Adopting Innovation: investing in skills at the NHS front line

When was the last time you saw a great innovation from another part of the NHS, briefly thought about bringing it to where you work and then swiftly reconsidered? Did you feel disheartened when you realised how hard it would be to actually make it work?

Sadly, this experience is all too common and it’s one of the big reasons why unwarranted variation in patient experience and outcomes persists. I’ve experienced this many times during my career in health care.

I have also experienced the magic that happens when a great innovation meets a smart and well-organised team of ‘expert adopters’ who have the knowledge, skills and confidence to embrace the idea and work with others to make it happen. This might include changes to job roles, care pathways, IT infrastructure or whatever else is needed within that locality to get the very best out of the innovation. This is why here at the Health Foundation we are excited to have launched our Adopting Innovation programme which will provide up to £475,000 in funding for four innovation hubs across the UK for two and a half years.

What makes adopting innovation successful?

The best adopters are tenacious. They leave no stone unturned until the innovation is working well. They then stand ready to make more iterative changes where the data show room for improvement.

My favourite example of this teamwork is when I was involved with increasing the adoption of insulin pump therapy for people with type 1 diabetes in London several years ago. In certain clinical situations, the benefits of insulin pumps are clear. And yet many clinics struggled to offer pumps to all the patients who met the criteria in the NICE Technology Appraisal. Clinics faced barriers such as needing to adjust the skill mix within their teams, requiring new IT software, or having to organise a new flow through the clinic for patients, to allow their insulin pump data to be downloaded into their electronic patient record before each consultation.

Making these kinds of changes takes time, energy and appropriately-skilled staff to lead the change, which not all teams have. So, we brought together 10 clinic teams as a London diabetes collaborative and subsequently saw a big increase in the number of patients benefiting from using an insulin pump. By participating in the London collaborative, the clinic teams gained the time and headspace to address the barriers to using more insulin pumps by learning how to improve staff training and skill mix, solve procurement issues and clinic flow processes, all with a constantly practical focus.

Why the urgency to invest in adopting innovation?

We know that successful adoption of innovation is eminently achievable, when the adoption stage is resourced properly. Investment is required to help create teams of expert adopters and give them the infrastructure that they need. The reinvention of many NHS services demanded by the COVID-19 pandemic has made such investment even more critical.

Adopters based in health care provider organisations will play an essential role in making sure that health systems can keep implementing new ideas and approaches through this challenging time. The Health Foundation recently published analysis on service shifts during the pandemic, and by investing in the adopters now, we are putting into practice the learning from our 2018 report, The spread challenge, which described the challenges of effective adoption and highlighted how adoption is often under-supported in comparison to innovation.

How will this programme help?

The four innovation hubs that we will fund through the Adopting Innovation programme will be based in health care provider organisations and this will ensure that the hubs work directly alongside and on behalf of front-line staff, patients and local communities. At the same time, hubs will only succeed if they work creatively and collaboratively with local health system partners. Partnerships must include a regional or national health care organisation. We expect this organisation to be the national improvement or innovation bodies in the devolved nations: Healthcare Improvement Scotland, Health and Social Care Quality Improvement in Northern Ireland, and in Wales Improvement Cymru or Life Sciences Hub Wales. In England, we expect this partner to be an Academic Health Science Network (AHSN), Integrated Care System or Sustainability and Transformation Partnership. Some applicants may choose more than one of these organisations to partner with.

For AHSNs, securing one of the four hubs in your patch will create a well-resourced team of adopters who are hungry to make AHSN-supported innovations happen in their local health economy. As someone who has worked in an AHSN for several years, I know very well what a difference this level of investment in local adopters can make.

Expressions of interest for Adopting Innovation are now open until midday on 11 November 2020 and we are excited to see the ideas and partnerships in the proposals. We have an opportunity to build on the rapid adoption of innovation seen in health care in recent months. We can help by giving teams the headspace, skills and resources to continue taking up innovations in these challenging times, supported by people whose job it is to identify promising practice and then make it happen, without being distracted by the million operational pressures that will always be there. Together we can help more organisations across the NHS build the capability to be effective adopters of innovation for the long term. I can’t wait to see the results and the learning it brings to us all.

Laura Semple (@LauraSemple3) is Assistant Director of Improvement at the Health Foundation.