The Long March of Innovation in Health and Social Care

Some things take time. A long time. Sometimes, they take 6,000 miles’ worth of time, give or take a few muddy battlefields and an insurmountable number of blisters. Jim Collins’ Great by Choice talks about the 20-Mile March, a principle of steady, consistent effort over time. The idea is simple: progress isn’t about heroic sprints or fits of inspiration; it’s about discipline, patience, and persistence. 

This resonates with me now more than ever. As someone who has run an endurance race (and let me tell you, it was nothing like the Chinese version), I get it. One foot in front of the other, through exhaustion, setbacks, and the odd existential crisis about why you signed up in the first place. 

But here’s the thing—this concept isn’t just for athletes. It applies to business, careers, health and social care reform, and, oddly enough, folk music. (Stay with me here.) 

The Long March of Musical Mastery 

I just returned from the Port Fairy Folk Festival, where I watched my 17-year-old daughter perform with her Irish Traditional Music trio, Glór. They played to sold-out crowds, received standing ovations, and left me in a dazed mix of parental pride and sheer exhaustion. But this wasn’t an overnight success. This was the result of years—years—of slow, steady progress. Since the age of four, she has been playing, practising, refining. Her dad has guided her, tirelessly, until she no longer needed guiding. And then, suddenly, she was on stage, soaring. 

This week, though, the post-festival crash has been real. She hasn’t wanted to go to school; I haven’t wanted to sit at my desk. We’re in recovery mode, drained from the high of performance and the sheer effort that preceded it. 

And this is where we return to the 20-Mile March. Because success—whether in music, business, or workforce reform—isn’t just about bursts of effort. It’s about what happens after the ovations, in the quiet moments when no one is watching. It’s about the small steps that come next. 

The Long March of Innovation in Health and Social Care 

Twenty-four years. That’s how long I’ve been working in health and social care. It’s been twenty years since I first started researching how to better organise workforces and services for patients. And it’s been at least ten years since I started thinking about the tool I have now developed and piloted. That is a long march. 

But here’s the thing: this is where the real work begins. The tool isn’t a magic wand. It won’t fix everything overnight. It needs to be implemented with a long-term vision, a commitment to cultural shift, and a deep understanding that real change is slow. It’s a process of steady, intentional progress—step by step, mile by mile. 

The 20-Mile March vs. The Giant Leap 

If you’ve been following my LinkedIn posts, you know I recently wrestled with a big decision: whether or not to go for the NDIA tender for a software build. Thanks to the wise counsel of many, the decision was a no—for now. The tender would have been a giant leap, but possibly not the right one. Instead, I’ve taken smaller, deliberate steps: 

  • Formed a company. 
  • Trademarked my software. 
  • Secured the right insurance. 
  • Found a software company to support me. 
  • Connected with an academic team specialising in AI and machine learning. 
  • Made small but essential refinements to version 1.0 of my software. 

These are big steps in hindsight, but at the time, they were painstakingly small. And the next few months? They’ll continue at this slow, intentional pace, because that’s what my body, mind, and software need. 

What’s Your Long March? 

If you’re reading this, you probably have your own long march—your own 20-Mile March that you’ve been trudging along, perhaps without fully recognising the effort it takes. Maybe it’s a project, a business, a commitment to a cause, or a personal goal that’s been quietly, stubbornly growing for years. 

So here’s my challenge to you: Take a moment to acknowledge the small steps you’ve taken. Celebrate them. Recognise that while they may feel insignificant in the moment, they are the foundation of something far bigger. 

And while we’re on the subject of long marches, let’s also talk about the long-overdue need for more business books written by women. If you have recommendations, please send them my way! Because while Jim Collins has some great insights, I’m at a stage in life where I really want to hear from women who have navigated these journeys themselves. 

Here’s to the small steps, the steady progress, and the long march ahead. What’s yours?

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