Successfully Scaling Innovation in the NHS

In Against the Odds: Successfully scaling innovation in the NHS, the Innovation Unit and The Health Foundation identity 10  different UK innovations.  The authors look at various case studies to explore how these insights build on, and challenge, existing wisdom in the NHS.

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Image source: http://www.innovationunit.org

The key findings of the report include:

  • 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.

 

The full report can be found here

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Adoption and spread of innovation in the NHS

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

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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.

Full report: Adoption and spread of innovation in the NHS

 

Growing innovative models of health, care and support for adults

This briefing explains that innovative, often small-scale models of health, social care and support for adults could be scaled up to benefit as many people as possible | Social Care Institute for Excellence

Based on research conducted during the spring of 2017, this briefing from the Social Care Institute for Excellence offers the following key messages:

  • Innovation is needed more than ever as challenges grow. Innovation does not only mean technological breakthroughs or large restructures. New and better ways of delivering relationship-based care are needed, and already exist, but are inconsistently implemented or poorly scaled.

 

  • For innovation to flourish,  better ways to help people bring good ideas from the margins into core business need to be found . The keys to success are:
    • a shared ambition to embed person- and community-centred ways of working across the system, using the best available tools and evidence
    • co-production: planning with the people who have the greatest stake in our services from the beginning
    • a new model of leadership which is collaborative and convening
    • investment and commissioning approaches which transfer resources from low quality, low outcomes into approaches which work effectively
    • effective outcomes monitoring and use of data to drive change
    • a willingness to learn from experience.

The report also has a series of recommendations for Local and National Government.

Full report: Growing innovative models of health, care and support for adults

 

The effect of good people management

This report illustrates the effect of good people management with an analysis of the NHS | What Works Centre for Wellbeing

This report found Trusts that made the most extensive use of good people management practices were over three times more likely to have the lowest levels of staff sickness absence and at least four times more likely to have the most satisfied patients.

They were also more than twice as likely to have staff with the highest levels of job satisfaction compared to NHS Trusts that made least use of these practices, and over three times more likely to have staff with the highest levels of engagement.

Full report: Good work, wellbeing and changes in performance outcomes: Illustrating the effects of good people management practices with an analysis of the National Health Service.

Making a reality of the Accelerated Access Review: Improving patient access to breakthrough technologies and treatments

Department of Health

The government has announced a new fast-track route into the NHS for “breakthrough” medicines and technologies. This will speed up the time it takes for patients to benefit from ground-breaking products for conditions such as cancer, dementia and diabetes.

From April 2018, the new ‘accelerated access pathway’ will mean products with the greatest potential to change lives could be available up to 4 years earlier. It will be done by reducing the time it takes to negotiate evaluation and financial approvals before the NHS can purchase the products.

Under the scheme, a number of products each year will receive ‘breakthrough’ designation. This will unlock a package of support allowing firms to accelerate clinical development and gain a fast-track route through the NHS’s approval processes.

Transformational change

Leading Large Scale Change: A practical guide | NHS England Sustainable Improvement Team | NHS England Horizons Team

This guide from NHS England has been produced to help all those involved in seeking to achieve transformational change in complex health and care environments. This is a fully revised update of the original 2011 publication, responding to current health and care policy and practice, and introducing new concepts, tools and techniques to help deliver successful large scale change. It is relevant to all those involved in transformational change programmes such as Sustainability and Transformation Partnerships (STPs) and the development of new care models, and has relevance across public services.

The publication includes:

  • Updates on the leading transformational change models
  • The latest thinking from national and global improvement
    experts and change leaders
  • New tools, techniques and tips to help effectively progress
    large scale change programmes
  • Case studies and learning that will help leaders and
    change agents in health and care and across public
    services
  • Signposting to a host of new online resources including
    videos, presentations and digital media links.

Full document: Leading Large Scale Change: A guide to leading large scale change through complex health and social care environments

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Image source: http://www.england.nhs.uk