Open Source Policy

1 February 2021

A start-up that is helping people achieve change and reduce inequalities in the healthcare system by translating patients’ and healthcare professionals’ experiences into policy changes.

The vast majority of people have a positive experience of the NHS, thanks to dedicated staff delivering excellent care. But a decade of austerity has left the healthcare system chronically overstretched, with a 34 per cent increase in patient complaints since 2010. There is a huge strain on healthcare professionals, contributing to a mounting staffing crisis amid overwork and burnout.

Almost 60 per cent of people who experience poor care feel unable to complain. That’s one person every two minutes. Structural inequalities, including racism, affect who complains, and whose complaints are truly heard (and whose are left partially, or fully, unresolved). Often, people from minority or marginalised communities are rendered voiceless and invisible. When patients don’t have an effective voice, it can (and often does) endanger their health, wellbeing, and even their life. The NHS spends £1 billion pounds a year in an effort to put things right following preventable deaths.

These were the issues Ash Ryan confronted when, following her friend Chloe’s* experience of feeling afraid to complain while a patient on a mental health ward, she conducted a series of informal patient and staff interviews. Chloe was not alone in her experiences; in England, 20 per cent of mental health patients feel unsafe in NHS care, yet 48 per cent are unlikely to complain. It became evident that the existing patient feedback mechanism unintentionally leaves a sizeable number of patients without a voice.
*Name changed to protect privacy.

Due to the complexity of the healthcare ecosystem and the enormous pressures on NHS staff, healthcare professionals also lack ways to achieve systemic change beyond their immediate workplace sphere, contributing to stress and burnout. The need to revise the complaints and feedback system became clear. In May 2020, Ash, together with her founding team Karmah Boothe, a healthcare commissioner, and Genevieve Ryan, an NHS manager, founded Open Source Policy to tackle this problem.

The social enterprise will provide patients and staff with a safe and transparent way to offer feedback. Their well-designed feedback system brokers a structured dialogue exchange, recording both positive and negative patient experiences and building long-term relationships with patients and healthcare professionals from across all levels of the NHS, promoting a collaborative and transparent approach to change.

Open Source Policy are working to change systems (rules, policies and procedures) by starting with exploring the desired change and then designing the best solutions, with social impact and reducing inequality at the heart of their work. Potential solutions will be tested through pilot schemes run in partnership with healthcare providers.

Policy recommendations made following the pilots will be evidence-based, have a practical track record and provide a convincing business and ethical case for change, including not only the potential savings to the NHS, but also the ways in which the proposed change could reduce the incredible pressure on NHS staff while improving clinical outcomes for patients.

This innovative approach disrupts the notion of what “feedback” and “complaints” mean, departing from traditional feedback methods like surveys and moving to a partnership model. This enables true co-creation of health services, which the team believe is the future of healthcare.

Open Source Policy - Feedback System
An image explaining the steps involved in Open Source Policy’s innovative feedback system

The impact

  • Solving 10 per cent of patient safety issues could save 1,100 lives a year, save the NHS £100 million a year and generate £3-5m in revenue for the venture.
  • Open Source Policy will re-invest its revenue into helping secure further change for the benefit of society and the NHS.
  • Project Spotlight, the venture’s first policy proposal, has the potential to protect over 112,000 people while saving the NHS £12 million a year. The project has an anticipated social return on investment of £27 of social value for every £1 invested.
  • The idea for Project Spotlight was awarded the best analysis prize at Policy Idol 2020, run by the Policy Institute, King’s College London. The quality of the proposal was personally commended by Charles Clarke, former Home Secretary, and Jo Johnson, former head of the No. 10 Downing Street Policy Unit.

Open Source Policy has raised significant awareness with national health organisations, charities, policymakers and government.

Open Source Policy represents what seems to me an entirely new approach to engage with patients … [This] patient-led organisation could improve patient outcomes and safety by facilitating a constructive conversation between the many stakeholders involved, from Whitehall to hospital corridors … [Open Source Policy] will attract interest from Members of Parliament and the Civil Service, because it will help them to better address the challenges of high quality healthcare in our society.”
Charles Clarke, former Home Secretary

The start-up journey: Key learnings

The founding team credit their respective universities with helping them to develop the sustainability of their ideas and drive them forward, as well as providing a network of support, opportunities and connections which have been integral to the start-up’s progress. The Masood Enterpreneurship Centre at the University of Manchester has helped to make connections to the right people and provided guidance on their start-up journey.

Tony Walker, MEC’s Deputy Director, has been particularly supportive and gave up his time to help the team prepare their pitch for the Aspect Student Accelerator Programme (ASAP). In September 2020, Open Source Policy became one of 20 ventures accepted onto the inaugural ASAP social enterprise accelerator. ASAP will equip the start-up with the skills to maximise their social impact and develop their leadership skills further.

Some advice:

  • Be prepared for pitches, think about your audience and what they might ask you.
  • Stay in touch with everyone on your journey and tell people what your biggest current challenges are (as well as your successes); often people are willing to help you solve the problem or broker a valuable introduction.
  • Everyone can have a good idea for a social enterprise – and no matter what your background is, you can make a real difference to other people’s lives by bringing your idea into reality.
  • Starting a venture while doing a degree can complement its progress, as it keeps you motivated, and helps you build valuable skills – don’t wait until after university!

What’s next for Open Source Policy?

Work continues towards running the venture’s first pilot, Project Spotlight. ASAP is helping to drive the pilot phase forward and the team are already benefiting from mentoring, expert and peer support. A lot of work is going into designing their internal systems and processes in preparation for a wider launch.

The start-up has also started working with a specialist data security and privacy firm to ensure compliance with the regulations for handling healthcare information.

Finally, the venture is continuing conversations to access funding streams with the aim of having shared agreements with healthcare organisations and enabling the start-up to become financially self-sustainable.