People Powered Results (2016-2017)

In a program designed and delivered with Nesta, RRI has been working alongside the UK’s National Health System (NHS) health and care professionals and system leaders to tackle some of the most complex issues the health system is facing.

The Challenge

Our challenge is to support the leaders, staff, and users of the NHS to transform health in their communities at a time when the system is facing unprecedented financial pressure and a population living with more longer-term health conditions.

How We’re Tackling It

The People Powered Results team provide a structured approach combined with coaching support to enable front line staff from across a system to collaborate and rapidly experiment with new ways of working that achieve real results for people and communities.

Leaders from across the system empower, challenge and support teams of front line practitioners to develop and test innovative ways to improve care for people. Teams tackle and overcome systemic problems and test ideas in real time with real people on a rapid iterative basis.


Project 1: Essex

Our work with Nesta launched in 2015 with a pilot program taking place across West, Mid and South Essex. Multidisciplinary teams across signed up to 100-Day Challenges with the aim of improving outcomes for people across the area by integrating the provision of care and breaking down barriers between organizations.


Teams of frontline professionals sought to tackle questions such as:

  • How do we transform the care and support system to prevent people going into hospital on an unplanned basis?

  • When patients do need hospital services, how might we get them home quicker and safer?

  • How do we work with people to reduce their risk factors against diabetes?

  • How to improve outcomes for frail older people in a more joined-up way?

Local leadership in the area had spent approximately eighteen months exploring a new commissioning approach for frailty. Whilst there was good engagement across leadership the conversation remained largely strategic with little engagement of frontline staff.  

Team Results

  • The results from the first cycle ‘model month’ showed a  40% reduction in unplanned admissions.

  • These results were tracked through a 2nd and 3rd cycle and stabilized at a 10-12% reduction in unplanned admissions.

  • The above results were analyzed and validated locally by the CCG BI team and recognized as the ‘only scheme to show a real reduction in unplanned activity.’

The collaborative relationship continued to grow in scale (as more people experienced the approach) and quality (as the CCG and partners launched a new collaborative strategy for the Health economy). This work was shortlisted for a Health Services Journal award for improving outcomes for the frail population.

 Project 2: Elective Care

People Powered Results worked with NHS England Strategy Group to test ways of improving patient experience of, and speeding up access to, elective care by better managing demand for these services.


As one of a number of measures to improve the relationship between primary and secondary care, the Elective Care Rapid Testing (ECRT) program trialed several approaches:

  • how better support for primary care (as set out in the General Practice Forward View) such as specialist consultant hotlines and advice) can improve referral accuracy, reducing the potential for patients to have multiple hospital appointments before finding the right service;

  • how better use of technology such as virtual follow-up appointments can reduce the need to attend unnecessary outpatient appointments, and;

  • how increasing the use of shared decision-making where professionals and patients discuss options and preferences for different treatments and providers can improve patient experience, choice and outcomes.

During their 100-Day Challenges, two New Care Model Vanguards – Stockport Together, and Harrogate and Rural District – set their own goals and tested innovative approaches to Elective Care. Teams included nurses, pharmacists, general practitioners, occupational therapists, consultants, dieticians, advanced nurse practitioners, physiotherapists, and service managers.

Team Results

  • A joint cardiology and respiratory clinic has been created in the community for people experiencing breathlessness who are on the waiting list for a hospital outpatient appointment. Clinicians and diagnostics services jointly run the ‘one stop’ clinic, with a focus on designing a management plan around all the patient’s needs.

  • Deflecting referrals to hospital based trauma and orthopedics services through the triage of referrals by an extended scope physiotherapist. Helping to ensure patients receive the most appropriate and effective treatment for them with a focus on educating patients to help them make decisions about what care is right for them.

  • Creation of patient education classes.

  • Standardization of follow ups across specialties.

  • Creation of virtual clinics.

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