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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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

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


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


Advancing applied analytics

The Health Foundation has selected 12 projects to take part in the first round of its Advancing Applied Analytics programme.  The programme aims to improve analytical capability in support of health and care services.  It supports analysts who are working on local innovative projects, to help them demonstrate improvements to analytical capability in health and care services and provide lessons for the wider care system.

High-impact innovations for patient benefit

App that helps pregnant women monitor hypertension among new NHS innovations that will save lives and improve treatment | NHS England


A wireless sensor that better detects breathing rate in hospital patients, an app to help pregnant women monitor hypertension and another that directs patients with minor injuries to treatment units with the shortest queues are among the latest innovations set to be spread across the NHS.

Eleven projects are being backed in the latest round of NHS England’s programme to develop and spread pioneering ideas, equipment and technology that have the potential to save lives as well as money.

Further detail of this latest round of the NHS Innovation Accelerator (NIA) programme  can be found at NHS England



How ward staff engage with the implementation of a patient safety intervention

A patient safety intervention was tested in a 33-ward randomised controlled trial | BMJ Open


Objectives: No statistically significant difference between intervention and control wards was found. We conducted a process evaluation of the trial and our aim in this paper is to understand staff engagement across the 17 intervention wards.

Findings: First, there were palpable differences in the ways that the 17 ward teams engaged with the key components of the intervention. Five main engagement typologies were evident across the life course of the study: consistent, partial, increasing, decreasing and disengaged. Second, the intensity of support for the intervention at the level of the organisation does not predict the strength of engagement at the level of the individual ward team. Third, the standardisation of facilitative processes provided by the research team does not ensure that implementation standardisation of the intervention occurs by ward staff.

Conclusions: A dilution of the intervention occurred during the trial because wards engaged with Patient Reporting and Action for a Safe Environment (PRASE) in divergent ways, despite the standardisation of key components. Facilitative processes were not sufficiently adequate to enable intervention wards to successfully engage with PRASE components.

Full reference: Sheard, L. et al (2017) Exploring how ward staff engage with the implementation of a patient safety intervention: a UK-based qualitative process evaluation. BMJ Open. 7:e014558