Last year’s Liberating Ideas Award winners have been working hard on their innovative projects. Emma Dent catches up on their progress and aspirations.

The Capgemini and HSJ Liberating Ideas Award celebrates the best local innovations and sets the challenge for national adoption with the aim of delivering real changes to our health service.

Late last year three organisations, winners of the 2010 award, won a day developing their innovative idea in Capgemini’s Accelerated Solutions Environment.

The aim of the day? To help the organisations – NHS Swindon, the North West London cancer network and NHS Newham – to gain guidance and support for more extensive adoption.

“Looking at the progress each has made since, it is great to know that all our winners took the opportunity to refine the commerciality of their innovations,” says Capgemini vice president of healthcare Brendan Farmer.

“Being able to articulate a balanced range of benefits from all perspectives, including for the patient and their carers, the commissioners and QIPP [the quality, innovation, productivity and prevention programme] is key to broader adoption.”

Six months on, we take a look at how each project has developed, in what even the most seasoned NHS hand will admit has been one of the most challenging periods in the service’s history.

Recurring admissionpatient alert

The North West London cancer network was the overall winner, chosen on the day. Its prize was further support from Capgemini in order to work on constraints against the project’s widespread adoption and be able to deliver on it.

The recurring admission patient alert is a system for cancer patients, developed from a model originally devised by Sherwood Forest Trust and the NHS Improvement Programme.

“I had never been in that kind of environment before; it was very creative and a great developmental opportunity,” says acting network director Carolyn Garritt. “It helped flag up the limitations of what we had done, that we had taken RAPA locally as far as it could go.”

The team was challenged to think about the possibilities of the system being rolled out across the whole of the health service or into other disease groups or sectors, such as child protection.

Both these are areas which Ms Garritt is keen to see put into action.

“This is asking to be done in child protection, in mental health, for patients with dementia,” she says.

However, the timing of the win, when the original recurring admission patient alert project was coming to the end of its cycle, has proved a barrier to further development of the scheme.

“With the network recently having to shift its emphasis away from support for providers towards commissioners we have had to take a step back from some projects, including RAPA,” says Ms Garritt.

Ms Garritt adds that the network would love to see someone become able to take the scheme forward if it is not in a position to do so itself.

“We would love to be able to pick up linking it between organisations but if we can’t get the resources and support to do so someone should,” she says.

“It is such a clever, enabling, doable thing.”

Urgent care access

In a joint project from the South West, NHS Swindon and Swindon Borough Council had started to develop an urgent care centre to act as a 24/7 single point of access to urgent care services. This has since sought to become a single point of access for all health and social care, with a multidisciplinary team including nurses and social workers staffing the centre and its single point of access telephone number.

Joint interim director of community services Jan Trethewey says that in the second half of the last financial year local non-elective admissions fell by 6 per cent, resulting in savings of around £1m.

Looking ahead, the possibility of putting telehealth access to the centre into nursing and residential care homes is being explored.

More widely, Ms Threthewey says she sees “no reason” why the service could not be expanded beyond its immediate geographical area but adds there is more to do in building relationships across primary, secondary and community care.  

Ms Trethewey describes the time she and colleagues spent at the Accelerated Solutions Environment as “great”.

“Being out of the workplace really helped us develop our ideas and explain them with the wider team,” she says.

Ms Trethewey has some advice for organisations thinking of entering the Liberating Ideas Award 2012.

“You really need to think about your scheme in terms of selling the business case,” she says. “Even if it is a hit locally you have to be able to think about marketing on a bigger scale.”

Communities of Health

Now part of NHS East London and the City, NHS Newham’s Communities of Health scheme, which grafts health programmes onto existing community based social networks, has found a natural fit with projects already underway in its new coterminous areas, Hackney and Tower Hamlets.

“People used to say it could not work elsewhere because Newham has a huge number of community groups, but there are brilliant examples of community projects working alongside health throughout the whole inner north east London area, as well as inspirational local leaders,” says head of community ownership and engagement Ian McDowell. 

Publicity for Communities of Health has been ramped up and targeted stakeholder engagement has increased locally but Mr McDowell believes the scheme could be rolled out across the NHS.

“Communities of Health can transform the relationship between clinician and patient, which has been shown to lead to reduced did not attend rates; and the shared decision making vehicle is the holy grail of clinician-led commissioning.”

He says the Accelerated Solutions Environment helped him realise that what he knew was a great idea could also be perceived as such by leading figures from across the sector.

Innovation: what you said

In March Capgemini surveyed visitors at the 2011 NHS Innovation Expo to gauge opinion on how innovation can help save money – and the challenges managers face when implementing ideas.

Over 70 per cent of those who responded – which included directors, managers and consultants – felt the requirement for the NHS to save £20bn would promote innovation, and 58 per cent felt innovation was a priority for their organisation. Over 80 per cent felt that if they did have an innovative idea, they would know how to progress it.

But over 60 per cent reported that it was difficult to deliver change in their organisation. Culture – such as being unwilling to take risks – resources and organisational structure, including lack of leadership, were most commonly cited

Equally, culture, described variously as “embedding change into the fabric of organisation” and “encouraging tools to support change”, along with communication – such as “cross departmental involvement” – and a strong leadership buy-in, were cited as the best ways to overcome barriers.