A new report from The King’s Fund, commissioned by six Academic Health and Science Networks, charts the journeys of eight innovations from creation to widespread patient use.
The report, published today (16 January 2018) examines examples of successful innovations in the NHS and charts their journeys to draw out common themes and learnings. The examples in the report range from new communication technologies for patients with long-term conditions, to new care pathways in liver disease diagnosis, to new checklists for busy A&E departments.
It highlights that thousands of patients are receiving innovative treatment for arthritis, diabetes, cardiovascular disease and chronic liver disease, following support from England’s health innovation bodies, the Academic Health Science Networks, to spread them across health and care services.
Despite recent progress, “significant obstacles” often lie in innovators’ paths and the report makes a powerful case for greater discussion and debate on how innovation is spread.
Themes highlighted in the report include:
- As long as the NHS sets aside less than 0.1% of available resources for the adoption and spread of innovation, a small fraction of the funds available for innovation itself, the NHS’s operating units will struggle to adopt large numbers of innovations and rapidly improve productivity.
- New innovations may appear simple to introduce but can have a domino effect - triggering a series of changes to diagnosis and treatment, revealing new patient needs and resulting in big changes to staff and patient roles. That’s why staff need time and resources to implement them.
- Providers need to be able to select and tailor innovations that deliver the greatest value given local challenges and work in the local context.
- Fragmentation of NHS services remains a barrier to adoption and spread of innovation, making it harder to develop shared approaches and transmit learning across sites. At least in theory, the establishment of accountable care systems in England presents an opportunity to address many of the barriers to adoption and spread identified in the report and establish organisations with stronger mechanisms for sharing learning and improvement.
Chair of the Academic Health Science Networks, Mike Hannay, said: “This report shows the transformative power of simple, low-cost innovations and the dramatic difference that they can make to people’s lives.
“But the reality is that, “simple” as an innovation might be, spreading innovations is never simple. Getting a new, even life-saving technique from one hospital to another is challenging and painstaking work. New innovations can have a domino effect - triggering a series of changes to diagnosis and treatment, revealing new patient needs and resulting in big changes to staff and patient roles.
“All too often, this complexity is overlooked and the NHS is simplistically blamed for being slow to adopt new techniques. It’s time to shift the debate on this, to recognise the pressure staff are under and the resource and support needed to effectively spread innovation at a local level. This will improve care, save money and save lives.”Ben Collins, lead author
and Projects Director at The King’s Fund, said: “Entrepreneurship is alive and well in the NHS
. Across the NHS, committed staff are enthusiastically pursuing innovation to transform services for their patients.
“But these same staff can face an obstacle course when they try to improve care. Whether it is securing permission to make changes or trying to find small amounts of funding and support, the barriers they can face are significant.
“Top down direction won’t solve these problems. We need to give staff the freedom, tools and resources to make improvements, strip out unnecessary bureaucracy, and support more systematic sharing of learning across services.”
Professor Mike Hurley is now a clinical director at the Health Innovation Network. His ESCAPE-pain programme features in the report. He said: “We knew we had an innovation that was proven to have life-changing effects and would save money. It meant that people who had previously been crippled by pain could start to live a normal life again and do simple things, like do their own shopping or play with their grandchildren. Yet we hit brick wall after brick wall. In particular complex commissioning processes can impede adoption and spread of innovation across the NHS.
“NHS staff have the ideas and knowledge that can improve care, but they need support to spread them, and a system behind them that is truly collaborative. I was fortunate to get support from Academic Health Science Networks. This type of support, motivation and encouragement is really important.”
The findings of the report
will be discussed in depth at a live online event hosted by The King’s Fund on Friday, 19 January at 10am. Register and read more details here.
England’s 15 AHSNs were set up by the NHS in 2013. They bring together the NHS, social care, public health, academic, voluntary and industry organisations to support the spread of innovation throughout the NHS and care. During their first licence (since 2013) they have spread over 200 innovations through 11,000 locations, benefiting 6 million people, creating over 500 jobs and leveraging £330 million investment to improve health and support the NHS, social care and industry innovators.