Innovation, Health and Wealth: A Formative and Summative Evaluation

Doctor holding a tablet

The Department of Health’s strategy for improving care and creating greater wealth through innovation, known as ‘Innovation, Health and Wealth’ (IHW), has the potential to systematically change the way the NHS operates. RAND Europe evaluated whether and how IHW actions have worked as planned and contributed to achieving the strategy's overarching aims.


The Department of Health’s strategy for improving care and creating greater wealth through innovation, known as ‘Innovation, Health and Wealth’ (IHW), in December 2011 set out the delivery agenda for spreading innovation at scale and pace throughout the NHS.


In this project, funded by the Department of Health’s Policy Research Programme, RAND Europe collaborated with Professor Ruth McDonald at the University of Manchester to understand whether the IHW strategy is (i) working as planned and (ii) delivering its intended outcomes.

Research Questions

  1. Are the actions set out in IHW working as planned?
  2. What is the impact of actions undertaken as part of IHW?
  3. By what process have any of the observed outcomes been achieved?
  4. Are IHW actions contributing to the overarching aims of the IHW strategy?
  5. Are there any barriers that inhibit the realisation of the objectives of IHW?


This project employed three research methods: document review, key informant interviews and a stakeholder survey.


  • The findings from the interviews and survey data suggest that there is broad stakeholder support for the overarching ambitions of the IHW strategy.
  • IHW was conceived to embed innovation into the NHS, but it evolved into a more fluid mechanism for supporting innovation. However, the impression from stakeholders is that the evolution of IHW has not been sufficiently informed by an overall strategic sense of direction.
  • Progress towards the overarching objectives of the IHW themes has been variable. For some themes, respondents reported positive progress towards some of the actions within the themes, but not others.
  • A number of challenges exist in the assessment of many of IHW’s actions and objectives. Some actions have been completed, but IHW’s ongoing involvement in those actions is not clear. Similarly, some actions have been implemented, but it is often still too early to assess their impact.


Overall, achieving progress in terms of the aims of IHW and each of its eight themes is more complex than simply implementing the actions within those themes. The relationship between actions and achievement of intended outcomes within IHW is not linear and progress is mixed. Furthermore, where there has not been measurable progress towards actions or themes, the IHW strategy may nonetheless have been important as a symbol of the shift towards innovation in the NHS.