Connecting improvement across the UK – insights and progress three years in | Pereira, P. & Creary, N. | The Health Foundation
Q is an initiative, designed to support and connect those leading change efforts
and to enable a more joined-up approach to health and care sector improvement in the UK. In 2015, in response to a recommendation in the Berwick Report, the Health Foundation worked with 231 people involved in improving health and care to understand what would help them to accelerate their work.
Q is the result of this process. Three years on from the co-design phase, more than 2,500 people have joined the community and Q has evolved into a multi-strand initiative, delivered in partnership with NHS Improvement and organisations from all the countries of the UK.
This report shares the progress and learning from this initiative three years in,
summarising the key messages of interest.
The spread challenge: How to support the successful uptake of innovations and improvements in health care | Horton, T. , Illingworth, J. , & Warburton, W. | Health Foundation
How to spread new ideas and effective practices from one organisation to another to
improve care and reduce unwarranted variations in performance is one of the central
challenges facing the NHS. This report investigates the factors affecting the successful uptake of innovations in healthcare.
The report is presented in the following sections:
Chapter 1 gives a brief overview of the ‘replicability problem’
Chapter 2 looks at why the complexity of many health care interventions poses challenges for spreading them
Chapter 3 considers some approaches to codifying complex health care interventions in ways that can support effective replication
Chapter 4 looks at the initial spread process and at how early adopters generate new learning about an intervention as they implement it in new contexts
Chapter 5 looks at some consequences for the design of large-scale spread programmes
The conclusion draws out the implications for policymakers and those overseeing
NHS England | September 2018 | NHS opens international search for new innovations
NHS England is calling on the best innovators from across the world to apply to join two schemes that aim to ensure NHS patients benefit from new technology faster.
Two programmes that look to spread innovation across the NHS have opened for new applications as NHS England once again champions the spread of the latest and greatest new technology.
Through the Innovation Technology Payment (ITP) NHS England can directly fund a small group of proven innovations to help spread them at scale across the NHS.
The NHS Innovation Accelerator (NIA) provides tailored support to innovators with compelling evidence-based innovations, to enable their innovations to be taken up at pace across the NHS. Eligible innovations must address one or more of the following priorities: prevention and early diagnosis (cancer, cardiovascular disease), mental health, primary care (Source: NHS England).
Public | April 2018 | The promise of Healthtech: How digital innovators are transforming the NHS
Innovations such as cloud computing, VR, 3D printing, genomics and artificial intelligence all provide opportunities for the NHS to sustainably relieve the demographic and financial pressures it faces. Public, an organisation that helps startups to support the public sector, cautions that “without major reform, the NHS may see a £30 billion funding gap open up over the next three years alone.”
There are three factors driving this change, they are the growing, ageing populations who are net consumers of public services, especially health care. The rise in long-term, chronic conditions evident across all age groups. The compounding effect of higher demand for health services and higher expectations for those health services as, in many cases, more expensive treatments become standard. The report includes a feature on ‘Healthtech 27’ which are the most promising startups in healthcare.
Nicola Blackwood, the author of this report and former Health Innovation Minister,
argues that the NHS is still ‘risk averse’. As part of this research, Public surveyed a number of health startups- they also spoke to NHS professionals, interviewing key decision-makers across the health and care landscape-to explore some of the barriers to innovation.
These interviews revealed:
Lack of clarity about evidence
Regulation of digital health products is fast evolving
Unclear data security standards
Limited change management and digital skills
Alongside this, Healthtech also predicts 9 areas of opportunity for the future
Procurement and productivity
Recruitment and training
Winter pressures and supported self-care
AI in Pathology and Radiology
Further details are available from Public’s website
NHS England | April 2018 | Heart patients among those to benefit as NHS England backs innovation
A scheme run by NHS England to identify and fast track specific innovations into the NHS is now in its second year. It delivers improvements in patient care by cutting bureaucracy for clinicians and other innovators and encouraging uptake through the NHS. NHS England has just announced four innovations that have the potential to benefit patients. Among the innovations is image analysis software that creates a 3D model of the heart and could prevent up to 35,000 patients a year undergoing invasive tests. Other innovations identified include a suture which is designed to reduce infections, a new device that will reduce the number of infections from catheters and a ‘bowel scope’ to improve colorectal examinations.
HeartFlow – Advanced image analysis software that creates a 3D model of the coronary arteries and analyses the impact that blockages have on blood flow to rapidly diagnose patients with suspected coronary artery disease. The use of the device can avoid the need for invasive investigations such as coronary angiography, usually carried out under local anaesthetic, where a catheter is passed through the blood vessels to the heart to release a dye before X-rays are taken. NICE estimate up to 35,000 people per year could be eligible.
Plus Sutures – A new type of surgical suture – stitching – that reduces the rate of surgery-linked infection (surgical site infection) such as MRSA, through the use of antimicrobial suture packs. There were 823 cases of MRSA reported in the NHS in 2016/17.
Endocuff Vision – A new type of ‘bowel scope’ that improves colorectal examination for patients undergoing bowel cancer tests. Bowel cancer is the fourth most common cancer in England with 34,000 people diagnosed each year. For every 1,000 people screened for cancer, it is estimated that six cases could be avoided thanks to early detection through the use of this device.
SecurAcath – A device to secure catheters that reduces the infection risk for patients with a peripherally inserted central catheter. The use of this equipment helps to reduce the time taken to care and treat dressing changes. This type of catheter is normally used in people needing intravenous access for several weeks or months in both inpatient and outpatient settings. NICE estimate up to 120,000 people per year could be eligible.
Professor Tony Young, National Clinical Lead for Innovation at NHS England, said: “For new innovations to flourish and spread at scale access to funding is critical, by buying these four innovations centrally NHS England has removed the barriers to the spread of these innovations so patients can benefit faster.
The NHS’ 15 Academic Health Science Networks across England – will take direct responsibility for accelerating uptake locally.
All information from NHS England, the news release can be read on this webpage
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.
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.
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.