This report, commissioned by the Academic Health Science Network, looks at opportunities to accelerate the adoption of service innovation in the NHS, drawing on findings from eight case studies of successful spread of innovation in the NHS | Kings Fund
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, the report details the highs and lows of an innovator’s journey through the NHS.
While thousands of patients are now receiving new innovative treatments for arthritis, diabetes, cardiovascular disease and chronic liver disease, thanks to successful innovations, the report outlines the significant barriers that stand in innovators’ paths.
The case studies reveal common themes:
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.
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.
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.
This case study shares the experience of Leeds Teaching Hospital NHS Trust on how they reduced levels of medical agency spending | NHS Employers
The Leeds Teaching Hospitals NHS Trust has reduced its medical agency spend by introducing a central deployment service and making effective use of e-rostering to deliver a consistent and professional approach to the deployment of junior doctors.
This case study details the work the trust has carried out, from the medical workforce team working with medical managers, consultants and junior doctors to standardisation of processes. Read up on the steps they took towards improvement and the successes that have been achieved.
NHS England has developed a repository of examples and case studies of best practice, which is available via the online Learning Environment.
In March 2016, NHS England introduced a new CCG Improvement and Assessment Framework (CCG IAF). This framework brings together a range of key indicators, enabling NHS England and CCGs to work together to drive improvement for patients.
The CCG IAF framework has indicators for six national clinical priority areas, including dementia. The dementia indicators are:
Estimated diagnosis rate for people with dementia.
Dementia care planning and post-diagnostic support.
NHS England recognises that CCGs will have varying levels of need for support based on their performance against the indicators, and in October 2016 published a support offer to help with this.
To substantiate the support offer, the NHS England Dementia Team has developed the Best Practice Repository on the NHS England Learning Environment website. This repository is currently being developed and case studies will be added to the NHS England Learning Environment website along with links to other resources.
The HFMA and NHS Improvement have worked in partnership to update and revise the NHS efficiency map.
The map is a tool that promotes best practice in identifying, delivering and monitoring cost improvement programmes (CIPs) in the NHS. The map contains links to a range of tools and guidance to help NHS bodies improve their efficiency.
The national focus on improving efficiency and productivity will mean taking local action to deliver savings remains a priority for all NHS organisations. Aimed at NHS finance directors and their teams and other NHS staff with an interest in the delivery of CIPs, the purpose of the NHS efficiency map is to highlight existing resources on eliminating waste, increasing efficiency and at the same time improving quality and safety.
The map is split into three sections: enablers for efficiency, provider efficiency and system efficiency. The map highlights the successes some NHS providers have had in delivering specific efficiency schemes and provides sign-posts to existing tools and reference materials. It also includes updated definitions for different types of efficiency.
The map will be updated as new tools and case studies are produced.
NICE Quality and Productivity case study. Published online: October 2016
The Salford lower limb vascular assessment and triage service provides assessments, diagnosis and clinical management plans for patients with suspected non-acute peripheral arterial disease. Clinics are run 5 days a week with weekly evening clinics and monthly Saturday slots. Referrals are made by GPs using an e-referral system, and may also come from general podiatry, diabetes specialist nurses, district nurses, physiotherapy and the tissue viability service.
The service operates out of 3 gateway community centres, providing care closer to home. This is an improvement because previously patients were referred to the hospital vascular surgery team, but 80% did not need surgery and were subsequently referred to community exercise schemes. GPs now refer patients with symptoms of severe limb ischaemia straight to hospital, rather than to the community triage service. Those patients are seen quicker because the hospital appointments are freed up for serious cases.
The service is podiatry-led, working with patients to address their individual cardiovascular and limb risks and develops and agrees individual treatment plans. These may include referral to a community exercise and support scheme run by the local cardiac rehabilitation team, or the vascular surgery team at Central Manchester Foundation Trust hospital if appropriate.