u manchester july 2013

Robust decisions in uncertain times

Foresight: Exploring the Future, Shaping the Present

8/4/2013 www.samiconsulting.co.uk 1

Using Scenarios Why use scenarios,

and how to make sure they are effective

Gill Ringland CEO & Fellow, SAMI Consulting

July 2013


SAMI

• Our offer – To enhance the capability to anticipate

– To transform emergent thinking into strategy and implementation

– Consulting, executive education and research to deliver “robust decisions in uncertain times”

• “You can never plan the future by the past” – Edmund Burke, 1729-1797

• Formed in 1989

– Until 1999 based at St Andrews University

– Now virtual, owned by Fellows and Principals

– Celebrated our 20th anniversary at the Royal Society

8/4/2013 2 www.samiconsulting.co.uk


Agenda

• Why use scenarios

– Scenarios & forecasts

– Early indicators

• Using scenarios: examples relating to Health

– Radical thinking in the National Health Service

– Scenarios lead to a rethink

– Scenarios for the future of diagnostics

– Health & Safety impacts of “Green” jobs



0

2

4

6

8

10

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1951 1961 1971 1981 1991 2001 2006 2011 2016 2020 2030

Actual Forecast now

London population

1991

forecast

“A trend is a trend until it bends” 04/08/2013 4 www.samiconsulting.co.uk


Forecasts

Today Trends

Range

Of

Uncertainties

Timing ?

Forecasts are over-precise



Scenarios

• Forecasts focus on “the right” answer and a partial “right” is often viewed as wrong

• Scenarios are – “an internally consistent view of what the future might be”,

– “not a forecast but one possible future outcome”

• Scenarios explore different possible futures

Forecasts Scenarios

Source: Professor Michael Porter, “Competitive Advantage:”, (Free Press, 1985)



Line manager, Corporate Strategist Scenarios Future

Engineer manager thinker

Early indicators Portfolio Ideas & systems Alternate “843” trends

Decisions, management Planning worlds interconnected

Timelines Options

Decisions

Thinking styles



Early indicators

• Early indicators are a powerful way of engaging the

organisation

• Are clear “events” which would be a sign that a scenario

is evolving

• Shell & gas fields

– Gorbachev promotion as early indicator of changes in Russia

– Decided not to buy gas fields as Russian ones would change

pricing

– Shell bought Russian gas after the price had collapsed

• Often ask a group to think up newspaper headlines that

would signal a scenario, as a way of “thinking in” to a

scenario.



Using scenarios

• Public policy


– Challenging assumptions about the Green economy

• Inside organisations

– Scenarios lead to a rethink in planning

– Scenarios for the future of diagnostics create a vision

• Will cover for each case study

– Process

– Presentation and communication

– Outcomes



NHS – Hemingford scenarios

• New Head of Planning at Department of Health, National

Health Service (NHS), Richard Walsh (now a SAMI

Fellow)

• Focal question: what and who is the NHS for?

• 30 people consulted on clinical practice, public values,

context for health care, demography, disease trends

• 12 people in a 2 day workshop at Hemingford

• 4 scenarios developed, with implications for

– Primary care led NHS,

– Health and health care

– Public involvement

www.samiconsulting.co.uk 10 8/4/2013


Drivers of change

Role of

NHS

Climate

change

Technology Budget

Changing

lifestyles

Increasing

population

Demographics +?

+++ -- - +++

+

++

+

Deficit reduction

National? Centralised?

--

+/-? +/-?

Wellness

or

illness? +++?


Scenario matrix for NHS

Forecastable

“trends” Uncertain

Less important

Important

Demographics - ageing

Increasing population

Changing lifestyles

Technology advances

Disease orientation or well-

being oriented?

Health national vs

international?

Centralised or decentralised

management?


Visualising the scenarios

Wellbeing as you like it

Cen

tralised

Decen

tralised

Wellbeing Illness oriented

International

National

Health is wealth

Science makes the big push

Renewed welfare order


The outcomes

•8/4/2013 www.samiconsulting.co.uk

• The scenario team designed and delivered briefing

events for senior management in the NHS to great

acclaim

• They went to a number of NHS sites and held lunch time

events with heated agreement

• They did not engage with the public

• They did not engage with the politicians

• When the next government came in, the new Minister

was not aware of the work & thought that the only task

was to spend more and make NHS more efficient at high

tech treatment of illness (Science makes the big push)


Wanless Report

SAMI Consulting 2006

• Treasury report chaired by Derek Wanless – “Securing Our Future Health: Taking a Long-Term View” (to

2022)

• Discussed the role of demographics, changing patterns of disease and cures, technology

• 3 simple scenarios – used a numerical model for demands, and for costs – Solid progress: less change in preventative care

– Slow uptake: NHS performance improvements

– Fully engaged : changes in demand

• Showed that – within any possible expenditure on the NHS

– changes in patterns of demand were needed to balance the books between demand and supply

– Neither Solid Progress or Slow Uptake were viable


The outcomes

•8/4/2013 www.samiconsulting.co.uk

• The report upset the “official future”

• Science makes the big push

• Started the understanding that technology is only part of

the answer

• Change in UK health policy focus towards changing

peoples’ behaviours

• Reduction in obesity

• Increase in anti-smoking campaigns

• Promotion of exercise

• GPs offer yearly check ups

• Also a move towards self help via pharmacists, etc


• SAMI Fellow Michael Owen ran GSK’s first scenarios project • Interviews & desk research

• Workshops to develop scenarios for the global health care industry, explore strategic options

• Led to new focus on global initiatives & new technologies

• Also projects in R&D, marketing, manufacturing & supply, regions

• SAMI asked back to work with manufacturing and supply, using scenarios to plan for flexible (“agile”) manufacturing processes

• Scenarios later used to set vision for diagnostics new business

http://www.gsk.com/


The diagnostics background

• Since the science and technology of

genetics was developing fast

– Should GSK develop their capability in

diagnostics and prognostics?

– If so, should this be by acquisition or

inhouse development?

• Decided to set up Predictive Medicine

Group

• Needed to set vision, mission, long

term goals

– Scenarios project coached by Clem Bezold

of Institute for Alternative Futures



Creating the scenarios

• Assumptions: we will be able to predict in the near future

– Who is likely to develop a particular disease

– How treatments will work with different individuals

– Likely outcome of treatments

• Scan for drivers of change, group into clusters which

were scored for probability and impact on Glaxo’s

business

• Create 4 scenarios

– Best guess Health care gains continue

– Hard times Recession slows health care gains

– Paradigm shift Integrated biosciences pay off

– Visionary paradigm shift Globalhealth.com



Using the scenarios

• Team identified the drivers which were important in all

four scenarios

• Drivers which were only found in one scenario were

used to develop early indicators

• The vision needed to be robust across all scenarios

– Improving lifelong healthcare through predictive knowledge

• The mission included integrating novel diagnostics and

prognostics with therapeutic interventions (GSK’s

traditional business)



Presentation

• Recognised difficulty of presenting

plausible futures to operational

managers

• Chose to use a mock television

interview around “The Fifth Colony”

• Four colonists had been in space and

developed a health care system for

their scenario over 10 years

• Why were they different?

• The Fifth Colony represented the ideal

future which captured the learning over

10 years from the colonists (scenarios) »



The outcomes

• Predictive Medicine Group’s recommendations accepted

• Scenarios widely used by Glaxo

– Briefings across the company

– Scenario brochure describing the scenarios distributed across

the company

– Scenarios used by other groups to formulate strategy

• Released to the public at an industry conference

– Then presented in seminars etc as a contribution to public policy

in medicine

• Early indicators used by Business Development to seek

new opportunities



Health risks associated with

‘green’ technologies

• Project for European Agency for Safety and Health at Work (EU-

OSHA) http://www.samiconsulting.co.uk/4EUOSHAreport2013.pdf

– SAMI team led by Fellow John Reynolds worked with UK Health and

Safety Laboratory (HSL) and Technopolis

• Looked at new and emerging risks from new technologies in ‘green

jobs’ to 2020

• Selection of (16) key drivers of change and (8) key technologies

• Developed a set of base scenarios

• Developed timelines for each key technology

• Analysed new and emerging risk for safety and health at work

• Presented across Europe, sponsored by Health & Safety

organisations

www.samiconsulting.co.uk 23


Main Drivers of Future Change

1. Economic Growth

• Growth In Europe

• Global Growth rates

2. Green Culture and Values

• Public Opinion

• Government Incentives and controls

• Energy Efficiency and Resource Use

• Waste Management and Recycling

3. Rate of Innovation in Green technology

24


Gre

en

Valu

es

Economic Growth

Deep Green Strongly green

culture and values

Bonus World Strong Growth

Global and European

Win - Win High innovation in Green Technology

Ve

ry S

tro

ng

Low Growth High Growth

We

ak

Three Scenarios


Win - Win

Defined by

– Strongly Green Values

– High economic growth

– High rate of Innovation in Green

Technologies

• Green growth is sustainable.

• Green activities are seen as a major contribution to

economic growth rather than simply as a cost

• Technology is delivering on its promise to make green

growth achievable

26


“I guess every smart grid needs a call centre but it’s still

pretty stressful”

“We scored 8 out of 10 in the last

green audit… how can we do

even better next time?”

“every day we continue to re-

design the human-machine

interface...”

“welcome to the L.Z.C. Safety & Health @

Work training module. Today

we look at everyday

hazards...”

Win-Win Human systems


Win-Win Manufacturing

now that robots or “co-bots” do

most of the work.... What’s there to worry

about ???

Boredom ... insecurity ... Keeping up with innovation ... And,

what if they do not keep out of our way...

+++ THIS HUMAN HAS A

POOR TRAINING

RECORD+++ KEEP HER

UNDER ACTIVE SURVEILLANCE

+++


Bonus World

Defined by

• High economic growth

• Low Green Values

• Medium rate of Innovation in Green

Technology (directed towards profits)

29


Deep Green

Defined by

• Strongly Green Values

• Low economic growth

• Medium rate of Innovation in Green

Technologies

30


Outcomes

• The scenarios provided a a neutral and safe

environment for important discussions between different

groups of stakeholders

– Many current assumptions were challenged (including targets

that are unlikely to be met)

– Some organisations realised that their plans were not robust

• The scenarios could be used for the analysis of a

broader range of technologies and policies

• The scenarios were a robust tool for the anticipation

and analysis of future challenges; and developing

more robust ‘future proofed’ strategies and policies



Summary

• Why use scenarios

– Scenarios & forecasts

– Early indicators

• Using scenarios: examples relating to Health


• But failure to communicate to decision makers

– Scenarios lead to a rethink

• Numerical models changed assumptions

– Scenarios for the future of diagnostics

• Communication to operational managers

– Health & Safety impacts of “Green” jobs

• Cartoons to highlight the different values embodied in the scenarios



Thank you!


If you would like to get our monthly enewsletter

eSAMI ---- please ask – [email protected].

For details of our training courses (with the

Horizon Scanning Centre of the Foresight

Unit) see www.samiconsulting.co.uk.

For details of our Blowing the Cobwebs off our Mind

events, please ask,

[email protected].

The NHS case study is in “Scenario Planning”,

published by John Wiley. The GSK case study is in

“Scenarios in Business”, also published by John Wiley

The Report from the “Green Jobs” study is on the SAMI

web site www.samiconsulting.co.uk. .

mailto:[email protected]

http://www.samiconsulting.co.uk/

mailto:[email protected]

http://www.samiconsulting.co.uk/

u manchester july 2013

Technology

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