Against the odds: Successfully scaling innovation in the NHS

A joint report from the Innovation Unit and the Health Foundation

January 2018

David Albury
Tom Beresford
Sarah Dew
John Illingworth
Katharine Langford
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Key points

  • The ‘adopters’ of innovation need greater recognition and support. The current system primarily rewards innovators, but those taking up innovations often need time, space and resources to implement and adapt an innovation in their own setting.
  • It needs to be easier for innovators to set up dedicated organisations or groups to drive innovation at scale. Scaling innovation can be a full-time job, and difficult to do alongside front-line service delivery. Dedicated organisations are often needed to consciously and strategically drive scaling efforts, including when innovators ‘spin out’ from the NHS.
  • System leaders need to take more holistic and sophisticated approaches to scaling. Targets and tariffs are not a magic bullet for scaling; while they can help, they don’t create the intrinsic and sustained commitment required to replicate new ideas at scale. Different approaches are needed, including articulating national and local health care priorities in ways that create strategic opportunities for innovators, and using commissioning frameworks to enable, rather than hinder, the sustainable spread of innovations.

This report from the Innovation Unit and the Health Foundation calls for new approaches to scaling tried and tested health care innovations. It highlights the need to create the right conditions to spread these successfully across the NHS.

Through a public crowdsourcing campaign and an expert working group, the report’s authors identified a shortlist of 10 innovations that have successfully spread across the NHS in recent years. From these, they have drawn out insights into how scale might be more effectively pursued and supported in the future.

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