This evening I attended thinkpublic’s screening and talk ‘Using Film to Create Change in the Public Sector” and was moved and inspired to share a few thoughts.
I wanted to do this firstly because over the past few years I have helped produce films as part of service design projects, and have always been an advocate of the power of showing people what their users are feeling and experiencing and saying about them in order to effect change. However, this is still too often done through dry documents – a hundred pages of statistics, pull-out quotes and prose that are less accessible, less compelling and detach great ideas from the human experiences and imperatives that inform them.
And secondly, because the talks that followed the two short films this evening uncovered the power of film as not just the means to an end, where a film is presented as part of evidence at the end of a research phase to validate and unlock the next phase, but an end in itself by including people in the process and even performing an organisational therapy. The two films each unlocked good points about this.
Just A minor Operation: Karen’s Story
The documentary was created by the NHS Institute for Innovation and Improvement. It followed a woman’s experience during the sudden death of her husband, who suffered complications after a minor operation.
What struck the audience was how it refrained from encapsulating lessons learned into a ‘seven point plan’ or ‘framework for patient dignity protocol’ or a ‘sensitive situation checklist’. Julia Schaeper from the NHS Institute for Innovation explained how the experiences and events were laid bare for the audience (so far at 2000 NHS staff and growing) to draw their own observations and conclusions.
Rather than providing pithy staff guidelines as a result of the film, which seek to standardise and synthesise common sense, good judgement and empathy, the film was shown directly to staff so that they experienced it. From gaining experience we mitigate the need to provide often obvious ‘guidance’ because we develop those skills and emotions more directly, and we are trusted with our good judgement and common sense for which we were hired.
The NHS is notorious for guidelines, targets and frameworks. But it’s also rife across other state institutions. Mark Fisher, in his book Capitalist Realism calls this situation in the UK ‘Market Stalinism’ – where the obsession with targets and how to achieve them obscures and even detracts from why you are trying to achieve them in the first place. We have already arrived in a place where the micro-motivations of efficiency have overtaken the macro-motivation of care.
Lewisham Customer Experiences
Lewisham Council worked with the Design Council and thinkpublic to improve the experiences of those using their Housing Options services. Many of these people are in crisis; including people who are homeless, running away from domestic violence or, in one case, a woman who couldn’t begin the application process until the day her house was repossessed.

Again, watching the film transferred more insight than what would have found its way into a research report. Furthermore, the interesting twist was that those filming the consultations and interviews were the council employees themselves.
Peter Gaddson, Head of Strategy and Performance with the Customer Services Directorate at Lewisham Council explained that the employees were ‘looking through a different lens’ and were suddenly asking different questions to those they would have asked were they working behind their desks, with databases and application forms. The film showed flaws in the system, and sometimes satisfactory, sometimes distressing outcomes and a noisy, even chaotic scene in the background. Peter boldly (and bravely) affirmed that “In order to improve, you need to admit that you get things wrong.”
A strong sentiment at a time when people, organisations and their cultures are more protective of their performance and defensive of criticism, but in doing so, block the potential for real change.