Learning from innovation around the world

The International Partnership for Innovative Healthcare Delivery (IPIHD) is a relatively new organisation set up in 2011. It aims to identify, learn from and support the scale up of innovative models of healthcare delivery across the globe.

We spoke to Natalie Grazin, who is currently on secondment from the Health Foundation, to find out more about the work of the partnership and what we can learn from other healthcare systems about their approach to innovation.

Tell us a bit about your new role at IPIHD

As Director of Knowledge Development my role is to identify the most valuable learning from across the partnership’s work and communicate this to our key audiences: policy makers, investors, innovators and those leading healthcare systems. We plan to produce case studies, reports and films which highlight exciting innovations from around the world and analyse the contexts that allowed those innovations to happen.

At the moment I’m working on a report for an international conference which will coincide with the Olympics. It will be attended by Ministers of Health from many different countries and is hosted by David Cameron. It’s a great opportunity to share our learning about innovation. The report focuses on how countries can create a context in which people – staff, patients and communities – can be used much more flexibly and effectively to deliver healthcare.

The IPIHD website says ‘the real challenge is not to invent but to implement’. Can you tell us what the organisation is doing to make this happen? 

This phrase really gets at the heart of IPIHD’s work. There is no shortage of new ideas coming out in healthcare, both around new business models, clinical research and applications of technology. What is lacking, and where IPIHD is trying to operate, is in scaling some of these ideas. IPIHD is creating a forum for innovators to share best practice and expertise, to access mentoring from business leaders, attend innovator-investor conferences and broadly work on challenges shared with other innovators.

What have you found most inspiring about the work of the partnership so far?

One of the key factors for successful innovation is passionate leadership, without which the status quo can’t be challenged. So it’s not surprising that most of the innovations are led by driven people. Seeing all these people in a room together is incredibly inspiring!

Secondly, I think that all the innovations we’re working with successfully address the three core challenges in delivering healthcare: accessibility, cost and quality. Whether they’re profit-making or non-profit making, they’ve succeeded by identifying and meeting previously unmet needs. In developing countries, this often means providing access to people who otherwise wouldn’t access healthcare at all. In developing these highly accessible delivery models, innovators are commonly designing very cost-effective but high quality models of care which have enormous relevance for the NHS and other developed countries.

Can you give an example of one of the more exciting innovations you've come across?

One that I’ve been studying closely is Lifespring, a private company that provides high-quality low-cost healthcare for women and children in India, particularly maternity care. It’s part of the IPIHD Innovator Network, which provides access to peer support from other innovators, plus advice and mentoring from larger, established international health organisations.

The first Lifespring hospital opened in 2005 and now they run seven hospitals. Their model improves quality by delivering care in high volumes (associated with better outcomes) and implementing a quality control system (which is rare in India).

Compared to other private hospitals the cost of deliveries at Lifespring is up to 50% cheaper. They achieve these lower unit costs per birth through specialisation, skilling up ancillary midwives and finding innovative ways of achieving high productivity from their staff and physical assets.

Over 80% of all healthcare costs are met out of pocket by patients in India, so creating an affordable option is literally a life-saver for the women who have their babies at Lifespring. 

There’s nothing innovative about the clinical care being delivered here: what’s innovative is their delivery model. They are bringing down the cost of maternal healthcare in the market by forcing other private players to be more competitive, and have been a catalyst for improving quality.

What can the NHS learn from so much innovation happening globally?

The common success factors across many successful innovations include the application of basic technology (eg mobile phones) in new ways; a high level of standardisation; right-skilling the workforce; and tapping into the assets of local communities and patients as part of the healthcare delivery team. These principles could be very powerful in thinking about how the NHS delivers care.

What is stopping the spread of innovation from the developing world to more developed countries like ours?

In a country like the UK, making change happen in healthcare delivery in the same way that we see in parts of Asia and Africa is difficult, not because we can’t innovate as individuals, but because the health system or broader ecosystem is not structured in such a way that innovation can be spread as readily.

Regulation, payment mechanisms and incentives, legacy systems, infrastructure and workforce: all of these forces play a defining role in what forms of innovation can be spread. It’s interesting, given the Health Foundation’s focus on patient safety, to ask to what extent the systems we have in place in the UK (registration of health professionals, payment mechanisms, institutional regulation by the CQC and Monitor, medical negligence legislation, etc) are getting the balance right between protecting patients from harm and encouraging innovation.

Do we need to change our approach?

When we think about innovation in the UK, we often think about break-through new research or scientific experimentation. We think less about business model innovation where the fundamental way something is done is changed.

The fact that poorer or developing countries are so resource constrained is why innovation is taking place. The high cost options in the developed world simply won’t work in these countries, so they’ve had to think of very different ways of delivering care.

As the UK health system finds itself in an increasingly difficult financial position, we too could benefit from expanding how we think about innovation.