Don’t be squeamish: learn to embrace innovation
Innovation, Health and Wealth, the report prepared by NHS South of England chief executive Sir Ian Carruthers, is a powerful and long overdue document.
Many from outside the UK are constantly surprised that we do not make more use of having one of the largest cohesive health services in the world. The ability of the NHS’s work to generate “real world evidence” is hugely significant and offers great potential to drive the development of new healthcare technologies.
There has long been some squeamishness in the service over working closely with the pharmaceutical and biotech sectors. It is time to put that aside. The NHS should not be embarrassed to help develop new technologies and therefore profits for these businesses. The important contribution to a shaky economy aside, the development of new medicines has slowed in recent years and a re-energised pipeline would benefit NHS patients and organisations.
With this in mind, however, it is vital any joint venture should have real and transparent benefits for the service. Learning how to do mutually beneficial deals with pharma and biotech businesses should be one of the priorities of the new education plans for managers and clinicians. The proposed academic health science networks should seek to learn and spread the lessons from successful centres in London, Cambridge and elsewhere.
NHS Confederation chief executive Mike Farrar has told HSJ: “People who innovate [need to] feel there is permission to try things. We need to promote more innovative and risk taking behaviour.” Sir Ian’s review, full of his typical optimism and ambition, goes a long way to solving this problem.
Not all the way, of course, because during a period of increasing central grip (see the HSJ100 supplement, launched Thursday 8 December), risk taking will not always be encouraged.
It is only a partial solution, too, because not all of the innovation review’s recommendations ring true.
One of the few dud notes is the suggested development of an “innovation portal” to showcase best practice. One of the iron rules of the internet is not to build something and automatically expect an audience to pitch up at its door. Better to generate the content and distribute it through the myriad existing public and professional media. The planned work with Which? to raise awareness of innovation is a much better idea.
There will also be concerns around formalising compliance with guidance from the National Institute for Health and Clinical Excellence. NICE chief executive Sir Andrew Dillon said the institute’s acceptance and influence on the NHS flowed from the non-mandatory nature of NICE’s recommendations.
Most significant, however, are concerns that attempts at encouraging innovation will mean providers and commissioners place too much emphasis on chasing the rewards and avoiding the penalties introduced into the system.
The nature of the system to bend to the latest set of incentives makes it vital the push on innovation gives as at least as much weight to the diffusion of best practice as to the pursuit of new ideas.
The increasingly influential NHS Atlas of Variation once again exposes how care across the country differs in a way that “cannot be explained by variation in patient illness or preference”.
The atlas suggests “no commissioner” has maximised the effectiveness of the money it is given and that resources tend to be allocated “on the basis of historical patterns” rather than best practice. Little wonder then that the atlas reveals, for example, a five-fold difference in liver disease emergency admissions or a seven-fold variation in 24-hour stroke care.
The innovation review is a timely reminder that the NHS should and can keep reaching for the stars. The atlas reminds us that some patients are being left in the gutter.
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Readers' comments (7)
sjburnell@focused-on.com | 7-Dec-2011 1:56 pm
Clearly, the NHS needs much more 'intelligent implementation' of great ideas that have already been 'innovated'.
I wonder, however, if the old idea of 'share & sustain' is now less likely to happen if an FT considers its innovation to be intellectual property providing a competitive commercial advantage?
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Anonymous | 7-Dec-2011 2:24 pm
'Mike Farrar has told HSJ: “People who innovate [need to] feel there is permission to try things. We need to promote more innovative and risk taking behaviour.” '
Well said. Currently innovation needs a) an innovative champion to identify and promote a change b) commissioners and provider managers to understand the innovation c) agree to consider it d) understand the risk:benefit ratio e) know they will be backed by their Directors f) approve it g) actually facilitate its introduction.
Sadly there are so many steps in the process that innovative change is almost impossible to implement. It will only welcomed if a major overhaul of NHS management pathways is completed. Currently the whole system mitigates against change, and too many so-called decision-makers in the pathway decide to take the safe route rather than the right course - the risk of failure is seen as too high.
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Kadiyali Srivatsa | 8-Dec-2011 8:38 am
Innovation has now become the "BUZZ WORD" in the NHS but doctors who strived hard to bring in changes to help benefit patient care were frowned upon. NHS did not help, support or encourage doctors to innovate in the last three decade. You need to understand “why and how”
Doctors who obtained Academic qualification were respected and accepted as experts. These academicians did not think innovation was the key to help us move forward, create products like our teachers did. They religiously supported major pharmaceutical and medical device manufacturers.
Unfortunately geniuses who contributed to advances in our knowledge or take risk in the past often had no qualification. They first identified a problem and then focused on finding a solution. They were not sitting at home preparing to pass examinations.
Doctors with innovative and inquisitive mind often find it hard to gain academic qualifications and so these geniuses were not supported or encouraged. This has stifled innovations and contribution that we can really be proud of.
Doctor who offer alternative product, method or device will always affect a major corporation. These corporations will do what it takes to stifle innovations.
I must also mention doctors who are innovative are passionate about their contribution and are not commercial. Their mission will be contribute and help make life better for fellow human and not the shareholders of a company.
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Vincent Sorel | 8-Dec-2011 3:11 pm
At a time when every penny counts and budgets are being squeezed, surely taking the plunge and working with third parties to make every aspect of the NHS more cost and time efficient has to be the way forward? By embracing innovation today, we are laying the foundations for a brighter future in the NHS.
Synuron, a membership organisation, works with UK health and social-care organisations to improve HR and recruitment efficiency and help hire the best talent, faster. We're currently working with 8 NHS members who've embraced the innovative tools we provide and are seeing the results. However, there's no getting away from the fact that bringing on members can be a challenge as we are asking them to put their faith in new systems that aren't the norm, and given that many decision makers are cautious and risk adverse, embracing innovation isn't always an easy task. Time and again we wonder why people stick with something if it isn't working and an alternative is out there?
We've already found that our members are benefitting from taking those risks and tend to recoup their investment within just 3 months. The time and money that's being saved on HR activities, be it shortlisting candidates, e-CRB checks or capping applicant numbers, can only have a positive knock on effect on front line staff who can do what they are best qualified to do, care.
All too often we are seeing organisations struggling with out of date systems and process that cause staff, across the board, to drown in unnecessary admin and for recruitment to cost more time and money than is necessary.
It's obvious that are many ways many elements of the NHS could embrace innovation to create a more effective, efficient service for all concerned, we just need people to have the foresight to want to find a better solution to their problems!
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Anonymous | 9-Dec-2011 5:54 pm
You can't mandate someone to be innovative, you need to inspire, enable and support.
When we get inspiration leaders in the NHS, innovation will flow...until then it is "comply or explain!"
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Anonymous | 12-Dec-2011 8:12 am
I agree with Anon's first sentence but not the second one. Innovation is a cure for 'leadership' not a dependent of it.
To innovate you have to challenge the current conventions of structure, thought and action ... you know like the ridiculous hierarchies, equivocal ideas and endless initiatives that promulgate the myth of leadership.
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Alan David Jones | 17-Dec-2011 11:46 am
Interesting that nobody seems to have contributed to any debate as to whether the biotech and pharmaceutical sectors should be working with the NHS! Now why is this I wonder?....
Alan Jones
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