The Diffusion Of Innovation In The NHS

The NHS is sadly notorious for the difficulties it has in both integrating and disseminating the huge range of innovations currently being developed in healthcare.  The job of disseminating the most effective innovations falls upon the Academic Health Science Networks (AHSNs).  They recently commissioned the King’s Fund to investigate innovation in the NHS.

The report suggests that there is no shortage of entrepreneurship in the NHS, but that transferring even simple innovations from one NHS organization to another is incredibly difficult.

The report suggests that traditional approaches, including publicising them at conferences and producing toolkits, are not working, and instead advocates the need for more manpower to help do the vital work of spreading new innovation.

This manpower should consist of teams built around the innovators themselves to help with things like marketing, change management and investment appraisal. Suffice to say, the resourcing for such teams is not present in the NHS today, with just 0.1% of total NHS spending devoted to the adoption of innovation.

“As long as the NHS sets aside less than 0.1 per cent 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,” the report says.

Behind the times

This also has to be set in the context that much of the work of the AHSNs is to find innovation within the NHS.  Looking through the case study innovations mentioned in the report, it’s hard to shake the image of the NHS as being an organization whose use of technology is several years behind that of the rest of society.

That’s not to say that attempts haven’t been made to improve matters, for these are legion.  Indeed, numerous attempts have been made to understand not only how the NHS performs on innovation, but how it compares with other countries around the world.

For instance, the King’s Fund report follows on from the Accelerated Access Review, which was designed to speed up the introduction of technologies and innovations into the NHS.  Many of the recommendations from that are shared with the King’s Fund report, as they are with another report from the Health Foundation.

The Healthcare Innovation Index aims to allow us to compare the performances of healthcare providers around the world.  The project, which is still very much a work in progress aims to provide an objective measure of the capabilities of a health system in taking up innovations, and indeed of the country’s ability to generate innovations in the first place.

“Such an index would help to pinpoint a country’s strengths and weaknesses, pinpointing bottlenecks and issues for attention. Identifying deficiencies in the functioning of a national system of innovation allows those systemic dimensions that are ‘failing’ in terms of comparative performance to be identified,” the authors say.

The elephant in the room

Whilst this is an interesting project, I do wonder just how useful it is likely to prove, not least because it looks at things very much from a managerial perspective.  It’s only really managers that compare healthcare innovation with peers in the industry.  For end users, they compare the ease and effectiveness of engagements with health providers with the other service providers they engage with each day.

It’s why there is so little fanfare among the public about the (very) gradual roll-out of telehealth, some 15 years after Skype was first released.  I’ve been tracking my health and fitness data for several years now, but my doctor has no idea about any of it.

The elephant in the room here is that no healthcare provider is good at adopting and disseminating new technologies and innovations, so comparing yourself with others won’t provide any indication of how you fit in with the wider lives of your stakeholders.

For instance, the UK has recently launched open banking regulations to free up our financial data.  If the NHS was to compare its own data governance with that, it would be an incredibly unfavorable comparison, but if they compare themselves with other healthcare providers, they may well think they’re doing okay.

It’s very unlikely that this will happen of course, and instead we will have new reports saying the same thing published on a regular basis, all whilst the gap between our health systems and the rest of society gets wider and wider.