Key points

  • This report shines a light on the challenges facing the NHS in improving the uptake of new ideas and practices, and the need for new approaches when developing national and local programmes to support the spread of innovation.
  • As NHS leaders and policymakers draw up the long-term plan for the NHS in England, the report highlights why health care improvement programmes need to be designed in more sophisticated ways if ambitions to improve health care services are to be realised.
  • Health care improvement is not only about finding innovative solutions to the challenges facing the health service, but also how to ensure these solutions are taken up successfully across the NHS. Challenging traditional ways of thinking, the report argues that programmes to spread innovation and improvement should support those adopting an idea developed elsewhere, as well as innovators.

Making health care innovations and improvements work in new contexts

While the invention of new technologies, practices, and models of care are exciting moments in health care, invention is only half the story. The NHS has a good record in innovation but often falls short when it comes to making improvements work everywhere.

Taking a health care intervention that has worked successfully in one location and then making it work in a new context is not simple. They are more likely to succeed if the new context is better understood and those adapting it better supported to do so.

To exploit the full potential of an intervention people need time, skill, resources, as well as space for creativity, to successfully replicate it at scale. To support the effective uptake of an intervention, the NHS needs to do more to reward teams for adopting innovations. This means recognising the important role that adopters play and investing in them to support implementation.

The report highlights key recommendations for practitioners involved in spreading health care improvement, including:

  • Innovators should be trained in the various theoretical approaches that exist for describing innovations in ways that can better support those adopting an idea from elsewhere to adapt them for new contexts and should be part of the innovator’s ‘toolkit’.
  • There should be more opportunities for real-world testing of innovations and improvements in health care before trying to spread them. The need to compare performance across different contexts should be a recognised stage of the innovation cycle for new practices, processes and pathways, just as it already is for new drugs and devices.

Read the executive summary 

Further resources

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Cite this publication

Horton T, Illingworth J, Warburton W, 'The spread challenge'. Health Foundation;2018 (https://www.health.org.uk/publications/the-spread-challenge)

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