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Executive Summary

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Research Questions

  1. How do organisations working in and closely with the NHS perceive and understand innovation, and how does this influence their actions?
  2. Who drives and contributes to innovation and how might successful innovation have greater scale, scope and impact?
  3. What practical changes to policy, culture and behaviour can support system-wide improvements to innovation pathways?
  4. What practical changes to policy, culture and behaviour can support system-wide improvements to innovation pathways?

Publicly financed healthcare systems around the world are facing increasing pressures to deliver high-quality care with limited resources. These pressures are accentuated by the need to respond to a growing and changing nature of demand in light of factors such as aging populations, a growing burden of chronic diseases and comorbidities and drives towards more personalised treatment provision. Innovations spanning technologies, products, services and new ways of working provide opportunities to respond creatively and effectively to growing to the challenges facing healthcare systems. However, such innovations need to be accomplished within well-recognised resource constraints, and both policymakers and wider stakeholders often lack the appropriate information, evidence, capabilities, resources, relationships, incentives and accountabilities to effectively support the development and uptake of innovations that can improve the quality of healthcare services and benefit patients. Against this context, and in light of the challenges facing the NHS in England, RAND Europe and the University of Manchester were asked to conduct a study on the potential of innovation to help deliver an efficient and effective healthcare service.

Key Findings

The report expands on key findings as they relate to the current landscape for innovating in healthcare, key developments and capacity-building priorities. These relate to the following themes:

  • Diverse social and technical skills and leadership capabilities are needed to help create an environment in which innovation can be effectively managed and implemented. We detail priority areas for capability building and how this could be pursed, including through evolution of the medical education curriculum and continuing professional development opportunities, the embedding of innovation champions into the healthcare system, and training for the private sector on how to effectively engage with the NHS.
  • The system of motivations and incentives for engaging with innovation has strengthened in recent years, but there has been less progress with ensuring accountability for innovation. This could be tackled through embedding innovation into regulatory regimes (but not mandating it) and through greater clarity and specificity about innovation-related job roles in provider organisations.
  • Decision makers across the health system have differing information and evidence needs and a national framework and infrastructure for overseeing and coordinating information and evidence flows needs to be established.
  • There are many initiatives and networks focusing on innovation but there is a need for better coordinating their activities. We detail the types of actions that can support this, including ensuring greater clarity on the respective roles and remits of different networks, more collaborative working and efforts to at a policy level reconcile goals for
  • The current landscape for patient and public involvement and engagement (PPIE) has evolved but there is a need for a national strategy and implementation plan for PPIE in innovation, based on a set of principles that are detailed in our report.
  • A variety of funding schemes support innovation in the healthcare system, but there is a need to improve the coordination, sustainability and stability of funding flows, including through closer collaboration between funders of innovation, research and healthcare improvement efforts, and through a focus on commissioning for solutions (i.e. combinations of innovations and not individual products or technologies exclusively).
  • Policymakers need to pay more attention to implementation and success criteria at policy
  • There is a need for more sophisticated evaluation evidence, and we detail the types of information that can support this.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Supporting an innovating health system: insights from the broader landscape

  • Chapter Three

    Study findings: presentation and overview

  • Chapter Four

    Strengthening skills, capabilities and leadership for innovation

  • Chapter Five

    Ensuring appropriate motivations and accountabilities

  • Chapter Six

    Improving the information and evidence environment

  • Chapter Seven

    Nurturing effective relationships and networks regionally and nationally

  • Chapter Eight

    Facilitating meaningful patient and public involvement and engagement with innovation

  • Chapter Nine

    Developing a funding and commissioning landscape to support innovation across the pathway

  • Chapter Ten

    Better aligning policy design with a consideration of implementation requirements and success criteria

  • Chapter Eleven

    Measuring innovation uptake and impact: how can we know whether we are succeeding?

  • Chapter Twelve

    In reflection: issues to consider when taking forward actions to support an innovating health system

Research conducted by

The research described in this report was prepared for the National Institute for Health Research and conducted by RAND Europe.

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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