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The Government launched its new strategy for innovation in the NHS at the end of last year, outlining their ambition to spread innovation 'at pace and scale' throughout the health service. With no increase in health budgets, and hard financial times ahead, the message is clear: NHS organisations need to innovate to survive.

In his foreword to the report, NHS Chief Executive David Nicholson says: '...simply doing more of what we have always done is no longer an option... We need to radically transform the way we deliver services. Innovation is the way – the only way – we can meet these challenges. Innovation must become core business for the NHS.'

Rethinking how we provide care

Even though the strategy defines innovation quite broadly as ‘an idea, service or product new to the NHS or applied in a way which is new to healthcare’, there is a tendency to focus on new scientific and technological inventions, perhaps because these are easier to explain.

Certainly these are revolutionising how we deliver care: medical robots, virtual simulations for trainees to practice surgery without risks to real patients, and pharmaceutical innovations helping the fight against cancer. However as the viewpoints in this month’s newsletter show, health innovation is not just about scientific breakthroughs. It’s also about rethinking how we provide care, innovating through changes to patient pathways and revolutionising traditional delivery systems.

In this issue we feature the DAWN project which used feedback from patients to transform diabetes care in Newham. Their new web-based consultations rely on technology, but the innovation itself is the redesign of traditional outpatient appointments. This has freed up time for staff and patients, and resulted in better outcomes and patient satisfaction levels.

Adapting and evolving our approach to delivering care, in line with the ways in which we increasingly use technology in our everyday lives, is helping to make our health services more future proof. Seeing technology as an enabler for innovation is a powerful tool.

In our conversation with Natalie Grazin from the International Partnership for Innovative Healthcare Delivery (IPIHD), we ask what can be learnt from health innovation around the world. She explains how emerging market economies have less money to spend on healthcare and simply can’t afford the high cost options used in the developed world. This has led to some fundamental changes to the business model behind how care is delivered. Lack of money, which we see as a barrier to innovation in the UK, can in fact create a dynamic environment for innovation on a grand scale.

How do we spread innovation at ‘pace and scale’?

It’s not that innovation isn’t happening in the UK. Small-scale innovation projects are going on all over the NHS, testing out new ways of working at a local level. It’s spreading this good practice across the whole health economy that is so hard.

There is the added challenge that not all NHS sites are the same, so it’s hard to develop ‘one size fits all’ solutions. In our experience, teams often need to adapt or reinvent a new way of working for their own local setting. Thus the innovation challenge is as much to spread and embed existing pockets of innovation as it is to introduce further new developments.

We have also learnt that improvement is vulnerable to an ‘evaporation effect’, particularly once projects are completed. To overcome this we need to see innovation not as a one-off event, but as a constant cycle of change and improvement.

A state of mind and a state of readiness

We need to create a culture within the NHS which welcomes and enables new ideas, where innovation isn’t just left to the scientists, but is a core expectation of all NHS staff. We don’t expect everyone to design the next robotic surgery procedure, but we want them to listen to patients and innovate in small ways every day.

To make innovation ‘core business’ for the NHS, we need to ensure a state of readiness within our NHS organisations. To do this we must develop leadership and improvement skills, ensure senior support for fresh thinking, align drivers for change, and importantly encourage peer support and pressure for innovation. We believe building vibrant social and professional networks and exploring new ways to collaborate will be at the core of encouraging this sharing, ultimately speeding up the adoption of innovation.

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