The High Intensity User service, Think Outs’ founder , Rhian developed has been adopted by NHS England’s RightCare programme and is currently mandated to be implemented in every area of England. Here, in poetic voice, Rhian gives her own personal reflections on the work.

“Hi, You…”

As you look over RightCare programmes you’ll read a lot about High Intensity Users (HIUs). It’s the current accepted phrase but, while an improvement on “Frequent Fliers” or other lazy pejoratives, it doesn’t evoke the feeling that a person is at the very heart of it.

Our work with HIUs has shown, time and again, that when you put these people in a box and label them – regardless of the label – you miss the point about how best to help them.

Our experience shows that the underlying personal reasons for HIU behaviours do not lend themselves to models, averages, or trend-lines.

They cannot be generalised.

They cannot be viewed usefully from the safety of an office, nor do they allow the luxury of a top down view. And this is why solutions designed at a safe distance for an abstract ‘typical’ HIU tend to fail.

We have succeeded by starting and finishing our interventions with the individual. We test what might work in the field; we’re fearless about the risk of mistakes; and we’re rigorous in learning from those mistakes before we move ahead.

Of course we want to lead these people away from their behaviour, for their own benefit and for the benefit of a stretched public service. But in order to Lead, we must first Serve.
We serve by listening before we decide. By understanding before we act. By personalising before we deploy.

“Serve to Lead.” It’s the motto of the Royal Military Academy, Sandhurst, and it’s right at the heart of this project.

When we meet a High Intensity User, we have a choice: to label them ‘HIU’ and trust them to the care of a standardised playbook; or to look the individual in the eye and say “Hi, You…”
And then listen, learn, and act.