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Research Questions

  1. How is innovation embraced in NHS organisations?
  2. Who drives and contributes to innovation and what types of organisational models are most conducive to effective and high-impact innovation processes and outcomes?
  3. What are the outcomes, impacts and costs of innovations?
  4. How can the impacts and cost-effectiveness of innovation be improved?

The demand for health services in England is both growing and changing in nature, yet resources are limited in their ability to respond to the scale and scope of need. As a result, the NHS is under increasing pressures to realise productivity gains, while continuing to deliver high quality care. RAND Europe and the University of Manchester have been commissioned to conduct a study to examine the potential of innovation to respond to the challenges the NHS faces, and to help deliver value for money, efficient and effective services.

'Innovation' in this study refers to any product, technology or service that is new to the NHS, or applied in a new way, aimed at delivering affordable and improved care. The learning we have gained adds considerable depth to the practical discussions presented regarding how innovation can be first nurtured and then made meaningful and actionable in a variety of settings. This is important given the complexity of health innovation systems and the diversity of elements that need to interact and work together for the overall system to function effectively.

We share insights related to skills, capabilities and leadership; motivations and accountabilities; information and evidence; relationships and networks; patient and public engagement; and funding and commissioning. We will develop these detailed learning points into a more systematic analysis as the research evolves. The research is funded by the Department of Health Policy Research Programme, in close collaboration with NHS England and the Office of Life Sciences.

Key Findings

The emerging insights highlight that successful innovation in the health system happens when combinations of drivers come together at national and local levels, and discusses how this happens in practice. These drivers span: skills, capabilities and leadership for innovation; motivations and accountabilities; information and evidence environments; relationships and networks; patient and public engagement efforts; and innovation funding and commissioning landscapes.

The insights also suggest that getting the best returns from the UK's health and care innovation requires designing approaches to innovation that:

  • Use the opportunities of interdependencies between health and care sectors as an asset rather than a barrier, drawing on the expertise of both clinical and allied health and social care professions, and focusing on cross-cutting and complementary health sector priorities.
  • Develop the relationships between macro-scale change (i.e. new policy developments driven by the national level), meso-level regional structures and processes (e.g. interconnected regional institutions that are both receptive to national policy and can help shape it), and micro-scale interventions (e.g. individual and organisational motivations and incentives).
  • Use both structural and behavioural interventions to progress innovations across the health innovation pathway.
  • Coordinate innovation and improvement policies at national and local levels for health and healthcare.
  • Adopt a portfolio approach to innovation — responding to both quality and cost considerations and the motivations of different stakeholders.


In the next phase of the study, we will build on the insights gained thus far to identify what are likely to be the highest impact actions that could enhance the contribution of innovation to health system performance. We aim to establish practical recommendations for stakeholders across policy and practitioner communities.

Table of Contents

  • Chapter One


  • Chapter Two


  • Chapter Three


  • Chapter Four

    Discussion and Next Steps

  • Appendix A

    Workshop agenda example

  • Appendix B

    Interview informed consent

  • Appendix C

    Interview protocol for regional case studies

  • Appendix D

    Examples of innovations in regions we engaged with

Research conducted by

The research described in this report was funded by the Department of Health Policy Research Programme in close collaboration with the National Health Service (NHS) England and the Office of Life Sciences and conducted by RAND Europe and the University of Manchester.

This report is part of the RAND Corporation Research report series. RAND reports present research findings and objective analysis that address the challenges facing the public and private sectors. All RAND reports undergo rigorous peer review to ensure high standards for research quality and objectivity.

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