Galvanising the NHS to Adopt Innovation

Background

The Department of Health and the Wellcome Trust, in co-operation with NHS England, asked RAND Europe to conduct a limited consultation with key stakeholders about the practicality of measures and incentives proposed as part of the NHS Accelerated Access Review, which aims to assess the pathways for the development, assessment, and adoption of innovative medicines and medical technology.

Goals

The project team explored the implications of a number of propositions outlined in the interim Accelerated Access Review report. Specifically, the project investigated the feasibility of implementation of three specific propositions by Academic Health Science Networks (AHSNs) and the role of secondary care organisations:

• A new earmarked fund to encourage AHSNs and other key innovation actors to re-design systems to embrace innovation
• Mobilising the influence of clinical system leaders to champion change
• Encouraging secondary care organisations to take on ‘innovation champion’ roles linked to financial incentives and a new emphasis on accountable care organisations

Methodology

The project team used a focused engagement exercise on the Accelerated Access Review interim report with key healthcare stakeholders. This engagement was used to explore the implications of selected propositions and feasibility of implementation for key actors, such as teaching hospitals, primary care, commissioners and academia.

The engagement included:

• A focused document review
• A workshop with AHSN CEOs and Commercial Directors
• 23 interviews with senior NHS staff in three regions (South West, University College London Partners, and North East, North Cumbria)

Key FIndings

The project team made a number of reflections on the feasibility of each recommendation and the factors that would facilitate their success.

• A new earmarked fund: AHSNs are generally trusted by participants to play a leading role in channelling an earmarked fund provided they are appropriately resourced, clear governance is in place and appropriate relationships can be demonstrated with commissioning groups. Combining the earmarked fund with existing funding mechanisms may help improve take up and minimise bureaucracy.
• Mobilising clinical leadership: The different models in use (innovation scouts and innovation champions) represent two different characteristics of the clinician role. A particularly strong enabling factor would be to encourage and combine both models, in terms of individual high profile champions and innovation scouts to obtain the maximum benefit.
• Innovation champions: For any given region it is likely that a number of innovation champions will be required to satisfy the full healthcare pathway. Decisions about the organisation of innovation champions will need to be made on a collaborative basis to ensure the widest possible buy in, and ensure the diffusion of innovation.

Publication

Project Team

Jo Chataway
Tom Ling
Sonja Marjanovic
Catie Lichten
Stuart Parris

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