It is often the case that in the most difficult conditions the best ideas are born and the greatest creativity flourishes. This is certainly true in the NHS.

An unprecedented black cloud is lingering over the health service in the shape of the predicted £30bn financial black hole which it faces by 2020. It is only through innovation in areas including methods of patient care, technology, structural reform, patient engagement and organisational change that the NHS can adapt to the challenges it faces.

As HSJ’s team of expert judges compiled our list of 50 top innovators, the level of innovation and creativity in the health service shone through.

We sought to identify people who have taken innovative approaches that make a tangible difference to patients, healthcare colleagues, the healthcare system or wider society. We hope our list represents innovators from a cross-section of areas of the NHS, representing different sectors and different cultures.

‘Innovation is the lifeblood of the NHS. It is right that our great innovators are recognised’

Some are NHS insiders, some disruptive innovators, some are clinicians, others are managers, and some work for companies outside the health service.

They may have contrasting backgrounds but they all share the same free-thinking spirit and an understanding that fresh ideas are required to ensure the NHS survives and prospers.

The list also contains a mix of innovators who have long track records of driving change and those whose ideas have the potential to effect great change.

Judges declared any conflicts of interests and, on one or two instances, stepped outside the room when their own attributes were discussed.

All were impressed by the diversity and breadth of the NHS’s talent pool, something which should hold it in good stead as it seeks to respond to the challenges ahead.

Innovation is the lifeblood of the NHS. It is right that our great innovators are recognised.

Nick Golding is news editor of HSJ