Stepping up a gear to accelerate innovation

All too often we hear about barriers to embracing innovation in the NHS and the seemingly impenetrable shield of financial and procurement governance.

The reality is that innovation is not impossible – it is happening in GP practices, hospitals and other care settings. The problem is that it’s not happening quickly enough.

November saw the launch of the Innovation and Technology Tariff. The new tariff will support areas where clinicians can bring new, proven technologies to improve diagnostics and treatments– bringing massive benefits to patients and citizens.

The Innovation and Technology Tariff is a practical solution which aims to overcome procurement problems.

It comes just two months after ‘digital doctor’ Bob Wachter produced his report following a review of what we need to do in order to harness the power of health information technology to improve care.

He spelled out the need for the NHS to modernise and transform – and warned that it isn’t a simple matter of technical change, that it involves ‘substantial and long lasting engagement’ between organisations’ leaders and their front line staff, to drive changes in working practices and culture.

There are various reasons why the NHS is slow to embrace new technologies – but we should be optimistic and recognise those areas where transformation is happening – in digitised GP practices and in the 12 trusts named by NHS England as global digital exemplars.

The Innovation and Technology Tariff is a practical solution which aims to overcome procurement problems. For instance it will help if a new product has been proved to improve a diagnosis or treatment and bring long term efficiencies to the health system, but its cost in the short term is viewed as prohibitive.

The aim is to ensure added value at an affordable cost, in six proposed innovation groupings. Providers who procure technology within any of the groupings, will be reimbursed through Clinical Commissioning Groups.

The groupings include apps to self-manage chronic obstructive pulmonary disease (COPD); and pneumonia prevention systems designed to stop ventilator-associated pneumonia.

The reality is that innovation is not impossible – it is happening in GP practices, hospitals and other care settings. The problem is that it’s not happening quickly enough.

The country’s 15 Academic Health Science Networks (AHSNs) then help by matching organisations who want to improve services in these areas with products - and supporting their procurement.

Another example is the theme of episiotomy. Almost 15 per cent of births in England require women to have this procedure; and in one quarter of cases this is problematic, resulting in injury and leading to anal incontinence, possibly requiring reconstructive surgery.

The cost of this surgery, plus litigation, is estimated at around £57m per year. A product which can prevent this happening is the Episcissors-60 which cut at a 60 degree angle, reducing the risk of injury, stopping repeat consultations and reducing costs arising from litigation and reconstructive surgery. The tariff will help by making products like this affordable to providers.

The Innovation and Technology Tariff programme is sponsored by NHS England, whose CEO Simon Stevens said when he launched the initiative: “The NHS has a proud track record of world firsts in medical innovation but getting wide uptake has often been far too slow.”

Some of the fantastic initiatives the AHSNs already deliver in partnership with NHS England include the NHS Innovation Accelerator. This was expanded with the announcement of eight more Innovation Fellows who will be given support to spread their technologies, products or approaches.

The new tariff will support areas where clinicians can bring new, proven technologies to improve diagnostics and treatments– bringing massive benefits to patients and citizens.

Results from the work of this next cohort of Innovation Fellows are likely to be one way of providing the route for nominations of key areas for the Innovation and Technology Tariff.

There is a ‘tipping point’ at which an innovation becomes the norm; this has been described by author Malcolm Gladwell as relying on people with a set of rare social gifts.

We need individuals who can inspire and influence our behaviours, such as the Innovation Fellows; but we also need to invest in our networks to speed up the pace of change.

We talk about ‘adoption and spread’ of innovation and this is the hardest part; once an innovation has been developed and proved to work, we have to convince people to adopt it - and it helps to have practical tools on hand to offer. The new tariff is the latest tool in our innovation armoury.

Liz Mear is CEO of the innovation agency (Academic Health Science Network (AHSN) for the North West Coast)