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NHS Service Improvement Tool 

 April 3, 2022

By  Dave Litten

An Impossible NHS Service Improvement Tool!

What is it?

When thinking about potential new ways of doing things, we often quickly dismiss some
ideas believing them to be impossible.

Nhs Service Improvement Tool Nhs

It can be valuable to challenge this thinking and you will find that ‘impossible’ ideas may actually be possible, or at least give you valuable different perspectives on what can be achieved.

Sometimes it is called ‘Innovation provocations.

When to use it

That’s impossible! is a tool you can use when the ideas that have been proposed are
simply variations on what already exists.

Nhs Service Improvement Tool Nhs

It helps people to move away from focusing purely on the current reality and can really help stretch people’s thinking to come up with different potential solutions – ie when you sense that people are reluctant to set ambitious goals for improvement, when people say things like:

• ‘Well, there is no way that you can…’
• ‘It’s simply not possible to…’

How to use it

Nhs Service Improvement Tool Nhs

Make a list of things related to the issue that are currently accepted as being impossible, such as:

• It is impossible to get laboratory results instantly.
• It is impossible to know if a patient is going to turn up for an appointment until they actually present at reception.
• It is impossible to get someone home exactly when we plan to.

For each item on the list, have a short session to generate ideas. Ask:

• How could we actually make that possible?
• Is anyone else, maybe in a different sector or industry, already doing it?
• How could we come close to doing it?
• How could we do it at least some of the time?

For example, It is impossible to know that a patient is going to turn up for an appointment until they actually present at reception…

Some ideas of how that could be made possible:

• You could call patients to see if they are coming.
• A large sign near a telephone in the car park could ask patients to ring when they are in the car park.
• Patients could have a special code to enter a car park that identifies them and notifies the clinic.
• Patients could have a swipe card for a special car park or clinic entrance. When they swipe the card on entry, a signal alerts the department that they are on their way.

Nhs Service Improvement Tool Nhs

What next?

• Review all the ideas. Use the Six Thinking Hats® tool to get down to the final few ideas.
• Run several small-scale tests to learn more and see what works in practice (PDSA).
• Share the findings. Consider using stakeholder analysis and communications matrix.
• Implement the best ideas.
Other useful tools and techniques that may help you
• Brainstorming
• Simple rules
• Process mapping

That’s impossible! Tips

Nhs Service Improvement Tool Nhs

Because you are working on something that is widely regarded as being impossible, be prepared for stronger than usual negative thinking as you begin using this tool.

Be sure to emphasize the rules of idea generation: suspend judgment, go for quantity, build on others’ ideas, etc. See brainstorming for the full list.

Capture all ideas for possible later development: don’t let laughter put you off.

Suggesting that someone tries something thought to be impossible often results in laughter… until someone actually does it!

Dave Litten


David spent 25 years as a senior project manager for USA multinationals, and has deep experience in project management. He now develops a wide range of Project Management Masterclasses, under the Projex Academy brand name. In addition, David runs project management training seminars across the world, and is a prolific writer on the many topics of project management.

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