thought
• Identify the purpose
• Design solutions
• Experiment
• Scale what worked or learn from those things that did not go well
• Share our knowledge and create an open learning system to showcase our design

I loved this video as feel it solved a wicked problem and hope you create your own health and care incubators to nurture your ideas and implement through action.